Universität zu Köln

Santelmann, Hanno, Franklin, Jeremy ORCID: 0000-0003-1536-0925, Buhoff, Jana and Baethge, Christopher (2016). Diagnostic shift in patients diagnosed with schizoaffective disorder: a systematic review and meta-analysis of rediagnosis studies. Bipolar Disord., 18 (3). S. 233 - 247. HOBOKEN: WILEY. ISSN 1399-5618

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Abstract

ObjectivesThe diagnosis of schizoaffective disorder (SAD) is well established in clinical practice but is heavily disputed on theoretical grounds. We analyzed the extent and direction of diagnostic shift in SAD patients. MethodsWe searched Medline, Embase, and PsycINFO systematically for all studies documenting two diagnostic assessments at different points in time (rediagnosis studies) and used meta-analytic methods to quantify diagnostic shift. Multiple prespecified and post-hoc subgroup analyses (e.g., rater blinding) and meta-regressions (e.g., year of publication) were carried out. ResultsWe included 31 studies out of 4,415 articles screened: 27 studies on the shift from and 23 studies on the shift to SAD (median time span was two years). A total of 36% of patients with a diagnosis of SAD at first assessment switch, many to schizophrenia (19%), 14% to affective disorders, and 6% to other disorders. Among patients diagnosed with SAD at second assessment, 55% had received a different diagnosis at first assessment, a large portion of whom had been initially diagnosed with affective disorder (24%), schizophrenia (18%), and other disorders (12%). ConclusionsDiagnostic shift in SAD patients is substantial. Psychiatrists need to reassess the diagnosis during the course of the illness and to adjust treatment. Slightly more diagnoses of SAD are changed to schizophrenia than to affective disorders, and among patients rediagnosed with SAD, fewer have been diagnosed with schizophrenia than with affective disorders. Thus, at the diagnostic level, there seems to be a slight trend toward schizophrenia during the course of functional psychoses.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Santelmann, Hanno UNSPECIFIED UNSPECIFIED UNSPECIFIED Franklin, Jeremy UNSPECIFIED orcid.org/0000-0003-1536-0925 UNSPECIFIED Buhoff, Jana UNSPECIFIED UNSPECIFIED UNSPECIFIED Baethge, Christopher UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-276370
DOI:	10.1111/bdi.12388
Journal or Publication Title:	Bipolar Disord.
Volume:	18
Number:	3
Page Range:	S. 233 - 247
Date:	2016
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1399-5618
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PROJECT 2-YEAR STABILITY; TEST-RETEST RELIABILITY; TERM-FOLLOW-UP; BIPOLAR DISORDER; FUNCTIONAL PSYCHOSES; 1ST-EPISODE PSYCHOSIS; PSYCHIATRIC DIAGNOSES; TREATMENT INITIATION; 1ST EPISODE; SCHIZOPHRENIA Multiple languages Clinical Neurology; Neurosciences; Psychiatry Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27637