Schizoaffective disorder is a medical condition which includes both schizophrenia symptoms and a mood disorder.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) of the American Psychological Association ( APA), schizoaffective disorder includes many of the diagnostic characteristics of a mood aspect of schizophrenia.
In this post, we discuss the characteristics, symptoms, and diagnosis of schizoaffective disorder as well as alternative treatment routes.
What is schizoaffective disorder?
Schizoaffective disorder is defined in the DSM-5 as “the intermediate between schizophrenia and bipolar disorder, and may not be a separate diagnostic entity.”
Of this reason , some people refer to the combination of schizophrenia and symptoms of mood disorder as schizoaffective-type schizophrenia although this is not a form of DSM-5-recognized schizophrenia.
Schizoaffective disorder can include psychotic symptoms such as mania or depression, as well as schizophrenic traits including hallucinations and delusions. Symptoms can also include speech or behavior erratic, and lack of emotional expression and motivation
A person with schizoaffective disorder can experience auditory hallucinations, which means listening to not real sounds and voices. They may have delusions and hysteria too. Discourse and thought may be disorganized, and it may be difficult for an individual to function socially and at work.
One study from Finland estimated that schizoaffective disorder occurs in around 3 in every 1,000 people. Nevertheless, the actual occurrence of this series of symptoms is unclear due to difficulties in distinguishing the disease from the schizophrenia or bipolar disorder.
Treatment may improve, but schizoaffective disorder is a complex condition, so it’s more difficult to treat than just a mood disorder.
Symptoms
Schizoaffective signs include symptoms of schizophrenia, such as:
- an uninterrupted period of illness, during which there is a major depressive or manic mood episode occurring alongside schizophrenia symptoms.
- delusions or hallucinations for a further 2 weeks in the absence of a major depressive or manic mood episode throughout the lifetime of the illness.
- symptoms that meet criteria for a major mood episode and are present for the majority of the total duration of the active and residual portions of the illness.
- disturbance that is not attributable to another medical condition or the effects of a substance, such as a drug of abuse or medication.
Specific symptoms include:
- delusions, or fixed or false beliefs
- disorganized, confused, and unclear thinking
- unusual thoughts and perceptions
- hallucinations
- paranoid ideas and thoughts
- periods of depression
- manic mood, or unexpected boosts of energy, with behaviors that are out of character
- erratic and uncontrollable temper
- irritability
- incoherent speech, often switching between topics that do not relate to the current conversation
- difficulties in holding attention
- catatonic behavior in which a person hardly responds or seems agitated without an apparent cause
- a lack of concern for personal hygiene or physical appearance
- sleep disturbances and difficulties
In schizoaffective disorder bipolar disorder and depression are the most common mood disorders that accompany these characteristics of schizophrenia.
Causes
Scientists still don’t know why people are developing schizo-affective disorder, but some suspect it might have a genetic component.
According to the National Institutes of Health ( NIH), if a first degree relative, such as a parent, sibling , or child has it, a individual might be at an elevated risk of developing schizoaffective disorder.
The risk of an individual can also increase if a first-degree relative has schizophrenia, bipolar disorder or another condition of mental health.
Some studies have suggested that children born to men who are in their late 30s and 40s at the time of conception may have an increased risk of developing a schizophrenia- spectrum disorder, including schizoaffective disorder. There’s little proof to support this, however.
Diagnosis
A medical professional may focus their diagnosis on the self-reported observations of an individual, as well as reports of unusual or uncharacteristic behavior witnessed by family members, associates, and colleagues.
In a clinical examination a psychiatrist or psychiatric nurse practitioner can diagnose schizoaffective disorder.
The condition is characterized by a number of criterias. Such criteria focus on the basic signs and symptoms of a person, as well as how long they have endured those effects.
According to DSM-5, the criteria include:
- schizophrenia with mood symptoms
- a mood disorder with symptoms of schizophrenia
- both a mood disorder and schizophrenia
- a non-schizophrenic psychotic disorder alongside a mood disorder
Other criteria, according to the APA, include the recognition of positive symptoms, which refers to active changes in patterns of thought or behaviour, including:
- delusions
- hallucinations
- incoherent or disordered speech
- disorganized behavior in the form of inappropriate dress or frequent weeping
A doctor can also remember negative symptoms. May involve a loss of function or withdrawal that is likely to be apparent in an individual who does not have the condition.
Negative symptoms may include:
- a declining interest in previously enjoyable activities, such as socializing, sexual relations, and interpersonal relationships
- problems concentrating
- changes in sleep cycle
- low motivation to leave the house
- social difficulties in communicating with people
A doctor must rule out other general medical conditions with similar symptoms before making a diagnosis, including:
- Cushing’s syndrome
- HIV-related illnesses
- temporal lobe epilepsy
- neurosyphilis
- thyroid or parathyroid problems
- alcohol or drug use disorders
- metabolic syndrome
Using a range of blood tests and scans, including electroencephalography ( EEG) and CT scans, they can rule out such conditions.
Bizarre delusions or hallucinations consisting of at least two voices speaking with each other or only one voice engaging in a running commentary on the behavior of the patient meet the diagnostic criteria alone.
Subtypes
The actual presentation of a schizoaffective disorder by an individual may fit into at least two subtypes depending on the disorder’s mood component. These include:
- Type Bipolar: A person has manic or mixed episodes.
- Depressive type: There are only severe episodes of depression without psychotic or mixed episodes.
A medical difficulty is distinguishing between schizoaffective disorder , schizophrenia and mood disorder. Nevertheless, mood changes are more severe in schizoaffective disorder, which usually last much longer than in schizophrenia.
Schizoaffective disorder can also occur during catatonia, causing a series of symptoms that may vary in movement and behavior.
Treatment
Psychiatrists also find schizoaffective conditions difficult to diagnose and treat.
Treatment usually requires a mixture of drugs such as antipsychotics, antidepressants, or mood stabilizers, and therapeutic treatments such as counselling.
Form and level of treatment depend on symptom frequency and the subtype involved.
Medications
A variety of medications is available to treat schizoaffective disorder, including:
- Antipsychotics, or neuroleptics: These can relieve psychotic symptoms, such as hallucinations, paranoia, and delusions. Examples include clozapine (Clozaril), risperidone (Risperdal), and olanzapine (Zyprexa).
- Mood stabilizers: This type of medication helps to regulate the highs and lows of bipolar disorder in people who have bipolar-type schizoaffective disorder. Examples include lithium (Eskalith, Lithobid) and divalproex (Depakote).
- Antidepressants: These can reduce symptoms of major depression, including hopelessness, lack of concentration, insomnia, and low mood. Examples include citalopram (Celexa) and fluoxetine (Prozac).
Counseling and psychotherapy
The aim of therapy sessions is to help an person understand their condition, to recover some quality of life, and to begin moving forward.
Usually, sessions focus on real-life plans, relationships and how to tackle issues. The therapist may also introduce new training habits at home and in the workplace.
Community or family counseling sessions provide an opportunity to address problems with loved ones or other people with the same experience. During times of psychosis, these interventions will help make sense of the world around a person with schizoaffective disorder. Group work can also may isolating feelings.
Outlook
Some older research has shown that the schizoaffective disorder prognosis could be marginally better than schizophrenia, and marginally worse than the affective psychotic disorder. Yet there are no more recent research available to support this.
Schizoaffective disorder risks include an elevated risk of developing schizophrenia, severe depression or bipolar disorder.
