DSM-IV and DSM-IV-TR (published in 2000) criteria for schizoaffective disorder were poorly defined and poorly . These and unreliable criteria lasted 19 years and led clinicians to significantly overuse the schizoaffective disorder diagnosis. Patients commonly diagnosed with DSM-IV schizoaffective disorder showed a clinical picture at time of diagnosis that appeared different from schizophrenia or psychotic mood disorders using DSM-IV criteria, but who as a group, were to have outcomes indistinguishable from those with mood disorders with or without psychotic features. A poor prognosis was assumed to apply to these patients by most clinicians, and this poor prognosis was to many patients. The poor prognosis for DSM-IV schizoaffective disorder was not based on , but was caused by poorly defined criteria interacting with clinical tradition and belief; clinician with assumptions from the diagnosis' history (discussed above), including the invalid Kraepelinian dichotomy; and by clinicians being unfamiliar with the limitations of the diagnostic and classification system.
The symptoms of schizophrenia are classified as positive or negative. These classifications help describe the characteristics of the disorder and predict the effects of antipsychotic medication. Positive symptoms are those additional to expected behavior (i.e., “excessive” function) and include delusions, hallucinations, agitation, and talkativeness. Negative (deficit) symptoms are those missing from expected behavior (i.e., decreased function) and include lack of motivation, social withdrawal, flattened affect, cognitive disturbances, poor grooming, and poor or impoverished speech content (see later text). Positive symptoms respond well to most traditional and atypical antipsychotic agents. Negative symptoms respond better to atypical than to traditional antipsychotics (see Chapter 19).
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To test whether the differences between the correlations in causal and perceptual words for the two groups (H4) wereinfluenced by differences in essay length, we conducted partial correlations with word count as a covariate. The observed correlations between causal and perceptual words remained significant for mood disorder essays (r = 0.546, adjusted P = 0.003) and for schizophrenia essays (r = –0.356, adjusted P = 0.002).