Behinderung und Residuum bei schizoaffektiven Psychosen - Daten, methodische Probleme und Hinweise für zukünftige Forschung

Abstract

Schizoaffective disorders take a position between schizophrenia and affective disorders regarding outcome in the sense of psychological residuum and social consequences. What prognosis a schizoaffective illness has depends mainly on intrasymptomatological factors: Melancholic episodes during course seem to predict a good long-term outcome, schizophrenia-typical symptoms in the opposite predestinate to the development of residuum and disability. Non-symptomatological factors do not have any direct influence on the development of a residuum and disability. The comparison of course studies is limited by severe difficulties based on methodological and definitional shortcomings. Such shortcomings are (a) broad definition of schizoaffective but also of schizophrenic psychoses, (b) globalization of the term "outcome", (c) partialization of the term "prognosis", (d) equalization of the terms "course" and "outcome", (e) ignoring of inhomogeneity and polymorphism of schizoaffective disorders, (f) global evaluation of "outcome", (g) short follow-up periods. Some suggestions how to limitate the mentioned methodological shortcomings are discussed.