Schizoaffective Disorder.

Schizoaffective Disorder is an uninterrupted illness featuring at some time a major depressive episode, manic episode, or mixed episode concurrently with characteristic symptoms of schizophrenia (e.g., delusions, hallucinations, disorganized speech, catatonic behavior).

In the same period, delusions or hallucinations for at least 2 weeks in the absence of prominent mood symptoms. DSM–5 identifies the mood episodes only as either major depressive or manic and emphasizes that mood disturbances must be present for a majority of the time. Also called schizoaffective psychosis; schizoaffective schizophrenia.

People who had symptoms of schizophrenia and who exhibited the characteristics of mood disorders (for example, depression or bipolar disorder) were lumped in the category of schizophrenia. Now, however, this mixed bag of problems is diagnosed as schizoaffective disorder. The prognosis is similar to the prognosis for people with schizophrenia. That is, individuals tend not to get better on their own and are likely to continue experiencing major life difficulties for many years.

There are two types. Each has some schizophrenia symptoms:

1. Bipolar type: This condition features one or two types of different mood changes. People with bipolar disorder have severe highs (mania) alone or combined with lows (depression).
2. Depressive type: People who have depression have feelings of sadness, worthlessness and hopelessness. They may have suicidal thoughts. They may also experience concentration and memory problems.

Diagnostic Criteria for Schizoaffective Disorder.

A. An uninterrupted period of illness during which there is a major mood episode (major depressive or manic) concurrent with Criterion A of schizophrenia.
Note: The major depressive episode must include Criterion A1: Depressed mood.

B. Delusions or hallucinations for 2 or more weeks in the absence of a major mood episode (depressive or manic) during the lifetime duration of the illness.

C. Symptoms that meet criteria for a major mood episode are present for the majority of the total durance of the active and residual portions of the illness.

D. The disturbance is not attributable to the effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.

Specify whether:

Bipolar type: This subtype applies if a manic episode is part of the presentation. Major depressive episodes may also occur.

Depressive type: This subtype applies only if only major depressive episodes are part of the presentation.

Specify if: With catatonia.

Symptoms.

The symptoms may vary greatly from one person to the next and may be mild or severe. They may include:

• Psychotic symptoms:

1. 1. Delusions (false beliefs with no basis in reality that the person won’t give up, even if given evidence to the contrary).
   2. Hallucinations (perceived sensations that aren’t real, such as hearing voices or seeing shadows).
   3. Inability to tell real from imaginary.
   4. Disorganized speech (difficulty producing clear and coherent sentences).
   5. Unclear thinking.
   6. Odd or unusual behavior.
   7. Paranoia.
   8. Lack of emotion in facial expression and speech.
   9. Poor motivation.
   10. Slow movements or inability to move.

• Depression symptoms:

1. 1. Low or sad mood
   2. Thoughts of death or suicide.
   3. Feelings of worthlessness or hopelessness.
   4. Guilt or self-blame.
   5. Lack of energy and low mood
   6. Loss of interest in usual activities.
   7. Poor appetite.
   8. Changes in sleeping patterns (sleeping a little or a lot).
   9. Trouble thinking or concentrating.
   10. Weight loss or gain.

• Mania symptoms:

1. 1. Agitation.
   2. Distractibility.
   3. Increased or rapid talking.
   4. Increased work, social and sexual activity.
   5. Inflated self-esteem.
   6. Not sleeping much.
   7. Rapid or racing thoughts.
   8. Self-destructive or dangerous behavior (spending sprees, reckless driving, unsafe sex).

Causes of Schizoaffective Disorder

Scientists don’t know the exact cause of Schizoaffective disorder. Risk factors for schizoaffective disorder include:

1. Genetics: You may inherit a tendency to get features linked to schizoaffective disorder from your parents.
2. Brain chemistry and structure: If you have schizophrenia and mood disorders, you might have problems with brain circuits that manage mood and thinking. Schizophrenia is also tied to lower levels of dopamine, a brain chemical that also helps manage these tasks.
3. Environment: Some scientists think things like viral infections or highly stressful situations could play a part in getting schizoaffective disorder if you’re at risk for it. It is unclear how that happens.
4. Drug use: Taking mind-altering drugs. (Your doctor may call them psychoactive or psychotropic drugs.)

Treatment of Schizoaffective Disorder.

• Skills training: This generally focuses on work and social skills, grooming and self-care, and other day-to-day activities, including money and home management.
• Hospitalization: Psychotic episodes may require a hospital stay, especially if you’re suicidal or threaten to hurt others.
• Electroconvulsive therapy: This treatment may be an option for adults who don’t respond to psychotherapy or medications. It involves sending a quick electric current through your brain. (You’ll get a type of medicine called general anesthesia to help you sleep through it.) It causes a brief seizure. Doctors use it because they think it changes your brain chemistry and may reverse some conditions.
• Psychotherapy: The goal of this type of counseling is to help you learn about your illness, set goals, and manage everyday problems related to the disorder. Family therapy can help families get better at relating to and helping a loved one who has schizoaffective disorder.

Reference,

David H. Barlow, V. Mark Durand. Abnormal Psychology, An Integrative Approach. (7th ed).