Personality changes in patients with schizoaffective disorder (a review)

Authors

DOI:

https://doi.org/10.14739/2310-1210.2023.1.262837

Keywords:

mental disorders, schizoaffective disorder, clinic, non-psychotic disorders, maladjustment, personality, mental health

Abstract

The aim of the work is to study the world experience and views on the clinic and systematics of non-psychotic manifestations in schizoaffective disorder (SAD) by analyzing modern scientific literary sources.

The relevance of study on SAD is determined by the significant prevalence in the population (0.2–0.6 %) and negative socio-economic consequences of the disease. Significant problems in SAD are family and work maladjustment, suicidality and states of psychoactive substance use comorbidity.

The nosological independence of the disease was put into question and it was reflected in diagnostic approaches and classifications. In the clinical practice, SAD is considered independently and as a variant of schizophrenia or affective disorders. Diagnostics and prognostic criteria regarding personality changes in SAD are still at the stage of determining.

Conclusions. Understanding of definitions “prognosis”, “outcome”, and “maladjustment” in SAD is not unified. Signs of SAD in remission and intermission is the most recent aspect of the SAD clinic, which dictates the need to assess personality changes and the level of social adaptation and functioning.

Author Biographies

V. V. Chuhunov, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor, Head of the Department of Psychiatry, Psychotherapy, General and Medical Psychology, Narcology and Sexology

M. Ye. Khomitskyi, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Associate Professor of the Department of Psychiatry, Psychotherapy, General and Medical Psychology, Narcology and Sexology

V. L. Pidlubnyi, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor of the Department of Psychiatry, Psychotherapy, General and Medical Psychology, Narcology and Sexology

References

Diachenko, L. I., Serhiienko, O. V., & Ofitserova, Yu. V. (2015). Rozpovsiudzhenist shyzoafektyvnoho rozladu v Ukraini [Prevalence of schizoaffective disorder in Ukraine]. NeiroNews, (1), 54-56. [in Ukrainian].

Pidkorytov, V. S., & Serikova, O. S. (2017). Predyktory ta osoblyvosti klinichnoi kartyny povtornykh napadiv shyzoafektyvnoho rozladu [Predictors and clinical features of recurrent attacks of schizoaffective disorder]. Ukrainskyi visnyk psykhonevrolohii, 25(1), 142-143. [in Ukrainian].

Voloshyn, P. V., Maruta, N. O., Linskyi, I. V., Minko, O. I., Panko, T. V., Koliesnik, T. M., & Vainer, I. M. (2019). Stan psykhichnoho zdorovia naselennia ta pokaznyky diialnosti psykhiatrychnoi ta narkolohichnoi sluzhby v Ukraini. Informatsiino-analitychnyi ohliad za 2014-2017 rr. [The state of mental health of the population and the performance indicators of the psychiatric and narcological service in Ukraine. Information and analytical review for 2014-2017]. Kharkiv : Strokov D. V. [in Ukrainian].

Bighelli, I., Leucht, C., Huhn, M., Reitmeir, C., Schwermann, F., Wallis, S., Davis, J. M., & Leucht, S. (2020). Are Randomized Controlled Trials on Pharmacotherapy and Psychotherapy for Positive Symptoms of Schizophrenia Comparable? A Systematic Review of Patient and Study Characteristics. Schizophrenia bulletin, 46(3), 496-504. https://doi.org/10.1093/schbul/sbz090

Hirjak, D., Hochlehnert, A., Thomann, P. A., Kubera, K. M., & Schnell, K. (2016). Evidence for Distinguishable Treatment Costs among Paranoid Schizophrenia and Schizoaffective Disorder. PloS one, 11(7), e0157635. https://doi.org/10.1371/journal.pone.0157635

Lindenmayer, J. P., & Kaur, A. (2016). Antipsychotic Management of Schizoaffective Disorder: A Review. Drugs, 76(5), 589-604. https://doi.org/10.1007/s40265-016-0551-x

Murru, A., Manchia, M., Tusconi, M., Carpiniello, B., Pacchiarotti, I., Colom, F., & Vieta, E. (2016). Diagnostic reliability in schizoaffective disorder. Bipolar disorders, 18(1), 78-80. https://doi.org/10.1111/bdi.12366

Jäger, M., Haack, S., Becker, T., & Frasch, K. (2011). Schizoaffective disorder – an ongoing challenge for psychiatric nosology. European psychiatry, 26(3), 159-165. https://doi.org/10.1016/j.eurpsy.2010.03.010

Pagel, T., Baldessarini, R. J., Franklin, J., & Baethge, C. (2013). Characteristics of patients diagnosed with schizoaffective disorder compared with schizophrenia and bipolar disorder. Bipolar disorders, 15(3), 229-239. https://doi.org/10.1111/bdi.12057

Pagel, T., Franklin, J., & Baethge, C. (2014). Schizoaffective disorder diagnosed according to different diagnostic criteria--systematic literature search and meta-analysis of key clinical characteristics and heterogeneity. Journal of affective disorders, 156, 111-118. https://doi.org/10.1016/j.jad.2013.12.001

Lake, C. R., & Hurwitz, N. (2007). Schizoaffective disorder merges schizophrenia and bipolar disorders as one disease--there is no schizoaffective disorder. Current opinion in psychiatry, 20(4), 365-379. https://doi.org/10.1097/YCO.0b013e3281a305ab

Pinna, F., Sanna, L., Perra, V., Pisu Randaccio, R., Diana, E., Carpiniello, B., & Cagliari Recovery Study Group (2014). Long-term outcome of schizoaffective disorder. Are there any differences with respect to schizophrenia? Rivista di psichiatria, 49(1), 41-49. https://doi.org/10.1708/1407.15624

Wilson, J. E., Nian, H., & Heckers, S. (2014). The schizoaffective disorder diagnosis: a conundrum in the clinical setting. European archives of psychiatry and clinical neuroscience, 264(1), 29-34. https://doi.org/10.1007/s00406-013-0410-7

World Health Organization. (2010). ICD-10 International Classification of Diseases. Version: 2010. http://apps.who.int/classifications/icd10/browse/2010/en#/V

Rink, L., Pagel, T., Franklin, J., & Baethge, C. (2016). Characteristics and heterogeneity of schizoaffective disorder compared with unipolar depression and schizophrenia - a systematic literature review and meta-analysis. Journal of affective disorders, 191, 8-14. https://doi.org/10.1016/j.jad.2015.10.045.

Tondo, L., Vázquez, G. H., Baethge, C., Baronessa, C., Bolzani, L., Koukopoulos, A., Mazzarini, L., Murru, A., Pacchiarotti, I., Pinna, M., Salvatore, P., Sani, G., Selle, V., Spalletta, G., Girardi, P., Tohen, M., Vieta, E., & Baldessarini, R. J. (2016). Comparison of psychotic bipolar disorder, schizoaffective disorder, and schizophrenia: an international, multisite study. Acta psychiatrica Scandinavica, 133(1), 34-43. https://doi.org/10.1111/acps.12447

Baethge, C., Jänner, M., Gaebel, W., & Malevani, J. (2017). Psychopathological and demographic characteristics of hallucinating patients with schizophrenia and schizoaffective disorder: an analysis based on AMDP data. European archives of psychiatry and clinical neuroscience, 267(4), 295-301. https://doi.org/10.1007/s00406-016-0738-x

Cheniaux, E., Landeira-Fernandez, J., & Versiani, M. (2009). The diagnoses of schizophrenia, schizoaffective disorder, bipolar disorder and unipolar depression: interrater reliability and congruence between DSM-IV and ICD-10. Psychopathology, 42(5), 293-298. https://doi.org/10.1159/000228838

Vollmer-Larsen, A., Jacobsen, T. B., Hemmingsen, R., & Parnas, J. (2006). Schizoaffective disorder-- the reliability of its clinical diagnostic use. Acta psychiatrica Scandinavica, 113(5), 402-407. https://doi.org/10.1111/j.1600-0447.2005.00744.x

Malhi, G. S., Green, M., Fagiolini, A., Peselow, E. D., & Kumari, V. (2008). Schizoaffective disorder: diagnostic issues and future recommendations. Bipolar disorders, 10(1 Pt 2), 215-230. https://doi.org/10.1111/j.1399-5618.2007.00564.x

Hanlon, F. M., Yeo, R. A., Shaff, N. A., Wertz, C. J., Dodd, A. B., Bustillo, J. R., Stromberg, S. F., Lin, D. S., Abrams, S., Liu, J., & Mayer, A. R. (2019). A symptom-based continuum of psychosis explains cognitive and real-world functional deficits better than traditional diagnoses. Schizophrenia research, 208, 344-352. https://doi.org/10.1016/j.schres.2019.01.024

Madre, M., Canales-Rodríguez, E. J., Ortiz-Gil, J., Murru, A., Torrent, C., Bramon, E., Perez, V., Orth, M., Brambilla, P., Vieta, E., & Amann, B. L. (2016). Neuropsychological and neuroimaging underpinnings of schizoaffective disorder: a systematic review. Acta psychiatrica Scandinavica, 134(1), 16-30. https://doi.org/10.1111/acps.12564

Mancuso, S. G., Morgan, V. A., Mitchell, P. B., Berk, M., Young, A., & Castle, D. J. (2015). A comparison of schizophrenia, schizoaffective disorder, and bipolar disorder: Results from the Second Australian national psychosis survey. Journal of affective disorders, 172, 30-37. https://doi.org/10.1016/j.jad.2014.09.035

Webb, C. A., & Keeley, J. W. (2017). Evaluating clinicians' representations of schizoaffective disorder. Comprehensive psychiatry, 74, 102-108. https://doi.org/10.1016/j.comppsych.2017.01.009

Ritsner M. S. (2016). Anhedonia of Patients with Schizophrenia and Schizoaffective Disorder is Attributed to Personality-Related Factors Rather than to State-Dependent Clinical Symptoms. Clinical schizophrenia & related psychoses, 9(4), 187-197. https://doi.org/10.3371/CSRP.RI.031513

Ritsner, M. S., & Ratner, Y. (2019). Predicting Predischarge Anhedonia Among Inpatients With Schizophrenia and Schizoaffective Disorders: A Large-scale Analysis. The Journal of nervous and mental disease, 207(1), 12-21. https://doi.org/10.1097/NMD.0000000000000923

Markova, M. V., Kozhyna, A. M., & Rakhman, L. V. (2015). Rol stresovykh faktoriv v syndromohenezi terapevtychno rezystentnykh depresii [The role of stress factors in the syndromogenesis of therapeutically resistant depression]. Ukrainskyi visnyk psykhonevrolohii, 23(3), 163-164. [in Ukrainian].

Auxéméry, Y., & Fidelle, G. (2011). Psychose et traumatisme psychique. Pour une articulation théorique des symptômes psycho-traumatiques et psychotiques chroniques [Psychosis and trauma. Theorical links between post-traumatic and psychotic symptoms]. L'Encephale, 37(6), 433-438. [in French]. https://doi.org/10.1016/j.encep.2010.12.001

Vardaxi, C. C., Gonda, X., & Fountoulakis, K. N. (2018). Life events in schizoaffective disorder: A systematic review. Journal of affective disorders, 227, 563-570. https://doi.org/10.1016/j.jad.2017.11.076

Kotov, R., Fochtmann, L., Li, K., Tanenberg-Karant, M., Constantino, E. A., Rubinstein, J., Perlman, G., Velthorst, E., Fett, A. J., Carlson, G., & Bromet, E. J. (2017). Declining Clinical Course of Psychotic Disorders Over the Two Decades Following First Hospitalization: Evidence From the Suffolk County Mental Health Project. The American journal of psychiatry, 174(11), 1064-1074. https://doi.org/10.1176/appi.ajp.2017.16101191

Cohen, A. S., Schwartz, E., Le, T. P., Fedechko, T., Kirkpatrick, B., & Strauss, G. P. (2019). Using biobehavioral technologies to effectively advance research on negative symptoms. World psychiatry, 18(1), 103-104. https://doi.org/10.1002/wps.20593

Kingston, T., Scully, P. J., Browne, D. J., Baldwin, P. A., Kinsella, A., O'Callaghan, E., Russell, V., & Waddington, J. L. (2018). Functional outcome and service engagement in major depressive disorder with psychotic features: comparisons with schizophrenia, schizoaffective disorder and bipolar disorder in a 6-year follow-up of the Cavan-Monaghan First Episode Psychosis Study (CAMFEPS). CNS neuroscience & therapeutics, 24(7), 633-640. https://doi.org/10.1111/cns.12836

Serikova, O. (2018). Klinichna dyferentsiatsiia psykhopatolohichnoi symptomatyky depresyvnoho, maniakalnoho ta zmishanoho typiv shyzoafektyvnoho rozladu u dynamitsi [Clinical differentiation of psychopathological symptomatics in depressive, maniacal and mixed types of schizoaffective disorder in dynamics]. ScienceRise: Medical Science, (4), 43-48. [in Ukrainian]. https://doi.org/10.15587/2519-4798.2018.132560

Correll, C. U., & Schooler, N. R. (2020). Negative Symptoms in Schizophrenia: A Review and Clinical Guide for Recognition, Assessment, and Treatment. Neuropsychiatric disease and treatment, 16, 519-534. https://doi.org/10.2147/NDT.S225643

Miller, J. N., & Black, D. W. (2019). Schizoaffective disorder: A review. Annals of clinical psychiatry, 31(1), 47-53.

Maruta, N. O., & Linska, K. I. (2018). Suchasni napriamky u rozrobtsi instrumentiv dlia obiektyvnoi diahnostyky afektyvnykh rozladiv (ohliad literatury) [Current trends in the development of tools for objective diagnosis of affective disorders (literature review)]. Ukrainskyi visnyk psykhonevrolohii, 26(1), 110-115. [in Ukrainian].

Kentros, M. K., Terkelsen, K., Hull, J., Smith, T. E., & Goodman, M. (1997). The relationship between personality and quality of life in persons with schizoaffective disorder and schizophrenia. Quality of life research, 6(2), 118-122. https://doi.org/10.1023/a:1026433932142

Gurrera, R. J., McCarley, R. W., & Salisbury, D. (2014). Cognitive task performance and symptoms contribute to personality abnormalities in first hospitalized schizophrenia. Journal of psychiatric research, 55, 68-76. https://doi.org/10.1016/j.jpsychires.2014.03.022

Goghari, V. M., & Harrow, M. (2019). Anxiety symptoms across twenty-years in schizoaffective disorder, bipolar disorder, and major depressive disorder. Psychiatry research, 275, 310-314. https://doi.org/10.1016/j.psychres.2019.03.050

Ipçi, K., Yildiz, M., İncedere, A., Kiras, F., Esen, D., & Gürcan, M. B. (2020). Subjective Recovery in Patients with Schizophrenia and Related Factors. Community mental health journal, 56(6), 1180-1187. https://doi.org/10.1007/s10597-020-00616-5

Ridgewell, C., Blackford, J. U., McHugo, M., & Heckers, S. (2017). Personality traits predicting quality of life and overall functioning in schizophrenia. Schizophrenia research, 182, 19-23. https://doi.org/10.1016/j.schres.2016.10.007

Grove, T. B., Yao, B., Mueller, S. A., McLaughlin, M., Ellingrod, V. L., McInnis, M. G., Taylor, S. F., Deldin, P. J., & Tso, I. F. (2018). A Bayesian model comparison approach to test the specificity of visual integration impairment in schizophrenia or psychosis. Psychiatry research, 265, 271-278. https://doi.org/10.1016/j.psychres.2018.04.061

Lynham, A. J., Hubbard, L., Tansey, K. E., Hamshere, M. L., Legge, S. E., Owen, M. J., Jones, I. R., & Walters, J. (2018). Examining cognition across the bipolar/schizophrenia diagnostic spectrum. Journal of psychiatry & neuroscience, 43(4), 245-253. https://doi.org/10.1503/jpn.170076

Hill, S. K., Reilly, J. L., Keefe, R. S., Gold, J. M., Bishop, J. R., Gershon, E. S., Tamminga, C. A., Pearlson, G. D., Keshavan, M. S., & Sweeney, J. A. (2013). Neuropsychological impairments in schizophrenia and psychotic bipolar disorder: findings from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) study. The American journal of psychiatry, 170(11), 1275-1284. https://doi.org/10.1176/appi.ajp.2013.12101298

Buck, B., Gagen, E. C., Luther, L., Kukla, M., & Lysaker, P. H. (2020). Dynamic relationships between emotional distress, persecutory ideation, and metacognition in schizophrenia. Journal of clinical psychology, 76(4), 716-724. https://doi.org/10.1002/jclp.22904

Caruana, N., Stein, T., Watson, T., Williams, N., & Seymour, K. (2019). Intact prioritisation of unconscious face processing in schizophrenia. Cognitive neuropsychiatry, 24(2), 135-151. https://doi.org/10.1080/13546805.2019.1590189

Barkl, S. J., Lah, S., Harris, A. W., & Williams, L. M. (2014). Facial emotion identification in early-onset and first-episode psychosis: a systematic review with meta-analysis. Schizophrenia research, 159(1), 62-69. https://doi.org/10.1016/j.schres.2014.07.049

Ruocco, A. C., Reilly, J. L., Rubin, L. H., Daros, A. R., Gershon, E. S., Tamminga, C. A., Pearlson, G. D., Hill, S. K., Keshavan, M. S., Gur, R. C., & Sweeney, J. A. (2014). Emotion recognition deficits in schizophrenia-spectrum disorders and psychotic bipolar disorder: Findings from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) study. Schizophrenia research, 158(1-3), 105-112. https://doi.org/10.1016/j.schres.2014.07.001

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2023-03-06

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1.
Chuhunov VV, Khomitskyi MY, Pidlubnyi VL. Personality changes in patients with schizoaffective disorder (a review). Zaporozhye medical journal [Internet]. 2023Mar.6 [cited 2024Apr.25];25(1):56-60. Available from: http://zmj.zsmu.edu.ua/article/view/262837

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Vol. 25 No. 1 (2023): Zaporozhye medical journal

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Review

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