A group of patients (n=48) with a manifestation of depressive schizoaffective disorder (SAD) (F25.1 ICD-10) was studied. The considerable frequency (79.2%) of pre-manifest affective disorders, which preceded the development of psychosis in overwhelming majority of cases (81.6%), was found. In accordance with the modality of the affect, pre-manifest affective disorders were attributed to depression (60.5%), bipolar affective disorder (31.6%), with dual phases, or, more rarely, with continuous course, and hypomania (7.9%). The considerable frequency (47.9%) of hypomania, bipolar disorder, mixed depression, alternating variants of mixed disorders was found at the active stage of current depressive SAD, in the end of the attack or in the next post-psychotic period without concomitant positive symptoms. Depending on the number of psychopathological syndromes, authors singled out mono- and polymorphic structures of a manifestation of depressive SAD. A number of significant clinical features inherent to the polymorphic clinical structure of depressive SAD, including those with mixed affective disorders, was noted compared to the monomorphic structure of the attack.