Pending enough primary studies, we invite reviews on this topic to be conducted. Alternatively, we will endeavour to conduct our own review to fill this gap in the Library.

February 2022

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The post Therapies for schizoaffective disorder appeared first on NeuRA Library.

Neurocognitive deficits are a core feature of both schizophrenia and bipolar disorder. People with either disorder may perform poorly on cognitive tasks assessing intelligence, memory, executive functioning, language, information processing and attention. Establishing differences in these cognitive domains may assist correct diagnosis and treatment of the two disorders.

What is the evidence for cognition in bipolar disorder compared to schizophrenia?

Moderate to high quality evidence found large effects of better overall cognition, attention, and social cognition, and medium-sized effects of better speed of processing, working memory, learning, reasoning, and problem solving in people with bipolar disorder. A small effect was found of better overall cognition in people with bipolar disorder compared to people with schizoaffective disorder (particularly depressive type), which remained across different cognitive domains, bipolar disorder type (I or I and II mixed), age, sex, duration of illness, antipsychotic use or no use, and symptom severity.

Moderate to high quality evidence found a medium-sized effect of higher premorbid IQ, and moderate to low quality evidence found a medium-sized effect of higher current IQ in people with first-episode bipolar disorder compared to people with first-episode schizophrenia. There were also medium-sized effects of better verbal memory and verbal fluency, and small effects of better working memory and processing speed in people with first-episode bipolar disorder.

Compared to controls without a mental illness, moderate to high quality evidence found a small effect of poorer pre-illness-onset cognitive functioning, and a medium-sized effect of poorer post-illness-onset cognitive functioning in people with bipolar disorder. In people with schizophrenia compared to controls, there was a medium-sized effect of poorer pre-illness-onset cognitive functioning and a large effect of poorer post-illness-onset cognitive functioning. Moderate quality evidence found similar, medium to large effects of poor semantic inhibition in people with bipolar disorder and in people with schizophrenia when compared to controls.

A medium-sized effect was found of better social cognition in people with bipolar disorder on Theory of Mind and negative facial emotion recognition tasks, particularly in male patients, but no differences between bipolar disorder and schizophrenia on positive (happy) facial emotion recognition tasks.

September 2021

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The post Cognition in bipolar disorder and schizophrenia appeared first on NeuRA Library.

Pending enough primary studies, we invite reviews on this topic to be conducted. Alternatively, we will endeavour to conduct our own review to fill this gap in the Library.

March 2019

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The post Medications for schizoaffective disorder appeared first on NeuRA Library.

Schizoaffective disorder is on the schizophrenia spectrum of illnesses. Diagnosis of schizoaffective disorder requires schizophrenia-like symptoms of psychosis, in addition to affective/mood symptoms such as depression. There is some debate as to whether schizoaffective disorder represents a unique diagnosis or an intermediary between schizophrenia and mood disorders. There are also considerable differences between different diagnostic criteria regarding the definition of schizoaffective disorder; particularly the Diagnostic and Statistical Manual (DSM) and the International Classification of Diseases (ICD) criteria. Specifically, the ICD and also the Research Diagnostic Criteria (RDC) require simultaneous and equally prominent presence of psychotic and affective symptoms; conversely, the DSM requires an additional period (>2 weeks) where the psychotic symptoms alone are present.

What is the evidence relating to schizoaffective disorder diagnosis?

Moderate to low quality evidence suggests schizoaffective disorder occupies an intermediary position between schizophrenia and mood disorders, but is not clearly distinct from either disorder.

Moderate quality evidence found people diagnosed with schizoaffective disorder using RDC/ICD criteria may have had fewer hospitalisations, are more likely to be male, and are more likely to be older or married than people diagnosed using DSM IIIR/IV criteria. Compared to people with schizophrenia, people with schizoaffective disorder may be more likely to be male, Caucasian, married, have a longer duration of illness, have lower levels of functioning, more depression, and more negative symptoms. Compared to people with bipolar disorder, people with schizoaffective disorder may be younger, have an earlier age at onset, fewer years of education, not Caucasian or African American, never married, have a longer duration of illness, more positive and negative symptoms, more depression, and higher IQ.

Around 36% of people initially diagnosed with schizoaffective disorder have their diagnosis changed at the second assessment. Conversely, around 55% of people diagnosed with schizoaffective disorder at the second assessment were originally diagnosed with other disorders. Schizophrenia or affective disorders were the most common original or subsequent diagnosis.

February 2022

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