O prognóstico para pacientes com transtorno esquizoafetivo, medido em termos de desfecho desfavorável geral e parâmetros como produtividade no trabalho e comprometimento cognitivo, parece ser melhor que o prognóstico de pacientes com esquizofrenia, mas pior que o prognóstico de pacientes com transtornos de humor.[31]Harrow M, Grossman LS, Herbener ES, et al. Ten-year outcome: patients with schizoaffective disorders, schizophrenia, affective disorders and mood-incongruent psychotic symptoms. Br J Psychiatry. 2000 Nov;177:421-6.
https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/tenyear-outcome-patients-with-schizoaffective-disorders-schizophrenia-affective-disorders-and-moodincongruent-psychotic-symptoms/0D2C6F8BEB0297B14D17309C14BA596F
http://www.ncbi.nlm.nih.gov/pubmed/11059995?tool=bestpractice.com
[39]Jäger M, Haack S, Becker T, et al. Schizoaffective disorder: an ongoing challenge for psychiatric nosology. Eur Psychiatry. 2011 Apr;26(3):159-65.
http://www.ncbi.nlm.nih.gov/pubmed/20646917?tool=bestpractice.com
[79]Jager M, Bottlender R, Strauss A, et al. Fifteen-year follow-up of ICD-10 schizoaffective disorders compared with schizophrenia and affective disorders. Acta Psychiatr Scand. 2004 Jan;109(1):30-7.
http://www.ncbi.nlm.nih.gov/pubmed/14674956?tool=bestpractice.com
[80]Torniainen M, Suvisaari J, Partonen T, et al. Cognitive impairments in schizophrenia and schizoaffective disorder: relationship with clinical characteristics. J Nerv Ment Dis. 2012 Apr;200(4):316-22.
http://www.ncbi.nlm.nih.gov/pubmed/22456585?tool=bestpractice.com
Sintomas afetivos
O transtorno esquizoafetivo do tipo bipolar com manifestação de episódios maníacos ou mistos parece ter um prognóstico melhor que o tipo depressivo.
Outros fatores de prognóstico
Assim como na esquizofrenia, os preditores de prognóstico desfavorável incluem evolução insidiosa, história prévia de funcionamento desfavorável, história familiar de esquizofrenia, sintomas psicóticos predominantes e sintomas negativos, recuperação desfavorável entre os episódios, sintomas psicóticos de humor incongruentes e ausência de fatores desencadeadores claros.[31]Harrow M, Grossman LS, Herbener ES, et al. Ten-year outcome: patients with schizoaffective disorders, schizophrenia, affective disorders and mood-incongruent psychotic symptoms. Br J Psychiatry. 2000 Nov;177:421-6.
https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/tenyear-outcome-patients-with-schizoaffective-disorders-schizophrenia-affective-disorders-and-moodincongruent-psychotic-symptoms/0D2C6F8BEB0297B14D17309C14BA596F
http://www.ncbi.nlm.nih.gov/pubmed/11059995?tool=bestpractice.com
Os preditores de desfecho modificáveis mais importantes são ambiente familiar, uso indevido de substâncias e duração da psicose não tratada.[17]Morgan C, Fisher H. Environment and schizophrenia: environmental factors in schizophrenia: childhood trauma - a critical review. Schizophr Bull. 2007 Jan;33(1):3-10.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2632300
http://www.ncbi.nlm.nih.gov/pubmed/17105965?tool=bestpractice.com
[81]Kane JM, McGlashan TH. Treatment of schizophrenia. Lancet. 1995 Sep 23;346(8978):820-5.
http://www.ncbi.nlm.nih.gov/pubmed/7545770?tool=bestpractice.com
[82]Wyatt RJ. Neuroleptics and the natural course of schizophrenia. Schizophr Bull. 1991;17(2):325-51.
https://academic.oup.com/schizophreniabulletin/article/17/2/325/1873643
http://www.ncbi.nlm.nih.gov/pubmed/1679255?tool=bestpractice.com
[83]Larsen TK, McGlashan TH, Moe LC. First-episode schizophrenia: I. Early course parameters. Schizophr Bull. 1996;22(2):241-56.
http://www.ncbi.nlm.nih.gov/pubmed/8782284?tool=bestpractice.com
[84]Malla AK, Norman RM, Manchanda R, et al. Status of patients with first-episode psychosis after one year of phase-specific community-oriented treatment. Psychiatr Serv. 2002 Apr;53(4):458-63.
http://www.ncbi.nlm.nih.gov/pubmed/11919360?tool=bestpractice.com