Schizoaffective disorder

Schizoaffective disorder is a perplexing mental illness that shares the features of both schizophrenia and bipolar disorder either simultaneously or at different points during course of their illness (Dlores Malaspina, 2013). The typical age of onset is late adolescence or early adulthood, 0.5{d1272f9be01bb360d2e08f42defc794b644e1298a474496e050da4509a809c3c} of population is affected and women tend to suffer more than men. The illness is thought to be caused by a combination of genetic and environmental factors (although the exact culprit is still not known).

SIGNS AND SYMPTOMS:

Schizoaffective disorder is characterized by:

PSYCHOTIC SYMPTOMS– hallucinations (auditory, most common), delusions and thought disorder

AFFECTIVE SYMPTOMS– mania, hypomania, depression or mixed state

DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) diagnostic criteria for schizoaffective disorder:

  1. Continuous period of illness during which there is a major depressive or manic episode  coexisting  with Criterion A of schizophrenia**.

Note: The major depressive episode must include Criterion A1: Depressed

mood*

  1. Delusions or hallucinations for ≥2 weeks in the absence of a major depressive or manic  episode during the lifetime duration of the illness.
  1. Symptoms that meet criteria for a major mood episode are present for the majority of the total duration of the active and residual portions of the illness.
  1. The disturbance is not attributable to the effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.

SUB TYPES

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 if only major depressive episodes are part of the presentation.

TREATMENT:

PHARMACOTHERAPY: antipsychotics, antidepressants and mood stabilizers ad anti-anxiety medication.

THERAPY: cognitive therapy, family therapy and creative therapies.

LONG-TERM OUTLOOK FOR SCHIZOAFFECTIVE DISORDER:

In short-term and long-term outcome studies, schizoaffective disorder patients had a significantly better prognosis than schizophrenia patients. Long-term outcome for patients diagnosed with schizoaffective disorder paralleled that of affective disorder patients.

 

Reference:

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders 5th ed. Arlington, VA: APA; 2013.

Harrow M, Grossman LS, Herbener ES, Davies EW. Ten-year outcome: Patients with schizoaffective disorders, schizophrenia, affective disorders and mood-incongruent psychotic symptoms. Br J Psychiatry. 2000;177:421–426

Jager M, Bottlender R, Strauss A, Moller HJ. Fifteen-year follow-up of icd-10 schizoaffective disorders compared with schizophrenia and affective disorders. Acta Psychiatr Scand. 2004;109:30–37. [PubMed]

Maj M, Pirozzi R, Formicola AM, Bartoli L, Bucci P. Reliability and validity of the dsm-iv diagnostic category of schizoaffective disorder: Preliminary data. J Affect Disord. 2000;57:95–98.

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