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The Munich 15-year follow-up study (MUFUSSAD) on first-hospitalized patients with schizophrenic or affective disorders: Assessing courses, types and time stability of diagnostic classification

Published online by Cambridge University Press:  16 April 2020

H.J. Möller ,
M. Jäger ,
M. Riedel ,
M. Obermeier ,
A. Strauss  and
R. Bottlender
H.J. Möller*
Affiliation:
Department of Psychiatry, University of Munich, Nussbaumstrasse 7, 80336Munich, Germany
M. Jäger
Affiliation:
Department of Psychiatry, University of Munich, Nussbaumstrasse 7, 80336Munich, Germany
M. Riedel
Affiliation:
Department of Psychiatry, University of Munich, Nussbaumstrasse 7, 80336Munich, Germany
M. Obermeier
Affiliation:
Department of Psychiatry, University of Munich, Nussbaumstrasse 7, 80336Munich, Germany
A. Strauss
Affiliation:
Department of Psychiatry, University of Munich, Nussbaumstrasse 7, 80336Munich, Germany
R. Bottlender
Affiliation:
Department of Psychiatry, University of Munich, Nussbaumstrasse 7, 80336Munich, Germany
*
* Corresponding author. Tel.: +49 89 5160 5501; fax: +49 89 5160 5522. E-mail address: hans-juergen.moeller@med.uni-muenchen.de (H.J. MÖller).
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Abstract

Objective

In the context of the development of DSM-V and ICD-11 it appears to be useful to get further data on the validity of the diagnostic differentiation between schizophrenic and affective disorders. This study investigated the relevance of the main diagnostic groups schizophrenia, schizoaffective psychosis and affective disorder in the context of different diagnostic systems (ICD-9, ICD-10, DSM –IV), assessing their time stability, long-term courses, types and functional outcome.

Methods

A total of 323 first hospitalized inpatients of the Psychiatric Department of the University Munich were recruited at index time. The full follow-up evaluation including standardized assessment procedures could be performed in 197 patients.

Results

The re-diagnosis of the patients’ disorders shows that with the transition from ICD-9 to ICD-10 or DSM-IV, the group of affective disorders increased numerically while the diagnostic groups of schizophrenia and schizoaffective disorders decreased in size. The structured clinical interview for DSM-IV (SCID) analysis showed that altogether ICD-10 and DSM-IV had a relatively high diagnostic stability. Of the patients with an ICD-10 diagnosis of schizophrenia, 57% had a chronic course; 61% of the patients with a DSM-IV diagnosis of schizophrenia. Patients with affective disorders, according either to ICD-10 or DSM-IV, had in more than 90% of the cases an episodic-remitting course. In terms of prediction of long-term outcome regarding the differentiation between chronic and non-chronic course, the ICD-10 diagnoses did give a slightly better predictive result than a dimensional approach based on the key psychopathological syndrome scores.

Conclusions

The differentiation between schizophrenic and affective disorders seems meaningful especially under predictive aspects. A dimensional syndromatological description does not exceed the predictive power of the investigated main diagnostic categories, but might increase the clinically relevant information.

Keywords

SchizophreniaAffective disordersNon-organic psychosisLong-term outcomePrediction
Type
Original article
Information
European Psychiatry , Volume 26 , Issue 4 , May 2011 , pp. 231 - 243
Copyright
Copyright © Elsevier Masson SAS 2011

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