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Schizoaffective and schizotypal disorders 

Schizoaffective and schizotypal disorders
Schizoaffective and schizotypal disorders

Ming T. Tsuang

, William S. Stone

, and Stephen V. Faraone

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date: 16 May 2022

This chapter focuses on two disorders in the schizophrenia ‘spectrum’: schizoaffective disorder and schizotypal personality disorder. The emphasis includes the clinical features, classification, diagnosis, epidemiology, aetiology, course, prognosis, and possibilities for prevention for each disorder. Some aspects will be underscored to reflect controversial issues, such as the heterogeneity apparent in each condition. Such issues relate to the accurate classification of the disorders, which is important for at least two reasons. First, it is essential to develop reliable and valid diagnostic criteria in order to study the aetiology of the disorders and then utilize that knowledge to develop rational and testable intervention strategies. Heterogeneity adds variance to the process that reduces both the reliability of diagnosis and also the statistical power of experimental designs to detect intervention/treatment effects. Second, the development of newer generations of psychopharmacological treatments holds the promise of matching more appropriate and efficacious medications with specific syndromes or types of symptoms. This trend underscores the importance of differential diagnosis in determining what treatment a patient will receive. Heterogeneity within a diagnostic category complicates achievement of this goal. Another area to be emphasized involves the goal of early interventions, in addition to palliative treatments for these disorders. In contrast, other areas such as the genetic aetiology of schizoaffective disorder and schizotypal personality disorder, and treatments for schizoaffective disorder, will receive less emphasis here, to avoid redundancies with other chapters in this volume. Each disorder will be considered separately, starting with a review of schizoaffective disorder, the more severe of the two spectrum conditions.

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