ICD-10 Classification of Mental and Behavioural Disorders, World Health Organization, Geneva, 1992
Definition | Diagnostic Guidelines | DCR-10 Criteria
These are episodic disorders in which both affective and schizophrenic symptoms are prominent within the same episode of illness, preferably simultaneously, but at least within a few days of each other. Their relationship to typical mood (affective) disorders and to schizophrenic disorders is uncertain. They are given a separate category because they are too common to be ignored. Other conditions in which affective symptoms are superimposed upon or form part of a pre-existing schizophrenic illness, or in which they coexist or alternate with other types of persistent delusional disorders, are classified under the appropriate category. Mood-incongruent delusions or hallucinations in affective disorders do not by themselves justify a diagnosis of schizoaffective disorder.Patients who suffer from recurrent schizoaffective episodes, particularly those whose symptoms are of the manic rather than the depressive type, usually make a full recovery and only rarely develop a defect state.
A diagnosis of schizoaffective disorder should be made only when both definite schizophrenic and definite affective symptoms are prominent simultaneously, or within a few days of each other, within the same episode of illness, and when, as a consequence of this, the episode of illness does not meet criteria for either schizophrenia or a depressive or manic episode. The term should not be applied to patients who exhibit schizophrenic symptoms and affective symptoms only in different episodes of illness. It is common, for example, for a schizophrenic patient to present with depressive symptoms in the aftermath of a psychotic episode (see post-schizophrenic depression). Some patients have recurrent schizoaffective episodes, which may be of the manic or depressive type or a mixture of the two. Others have one or two schizoaffective episodes interspersed between typical episodes of mania or depression. In the former case, schizoaffective disorder is the appropriate diagnosis. In the latter, the occurrence of an occasional schizoaffective episode does not invalidate a diagnosis of bipolar affective disorder or recurrent depressive disorder if the clinical picture is typical in other respects.
G1. The disorder meets the criteria for one of the affective disorders (F30.-, F31.-, F32.-) of moderate or severe degree, as specified for each category
G2. Symptoms from at least one of the groups listed below must be clearly present for most of the time during a period of at least 2 weeks (these groups are almost the same as for schizophrenia)
(1) thought echo, thought insertion or withdrawal, thought broadcasting
(2) delusions of control, influence or passivity, clearly referred to body or limb movements or specific thoughts, actions or sensations
(3) hallucinatory voices giving a running commentary on the patient's behaviour, or discussing the patient between themselves, or other types of hallucinatory voices coming from some part of the body
(4) persistent delusions of other kinds that are culturally inappropriate and completely impossible, but not merely grandiose or persecutory
(5) grossly irrelevant or incoherent speech, or frequent use of neologisms
(6) intermittent but frequent appearance of some forms of catatonic behaviour, such as posturing, waxy flexibility and negativism
G3. Criteria G1 and G2 above must be met within the same episode of the disorder, and concurrently for at least part of the episode
G4. Exclusion criteria.
ICD-10 copyright © 1992 by World Health Organization.