Schizoaffective Disorder

Definition

Schizoaffective disorder is an unusual psychiatric condition characterized by symptoms of both psychotic (schizophrenic) and mood (depressive, manic) disorders that may occur together or at different times. Because of these varied and overlapping symptoms, schizoaffective disorder manifests in different ways for different people and, as a result, can be more difficult to diagnose and treat than other mental health conditions.

Symptoms

Two primary types of symptoms occur with schizoaffective disorder. Some are psychotic symptoms, such as hallucinations, delusions, and disorganized thinking, speech, or behavior. The other symptoms are related to mood disorders, such as mania, with racing thoughts, feelings of euphoria or risky behavior, or depression, with feelings of sadness, emptiness or worthlessness. Individuals with this disorder may also have trouble communicating and may neglect to take care of themselves, resulting in poor personal hygiene. Men and women develop schizoaffective disorder at equal rates, but men tend to develop the condition at a younger age. Symptoms may begin in adolescence and worsen with age. If left untreated, people with schizoaffective disorder will find it progressively more difficult to function at home, school, or work on a day-to- day basis.

Because the symptoms of schizoaffective disorder overlap with those of bipolar or depressive disorder and schizophrenia, the condition can be difficult to diagnose. Schizoaffective disorder is diagnosed when there is a period of time with a major depressive or manic mood and, at the same time, at least one symptom of schizophrenia appears, or when there is no sign of a major mood disorder but clear symptoms of schizophrenia, such as delusions or hallucinations, persist for at least two weeks. Although there may be periods of time when there are no symptoms of a mood disorder, they are present most of the time.

Causes

Although the cause is unclear, heredity is thought to play a role in schizoaffective disorder. Someone with a parent or sibling who has schizoaffective disorder, schizophrenia, or bipolar disorder may be at higher than average risk for developing this condition. Scientists are beginning to look for differences in the neurochemistry and brain structure of people with schizoaffective disorder compared with those who don’t have the disorder. Use of psychoactive drugs (such as LSD) has been linked to schizoaffective disorder and extremely stressful events are known to trigger the onset, or the symptoms, of this condition.

Treatments

Treatments for managing schizoaffective disorder are similar to treatments for schizophrenia. They may include antidepressant, antipsychotic, or mood regulating medications. The effectiveness of these drugs can vary from person to person. Medication compliance is a major problem and can be easier to ensure when the patient has a stable social support network. When the proper medication is taken, there is less likelihood of re-hospitalizations, discontinuation of medicine, or dying at a younger age than with inappropriate medication, or no medication at all. Treatment may also include psychotherapies, such as cognitive-behavioral therapy that can help improve the person’s understanding of the condition and ability to manage their day-to-day life, as well as family-focused therapy for the person’s family members.

References

Volavka J, Czobor P, Sheitman B, et al. Clozapine, olanzapine, risperidone, and haloperiodol in the treatment of patients with chronic schizophrenia and schizoaffective disorder. Focus. Jan 2004; 2(1): 59-67. http://focus.psychiatryonline.org/doi/10.1176/foc.2.1.59 utm_source=TrendMD&utm_medium=cpc&utm_campaign=Focus_TrendMD_0

Tiihonen J, Walhbeck K, Lonnqvist J, et al. Effectiveness of antipsychotic treatments in a nationwide cohort of patients in community care after first hospitalisation due to schizophrenia and schizoaffective disorder: observational follow-up study. BMJ. 27 July 2006; 333. http://www.bmj.com/content/333/7561/224.short

National Alliance on Mental Illness website. Schizoaffective Disorder. [Accessed April 10, 2017.] http://www.nami.org/Learn-More/Mental-Health-Conditions/Schizoaffective-Disorder

American Psychiatric Association. Understanding Mental Disorders: Your Guide to DSM-5. 2015. American Psychiatric Publishing.

Last reviewed 10/19/2017