The prognosis of patients with schizoaffective disorder, measured in terms of overall poor outcome and parameters such as work functioning and cognitive impairments, appears to be better than the prognosis of patients with schizophrenia but worse than the prognosis of patients with mood disorders.[31]Harrow M, Grossman LS, Herbener ES, et al. Ten-year outcome: patients with schizoaffective disorders, schizophrenia, affective disorders and mood-incongruent psychotic symptoms. Br J Psychiatry. 2000 Nov;177:421-6.
https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/tenyear-outcome-patients-with-schizoaffective-disorders-schizophrenia-affective-disorders-and-moodincongruent-psychotic-symptoms/0D2C6F8BEB0297B14D17309C14BA596F
http://www.ncbi.nlm.nih.gov/pubmed/11059995?tool=bestpractice.com
[39]Jäger M, Haack S, Becker T, et al. Schizoaffective disorder: an ongoing challenge for psychiatric nosology. Eur Psychiatry. 2011 Apr;26(3):159-65.
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[79]Jager M, Bottlender R, Strauss A, et al. Fifteen-year follow-up of ICD-10 schizoaffective disorders compared with schizophrenia and affective disorders. Acta Psychiatr Scand. 2004 Jan;109(1):30-7.
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[80]Torniainen M, Suvisaari J, Partonen T, et al. Cognitive impairments in schizophrenia and schizoaffective disorder: relationship with clinical characteristics. J Nerv Ment Dis. 2012 Apr;200(4):316-22.
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Affective symptoms
Schizoaffective disorder, bipolar type, meaning the presence of manic or mixed episodes, appears to have a better prognosis than the depressive type.
Other prognostic factors
As in schizophrenia, predictors of poor prognosis include an insidious course, prior history of poor functioning, a family history of schizophrenia, predominant psychotic symptoms and negative symptoms, poor recovery in between episodes, mood-incongruent psychotic symptoms, and lack of clear precipitants.[31]Harrow M, Grossman LS, Herbener ES, et al. Ten-year outcome: patients with schizoaffective disorders, schizophrenia, affective disorders and mood-incongruent psychotic symptoms. Br J Psychiatry. 2000 Nov;177:421-6.
https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/tenyear-outcome-patients-with-schizoaffective-disorders-schizophrenia-affective-disorders-and-moodincongruent-psychotic-symptoms/0D2C6F8BEB0297B14D17309C14BA596F
http://www.ncbi.nlm.nih.gov/pubmed/11059995?tool=bestpractice.com
The most important modifiable predictors of outcome are family environment, substance misuse, and duration of untreated psychosis.[17]Morgan C, Fisher H. Environment and schizophrenia: environmental factors in schizophrenia: childhood trauma - a critical review. Schizophr Bull. 2007 Jan;33(1):3-10.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2632300
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[81]Kane JM, McGlashan TH. Treatment of schizophrenia. Lancet. 1995 Sep 23;346(8978):820-5.
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[82]Wyatt RJ. Neuroleptics and the natural course of schizophrenia. Schizophr Bull. 1991;17(2):325-51.
https://academic.oup.com/schizophreniabulletin/article/17/2/325/1873643
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[83]Larsen TK, McGlashan TH, Moe LC. First-episode schizophrenia: I. Early course parameters. Schizophr Bull. 1996;22(2):241-56.
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[84]Malla AK, Norman RM, Manchanda R, et al. Status of patients with first-episode psychosis after one year of phase-specific community-oriented treatment. Psychiatr Serv. 2002 Apr;53(4):458-63.
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