Earlier studies showed that new cases of 'schizomanic' patients (i.e. manic patients who also demonstrated schizophrenic or paranoid symptoms) numbered approximately 1.Z per 100 000 per year.(5) This was less than the 4 per 100 000 per year shown by 'schizodepressive' patients. The number of schizoaffective cases in this study exceeded the number of manic patients, and made up half of the number of schizophrenic cases. More recently, Tien and Eaton (21) analysed data from the Epidemiologic Catchment Area Study for three non-overlapping groups with psychotic symptoms. One of these groups comprised individuals with 'psychotic affective syndrome', which was similar to schizoaffective disorder except that most members of the group (59 per cent) demonstrated psychotic symptoms only in conjunction with a mood disturbance (essentially DSM-IIIR mood disturbance with psychotic symptoms). The incidence of this disorder was 1.Z per 1000 per year, which was approximately equal to the rate for schizophrenia (2.0 per 1000 per year). Even if the 59 per cent of the group who met the criteria for a mood disorder with psychotic features was excluded, the remaining 41 per cent would still comprise a higher incidence rate than that detected by earlier studies. Differences in sampling procedures (treated versus non-treated samples) may have contributed to the differences observed in the rates. More importantly, however, these studies showed that schizoaffective disorder occurred at 50 to 85 per cent of the rate of schizophrenia, thus confirming that patients with this disorder comprise a clinically significant population.

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