Basics
July 21, 2020

Pranav Harish

What You Need to Know About Schizoaffective Disorder

A person with schizoaffective disorder experiences cycles of symptoms of both schizophrenia and mood disorders such as bipolar disorder or a depressive disorder.

Schizoaffective disorder is prevalent in less than 0.3% of the population. It is more common in women than men, and it develops between the ages of 16 and 30 years.

But, it is unclear whether schizoaffective disorder is related to schizophrenia or mood disorders. It is thus, considered as a combination of both conditions.

Types of Schizoaffective Disorder

"Schizo" refers to the psychotic symptoms associated with schizophrenia. "Affective" refers to the mood symptoms of bipolar/depressive disorder.

Since there are different types of mood disorders, there are also different types of schizoaffective disorders.

Manic Type

Symptoms of both schizophrenia and mania occur during an episode.

Depressive Type

Symptoms of both schizophrenia and depression occur at the same time.

Mixed/Bipolar Type

Symptoms of schizophrenia with mania and depression.

What can cause schizoaffective disorder?

The exact causes of schizoaffective disorder are unclear. However, studies have suggested that it may be hereditary, or certain stressful events can cause its onset.

Significant alterations in the brain circuits and chemistry also seem to cause the disorder. The use of psychoactive drugs like LSD can cause schizoaffective disorder.

What are the symptoms of schizoaffective disorder?

Symptoms tend to be complicated, severe, and vary between individuals. Those who experience symptoms of both mania and depression in cycles are bipolar types. (1)

Manic Symptoms

  1. Risky behavior - spending lots of money, having casual sex with multiple partners, reckless driving, drug and alcohol abuse, or gambling.
  2. Over-enthusiasm and euphoria
  3. Hyperactive and aggressive
  4. Need for less sleep
  5. More irritable than usual
  6. Making irrational plans
  7. Easily distracted and racing thoughts

Depressive Symptoms

  1. Low mood and energy
  2. Hopelessness and loneliness
  3. Negative thoughts
  4. Difficulty concentrating and remembering
  5. Lack of sleep, or sleep too much, or disturbed sleep
  6. Loss or increase in appetite
  7. Suicidal thoughts

Psychotic Symptoms

  1. Hallucinations - see, hear, or feel things that are not real
  2. Delusions - Believe in things that are not true and can cause paranoia
  3. Impaired speech - repeating meaningless words or phrases that don't make sense, unable to hold a conversation
  4. People think they are under the control of outside forces like god or aliens. They start thinking that the thoughts aren't theirs, and someone has inserted into their minds.
  5. Catatonic behavior - Unable to move or slow movements
  6. Negative symptoms - facial expressions, speech, and behavior lacks emotions

Apart from sharing the symptoms of psychosis, the difference in schizophrenia and schizoaffective disorder lies in one crucial fact. That is the occurrence of mood episodes (mania or depression) in schizoaffective disorder, which is otherwise absent in schizophrenia.

Diagnosis

Schizoaffective disorder is one of the most misdiagnosed psychiatric conditions. Knowing the complete medical history of the patient is pivotal in its diagnosis. (2)

A person's diagnosis will depend on the following:

  1. You experience a major mood episode (mania or depression) along with symptoms of schizophrenia in at least one month. The schizophrenia symptoms must be at least two of the following:
  2. Delusions
  3. Hallucinations
  4. Disorganized speech
  5. Catatonic behavior
  6. negative symptoms.
  7. Hallucinations and delusions for at least two or more weeks in the absence of a major mood episode - manic or depression
  8. You experience the symptoms of a major mood disorder (mania or depression) during the majority of the total period of illness. Bipolar type includes cycles of mania and depression, whereas depressive type includes only depression.
  9. Your symptoms are not due to drug or substance abuse.

Treatment

Treatment can help manage the symptoms and ease complications.

Medication -

  • Lithium and mood stabilizers for schizoaffective disorder - manic type
  • Antidepressants for schizoaffective disorder - depressive type
  • Antipsychotics to treat hallucinations and delusions in schizophrenia

Cognitive-behavioral therapy (CBT) will help you recognize the symptoms, learn about the illness, determine how to manage and control issues, improve cognitive and social skills, self-manage, prevent relapse, and lead a better life.

In severe cases, when a person appears to be suicidal or a threat to others, then hospitalization is imperative.

There is no cure for schizoaffective disorder. However, medication and therapy can help improve your life and the lives of those around you.

References:

(1) Douglas F. Levinson, C. Umapathy, and Mohamado Musthaq. Treatment of Schizoaffective Disorder and Schizophrenia With Mood Symptoms. American Journal of Psychiatry. 1999;156(8):1138-1148.

(2) Tom Joshua P and Abdolreza Saadabdi. Schizoaffective Disorder. StatPearls. 2020 Jan; NBK541012.

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