Major depressive disorder as a co-morbid diagnosis in schizophrenia versus the diagnosis of schizoaffective disorder – depressed type

Abstract

The purpose of this article is to focus on the importance of depressive symptoms in patients suffering from schizophrenia, and the dilemma posed by hierarchical classification methods, which exclude co-morbid diagnoses such as Major Depressive Disorder in patients with schizophrenia. The question arises that if Major Depressive Disorder is only categorized under the diagnosis of Schizoaffective Disorder (depressed type), are we able to recognize these symptoms promptly and treat them sufficiently? The duration of the substantial period of depressed mood referred to in the DSM IV TR criteria for Schizoaffective Disorder is unspecified. We suggest that one should only allocate the latter diagnosis if the substantial period is that of one third or more of the whole duration of the illness. Identification of the optimal cutoff point can generate further hypothesis testing research and refinement of the diagnostic model. It is not only important to refine the diagnosis, but it is even more important to detect these symptoms and treat promptly and effectively. According to the latest literature, the best possible treatment for depression in schizophrenia appears to be the combination of a second-generation antipsychotic and cognitive psychotherapy.

Keywords: major depression, schizophrenia, schizoaffective, depressed

South African Psychiatry Review Vol. 8(4) 2005: 134-139