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Re: schitsophrenia NMDA and lithium med_empowered

Posted by SLS on July 13, 2005, at 11:07:41

In reply to Re: schitsophrenia NMDA and lithium, posted by med_empowered on July 13, 2005, at 1:07:03

> The line between schizoaffective and schizophrenia is blurry at best;

No way!

Sorry to disagree with you on this one.

They are two different beasts entirely. Schizoaffective disorder is more than simply a comorbid occurence of schizophrenia and bipolar disorder.

The differential diagnosis is easy to make, especially if you can get any sort of life-chart assembled through careful interview of patient and family. Otherwise, the syndrome must be followed prospectively. The description of schizoaffective disorder can be found here:

Unfortunately, this description makes no mention of whether these symptoms appear in any particular order. I believe that they do.

I was able to observe very closely the progression of schizoaffective disorder as it manifested in a friend of mine. I also come in contact with several people who have schizophrenia. I am able to see the difference easily without needing special training. The thought disorder of schizophrenia is not accompanied by a variability in affect and tends to remain stable without intervention.

I observed the order and character of the changes and overlap in mental state seen in my friend's presentation of schizoaffective disorder were predictable and obvious:

Euthymia -> anxiety / hypomania / insomnia -> manic psychosis / delusions -> schizoid thought disorder / hallucinations -> depression -> euthymia -> etc.

For what it's worth, I worked as a research assistant to Baron Shopsin, MD, one of the first to identify the schizoaffective presentation as a separate disorder. He authored several books on the subject. This was as early as 1983.

- Scott




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