Psychiatric Quarterly [psaq] ph259-psaq-482361 May 9, 2004 7:10 Style ﬁle version June 4th, 2002
Psychiatric Quarterly, Vol. 75, No. 3, Fall 2004 (
IS SCHIZOAFFECTIVE DISORDER A
STABLE DIAGNOSTIC CATEGORY: A
Patricia M. Averill, Ph.D., Deborah L. Reas, Ph.D.,
Andrew Shack, Ph.D., Nurun N. Shah, M.D.,
Katherine Cowan, M.D., Kenneth Krajewski, M.D.,
Charles Kopecky, M.D., and Robert W. Guynn, M.D.
Debate continues about whether clear nosologic boundaries can be drawn be-
tween schizoaffective disorder (SA), schizophrenia (SP), and bipolar disorder
(BPD). This study attempted to clarify these boundaries. A retrospective re-
view of the records of adult psychiatric inpatients with DSM-IV diagnoses of
SA (n = 96), SP (n = 245), and BPD (n = 203) was conducted. Patients were
assessed at admission and discharge using standardized rating scales (com-
pleted by physicians and nurses) and self-report inventories. Differential im-
provement over time also was examined. Signiﬁcant differences were found
for gender, legal status at admission, age, LOS, episode number, and ethnicity.
Overall, SA was rated by clinicians as intermediate between SP and BPD, al-
though SA rated themselves as the most severe. SA was similar to SP on positive
symptoms, intermediate on negative symptoms, and similar to BPD on mood-
and distress-related symptoms. Independent of diagnosis, differences in change
scores from admission to discharge were related to severity level at admission.
All authors are afﬁliated with University of Texas Health Science Center at Houston,
Department of Psychiatry and Behavioral Sciences and the Harris County Psychiatric
Center, Houston, Texas.
Address correspondence to Patricia M. Averill, Ph.D., Harris County Psychiatric Center,
2800 South MacGregor Way, Houston, TX 77021; e-mail: email@example.com.
2004 Human Sciences Press, Inc.