Schizoaffective Disorder in an acute psychiatric unit: Profile of users and agreement with Operational Criteria (OPCRIT)

BACKGROUND: Schizoaffective Disorder is a controversial and poorly understood diagnosis. Experts disagree on whether it is a discrete disorder; whether it is on a spectrum between Bipolar Disorder and Schizophrenia or whether it even exists. Lack of individual research attention given to this disorder, changing diagnostic criteria and hence poor diagnostic stability have all contributed to the dearth of knowledge surrounding Schizoaffective Disorder. OBJECTIVES: To describe the profile of mental health care users (MHCUs) diagnosed with Schizoaffective Disorder and determine the degree of agreement between the clinicians’ diagnosis and Operational Criteria (OPCRIT). METHOD: All MHCUs at Helen Joseph Hospital psychiatric unit with Schizoaffective Disorder between 01 January 2004 and 31 December 2010 were included. The demographic, clinical and treatment profiles as well as data required for OPCRIT were extracted from hospital records and discharge summaries. RESULTS: Most MHCUs with Schizoaffective Disorder were female (68.89%), with a mean age of illness onset of 25 years (SD ± 7.11), had a family history of mood disorders (76.92%) and displayed impaired functioning. Majority (80%) were treated with at least one antipsychotic and one mood stabiliser. No agreement was found between the clinicians’ diagnosis and OPCRIT. CONCLUSION: While the profile of MHCUs with Schizoaffective Disorder in this study is similar to other studies, the lack of agreement between the clinicians’ and OPCRIT diagnoses calls for further research using larger population samples and a dimensional approach to diagnoses in order to improve understanding and management of Schizoaffective Disorder.