Despite a clear recognition of the existence of patients with co-morbid psychotic and mood symptoms, many studies conclude that
schizoaffective disorder as a distinct diagnosis does not exist. Regardless of one's opinion on
schizoaffective disorder, psychiatrists remain dependent on phenomenological descriptions for diagnosing
psychiatric disorders, and these phenomenological criteria are also used for clinical trial entry. On the other hand, many psychiatrists prescribe for specific target symptoms and do not always rigidly follow diagnostic systems and, moreover, there have been very few trials that have specifically studied
schizoaffective disorder. Despite recent intriguing work in epidemiology, genetics, neurocognition and electrophysiology, the diagnosis of
schizoaffective disorder remains controversial. Taken together, these studies suggest that even if
schizoaffective disorder exists as a separate diagnosis, it may not be useful clinically due to considerable variation in the general use of this term. It is possible that diagnostic criteria in the future will include genetic, imaging and electrophysiological components, and that this will allow for better differentiation of disease states among the heterogeneous pool of patients currently believed to have
schizophrenia,
schizoaffective disorder or
bipolar disorder. Although it is likely that most, if not all,
antipsychotics are effective for
schizoaffective disorder, given recent regulatory approval of a specific
antipsychotic agent for the acute treatment of
schizoaffective disorder, greater attention is now being focused on the entity of
schizoaffective disorder and potential treatment decisions. However, based on the limited extant evidence, it is not yet possible to make definitive treatment recommendations for
schizoaffective disorder. Additional clinical trials that include other
antipsychotics, mood stabilizers and
antidepressants are desirable and necessary before clear and comprehensive evidence-based treatment recommendations can be made.