Schizoaffective disorder is a condition in which a person experiences a combination of schizophrenia symptoms — such as hallucinations or delusions — and of mood disorder symptoms, such as mania or depression.
Schizoaffective disorder is not as well understood, or defined, as are other mental health conditions. This is largely because schizoaffective disorder is a mix of multiple mental health conditions that may run a unique course in each affected person.
Untreated, people with schizoaffective disorder may lead lonely lives and have trouble holding down a job or attending school. Or, they may rely heavily on family or live in psychiatric group homes. Treatment can help manage symptoms and improve the quality of life for people with schizoaffective disorder.
Schizoaffective disorder symptoms vary from person to person. Generally, people who have the condition experience psychotic symptoms — such as hallucinations, disorganized thinking and paranoid thoughts — as well as a mood disturbance, such as depressed or manic mood. They tend to be isolated and avoided.
Psychotic features and mood disturbances may occur at the same time or may appear on and off interchangeably. The course of the schizoaffective disorder usually features cycles of severe symptoms followed by an improved outlook. To establish a diagnosis, a person must have demonstrated, at some point, delusions or hallucinations for at least two weeks even when mood disorder symptoms are under control.
Most commonly, the mood disorder accompanying the schizophrenic features is either bipolar disorder (bipolar-type schizoaffective) or depression (depressive-type schizoaffective).
Signs and symptoms of schizoaffective disorder may include:
When to see a doctor
Schizoaffective disorder, like schizophrenia, appears to have distinct genetic links. It's unknown exactly what causes the disorder, but it may involve brain chemistry, such as an imbalance of serotonin and dopamine in the brain. Serotonin and dopamine are neurotransmitters — chemicals that help relay electronic signals in the brain — and help regulate mood.
Exposure in the womb to toxins or viral illness, or even birth complications, also may play a role.
Schizoaffective disorder is thought to involve delays or variations in the way a child's brain develops — like in schizophrenia. Genetics plays a role in development of the disorder, and people with relatives who have schizoaffective disorder are more likely to develop this condition. Environmental factors also may be involved.
Factors that increase the risk of developing the schizoaffective disorder include:
People with schizoaffective disorder are at an increased risk of:
Preparing for your appointment
If you're seeking help for someone with mental illness, you may start by seeing his or her family doctor or a general practitioner. However, in some cases when you call to set up an appointment, you may be referred immediately to a psychiatrist.
It's a good idea to prepare for the appointment. Here's some information to help you.
What you can do
Preparing a list of questions ahead of time will help you make the most of your time with the doctor. For schizoaffective disorder, some basic questions to ask include.
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
What you can do in the meantime
Tests and diagnosis
Diagnosis of schizoaffective disorder usually comes after an in-depth interview with a doctor. As part of this interview, the doctor will likely take a medical, psychiatric and social history and also ask about symptoms and mental well-being. A physical examination can help rule out other conditions, and a mental health professional will likely be consulted.
To be diagnosed with schizoaffective disorder, a person must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association.
DSM criteria for the diagnosis of schizoaffective disorder include:
Diagnosis requires that the condition is not due to the direct effects of a substance — such as a recreational drug or medication — or due to a general medical condition. In addition, the person must never have met the criteria for any other schizophrenic disorder.
Treatments and drugs
People with schizoaffective disorder generally respond best to a combination of medications and counseling. Treatment varies depending on the type and severity of symptoms, and whether the disorder is depressive-type or bipolar-type.
In general, doctors prescribe medications to relieve psychotic symptoms, stabilize mood and treat depression. The only medication approved by the Food and Drug Administration (FDA) for the treatment of schizoaffective disorder is the antipsychotic drug paliperidone (Invega). However, a number of medications approved for the treatment of other mental health conditions also may be helpful for schizoaffective disorder.
In addition, psychotherapy can help normalize thought patterns, teach social skills and reduce social isolation.
Medications used to treat schizoaffective disorder may include:
Nonmedication therapy may include:
In general, people with schizoaffective disorder have a better prognosis than people with schizophrenia, but not as good as people with mood disorders only. Long-term treatment is necessary, and the prognosis varies from person to person.
Last Updated: 2010-12-21
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