Schizoaffective Disorder - An Issue of Diagnosis

Objective: to highlight the diagnostic challenges in diagnosing a patient with schizoaffective disorder under dsm-iv-tr and to evaluate the effectiveness of changes in dsm-v in addressing these issues. methods: we present the evolution of the diagnosis from its inception, outline its complex nosology, review the diagnostic difficulties under dsm-iv-tr and critique the proposed changes made in dsm-v. results: a complex nosology, varied thresholds of diagnosis under dsm-iv-tr, and the inherent difficulty in obtaining a detailed longitudinal history from a patient contribute to the challenge of diagnosing a patient with schizoaffective disorder. changes in dsm-v attempt to increase the reliability of the diagnosis by specifying and raising temporal thresholds, moving the time of disease observation away from a single episode but towards the lifetime of illness. conclusion: changes made in dsm-v only address a small part of the difficulties raised and clinicians will continue to face challenges in diagnosing schizoaffective disorder under dsm-v. however, there might still be value in the proposed changes under dsm-v