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The key path
- Schizoaffective disorder is a mental health condition with both psychotic and mood disorder symptoms.
- People with schizoaffective disorder have periods where symptoms get better and worse.
- If the schizoaffective disorder is of the bipolar type, the person may have depressive episodes as well as manic episodes.
Schizoaffective disorder is a chronic mental health condition that combines symptoms of mood disorders (eg, mania and/or depression) with symptoms of psychosis (eg, hallucinations and delusions). Depending on which type of mood symptoms are present, schizoaffective disorder is diagnosed as either bipolar or depressive.
The prevalence of schizoaffective disorder in the population is thought to be around 0.3%, Which is less than schizophrenia or mood disorder. Research shows that women are at a slightly higher risk, but men develop the disorder at a younger age. It is usually first diagnosed between the ages of 16 and 30 and is rare in children.
People with schizoaffective disorder have periods of improvement followed by periods of worsening symptoms.
Whether you have been diagnosed with schizoaffective disorder or are concerned that someone you know may have the disorder or has recently been diagnosed, it is important to understand the common symptoms, how the diagnosis is made, and how treatment can help reduce symptoms and improve functioning in daily life.
Symptoms of schizoaffective disorder
The symptoms of schizoaffective disorder are severe and vary from person to person. These can be broadly classified into depressive symptoms, manic symptoms and schizophrenia symptoms.
Individuals with the bipolar type will experience a depressive episode and may have depressive episodes, while those with the depressive type will only experience depressive symptoms.
Symptoms of depression
The depressive symptoms of schizoaffective disorder can be psychological or physical. Psychiatric symptoms include:
- Sadness
- Feeling useless
- Hopelessness
- restlessness
- Lack of energy
- Loss of interest in usual activities
- Difficulty concentrating
- crime
- Blame yourself
- Thoughts of death or suicide
Physical symptoms may include:
- Poor appetite
- Weight loss or gain
- Sleeping too much or too little
Enemic symptoms
People with bipolar schizoaffective disorder may experience mania, which also has psychological and physical symptoms.
Psychiatric symptoms may include:
- Risky or self-destructive behavior (eg, spending, reckless driving, risky sex)
- Aphoria
- Irritable mood
- Racing ideas
- Magnificence
- Engagement
Physical symptoms may include:
- Increased energy and/or activity (eg, at work, socially, sexually)
- Talking more or faster than usual
- Less need for sleep
Psychiatric symptoms
Like other groups of symptoms, psychological symptoms can be divided into psychological and physical effects.
Psychiatric symptoms may include:
Physical symptoms include slow or no movement (catonia) and poor personal hygiene.
Although the above psychological symptoms describe how schizoaffective disorder appears to an outsider, it is also helpful to learn what these symptoms feel like to someone who has the disorder.
Disorganized thinking
If you’re experiencing disorganized thinking, you may feel like your thoughts are fuzzy or everything feels disconnected. When you talk, you may not remember what you were talking about, so it’s hard for people to follow what you’re saying. You may also feel that your thoughts are out of control.
Thinking that you are being controlled
You feel that you are being controlled by external forces such as aliens, God, or Satan. You may feel that someone is putting ideas into your head or that your thoughts are being erased. You may also feel as if others can hear or access your thoughts.
deception
You may hear one or more sounds that actually sound and seem to come from outside of you but no one else can. Maybe you start talking to them or doing things they ask you to do. In fact, these sounds are created by your mind and are not real.
Frauds
Delusions are things you believe to be true but are not perceived as real by everyone. They can start suddenly or form over time. Sometimes they relate to sounds you hear and seem to explain them in some way.
Most often delusions are baseless, such that you think people are conspiring against you or spying on you. You may choose to avoid these people because it may feel too creepy.
Suicidal ideation
Suicidal ideation and behavior can also be a problem for some people with schizoaffective disorder. If you know someone is at risk of attempting suicide or harming another person, stay with the person while you call 911 or your local emergency number. Another alternative is to take the person to the nearest hospital emergency room if you believe you can do so safely.
Complications of schizoaffective disorder
There are several potential complications of having schizoaffective disorder, including:
- Health problems
- homeless
- Poor academic and professional functioning
- Interpersonal conflicts
- poverty
- Stay away from people
- Substance use
- Suicidal thoughts and attempts
- Difficulty adhering to treatment
- unemployment
Diagnosis of schizoaffective disorder
Schizoaffective disorder is associated with other conditions so it can be difficult to diagnose. Sometimes, it’s misdiagnosed as just bipolar disorder or schizophrenia, which is why it’s important for mental health professionals to take a thorough history of symptoms before making a diagnosis.
A physical exam can be the first step in diagnosing schizoaffective disorder to rule out any possible medical contributions to the symptoms. Depending on the suspected diagnosis, this may mean undergoing blood tests and brain imaging.
Next, a psychiatrist or psychologist will conduct a clinical interview to determine whether the symptoms meet the criteria described in the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5). It includes a period of major mood disorder (depression or mania) and at least two of the following schizophrenia symptoms (at least one of the first three is required).
- Frauds
- deception
- Disorganized speech
- Disorganized or catatonic behavior
- Negative psychological symptoms
In addition, most hallucinations or delusions occur for two or more weeks in the absence of a mood episode. Mood symptoms may also be present for most of the duration of the illness.
Causes of schizoaffective disorder
Researchers do not know exactly what causes schizoaffective disorder. However, some suggest that it may result from a combination of risk factors that affect brain development early and throughout childhood and adolescence. These include:
- Birth defects
- Brain chemistry and structure
- Genetics
- Life stressors (death in the family, loss of job, breakup of marriage)
- Psychiatric or psychoactive drug use
- Viral infections including while in utero
Related Terms
People with schizoaffective disorder may also live with overlapping disorders such as attention deficit hyperactivity disorder, post-traumatic stress disorder (PTSD), anxiety disorders, and substance and alcohol use.
A co-occurring disorder can exacerbate the symptoms of schizoaffective disorder and make a person less likely to follow their treatment regimen. This is why proper diagnosis and integrated treatment are essential when it comes to managing and coping with dual diagnosis.
Schizoaffective disorder is often confused with other mental illnesses, including schizophrenia and bipolar disorders. These are two distinct disorders, however, each with their own diagnostic criteria and treatment. Although they share many symptoms, the main difference is that there is a prominent mood component with schizoaffective disorder.
recovery
Genetics, brain development, brain chemistry, stress and substance use may play a role in the development of schizoaffective disorder. It is also common for people with this condition to have mental illnesses such as ADHD, anxiety disorders, and PTSD.
Treatment of schizoaffective disorder
Treatment can help people with schizoaffective disorder live as long as possible. Treatment may take the form of medication, therapy, or hospitalization, depending on the specific symptoms.
Treatment
Medications such as mood stabilizers (eg, lithium), antipsychotics (eg, paliperidone), and antidepressants (eg, fluoxetine) may be prescribed for various aspects of schizoaffective disorder. Taking antipsychotic medication will help reduce hallucinations and delusions, reduce disorganized thinking, and calm agitation.
It is important for people with schizoaffective disorder to continue taking medications even if they feel better, as these medications help stabilize symptoms and prevent their recurrence.
Often, people with schizoaffective disorder need to take medication for the rest of their lives.
Therapy
Therapy such as cognitive behavioral therapy (CBT), family therapy, group therapy, or skills training may be used to treat schizoaffective disorder.
During therapy, a person with schizoaffective disorder learns about their illness, sets goals, learns how to handle everyday problems, develops skills for communicating with others, looks for a job, and practices life skills such as managing finances, housekeeping, and personal grooming.
Family members can participate in therapy to learn how to help their loved one.
Hospital admission
In the case of a severe psychotic episode, suicidal ideation, or threats to others, hospital treatment may be necessary. Unfortunately, there is no cure for schizoaffective disorder and long-term treatment and management.
However, medication and therapy can help reduce symptom relapse and disruption to a person’s life and the lives of those around them. This is why it is important for them to keep in touch with a psychiatrist to ensure that their treatment is optimal.
recovery
Schizoaffective disorder is a serious and lifelong condition. Effective treatments are available that can help manage symptoms, improve functioning, and promote well-being. In the event of a severe psychotic episode, hospitalization may be necessary.
When to get help
If you know someone who is showing symptoms of schizoaffective disorder, it can be difficult to know how to help. Although you can try to talk to your friend or relative, you can’t force them to seek treatment. Instead, try offering encouragement and practical advice, such as finding a number of doctors or investigating avenues for treatment in the community.
Also, people with this disorder can become disconnected from reality. In the event that the person is struggling with the basic necessities of life, such as food and shelter, or there are safety concerns, you can call 911 and ask for the person to be evaluated for treatment.
