The relationship between schizoaffective, schizophrenic and mood disorders in patients admitted at Mathari Psychiatric Hospital, Nairobi, Kenya

Abstract

Objective: The prevalence of schizoaffective disorder (SAD) and the relationship between schizophrenia (SCZ), SAD and mood disorders (MD) in non-Western countries is unknown. To determine the prevalence of SAD and the relationship between SCZ, SAD and MD in relation to socio-demographic, clinical and therapeutic variables in 691 patients admitted at Mathari Psychiatric Hospital, Kenya.

Method: A cross-sectional comparative study using both clinician and SCID-1 for DSM-IV diagnoses.

Results: Approximately twenty three percent (n=160) met DSM-IV criteria for SAD using SCID-1. There were significant differences between SCZ, SAD and MD regarding: affective and core symptoms of schizophrenia (with the exception of core symptoms of schizophrenia between SCZ and SAD); presence of past trauma; a past suicide attempt; and comorbidity with alcohol and drug abuse disorders. SAD and MD patients took significantly more mood stabilizers than SCZ patients. There were no significant differences between the three groups regarding socio-demographic  variables, brief psychiatric rating scale scores, cognitive performance, anxiety and depressive symptoms, presence of obsessions, and usage of both antipsychotics and antidepressants.

Conclusion: There is no distinct demarcation between the three disorders. This lends support to recent evidence suggesting that SAD might constitute a heterogeneous group composed of both SCZ and MD patients or a middle point of a continuum between SCZ and MD.

Keywords: Schizoaffective Disorder; Schizophrenia; Mood disorders; Epidemiology; Africa