related disorders
Schizoaffective Disorder
Introduction
Schizoaffective Disorder is a major psychiatric illness whose essential feature is the presence of both mood symptoms and symptoms of psychosis. It may be very difficult to distinguish this illness from Schizophrenia or mood disorders, particularly Bipolar Disorder, since there are no symptoms that individuals with Bipolar Disorder may not share with sufferers of Schizophrenia at some point during the course of their illness.
Subtypes
There are two subtypes of Schizoaffective Disorder:
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Depressive subtype, where only episodes of major depression are present. -
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Bipolar subtype, where manic episodes (with or without depressive symptoms or episodes) are present.
Prevalence
There are no firmly accepted figures related to the prevalence of this illness, but estimates place this figure at somewhere between 0.2% and 0.5%, somewhat less than the prevalence of schizophrenia.
Relationship to Schizophrenia
While there has been debate in the past, most clinicians now consider this disorder to be a part of the spectrum of illnesses that we refer to as Schizophrenia. If that is indeed the case, Schizoaffective Disorder may constitute a significant portion of people with Schizophrenia.
Diagnostic Criteria
The diagnosis of Schizoaffective Disorder is made when a person demonstrates primary symptoms of Schizophrenia and periods of time that meet criteria for either episodes of Major Depression or Mania.
What separates a person with this illness from someone who has a mood disorder (such as Major Depression or Bipolar Disorder), is that delusions or hallucinations must be present for at least two weeks at a time when there are no mood symptoms. What distinguishes this illness from Schizophrenia is that the mood symptoms are more intense and persistent than they would be in Schizophrenia.
Treatments
Standard treatment options are the same as for Schizophrenia and mood disorders. They include the combination of medications and and other interventions, such as psychotherapies. Psychotherapies include cognitive behavioral therapy, brief psychotherapy, and social skills training.
Medications consist of antipsychotics, antidepressants, and mood stabilizing agents. Atypical antipsychotics may offer some advantage over older (typical) antipsychotics in terms of their ability to improve mood.
Diagnostic Criteria
The diagnostic criteria for Schizoaffective Disorder include two or more1 of these symptoms present much of the time for at least one month:
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delusions
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hallucinations
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disorganized speech
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disorganized or catatonic behavior
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negative symptoms
Additionally, there must have been at least one episode of:
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major depression
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mania
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mixed episode
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1Only one symptom is necessary if it is a bizarre delusion, a single voice that is making comments, or voices talking with one another.
(Sources: The author’s knowledge base, unless otherwise noted.)
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