Schizoaffective Disorder

Schizoaffective disorder is a complex and serious psychiatric disorder which is very similar to schizophrenia in many ways. The primary difference, however, is that a person with schizoaffective disorder experiences the symptoms of schizophrenia as well as a significant mood episode (depression, mania or a combination of both).

Diagnosis

Diagnosis of this disorder can be a bit tricky at times. Knowing the timeframes and duration of symptoms, for example, is crucial to determine if schizoaffective disorder is the appropriate diagnosis. Other diagnoses in which both psychosis and mood symptoms are present include schizophrenia, with a second diagnosis of depressive disorder not otherwise specified; or possibly major depressive disorder with psychotic features, to name two.

Characteristics and Symptoms

Unlike schizophrenia, a person diagnosed with schizoaffective disorder must have a continuous period of illness which includes a mood episode at some point. This mood episode must be a manic episode, a major depressive episode, or a “mixed episode”. A mixed episode involves both manic and depressive symptoms. The person must have the mood symptoms during a significant part of the time they are ill.

Also, for at least two weeks during that period of illness, the person experienced either hallucinations or delusions without any pronounced mood symptoms.

Like schizophrenia, a person with schizoaffective disorder must have a one month period in which they exhibit two or more of these symptoms:

  • Delusions
  • Hallucinations (e.g., voices, seeing things)
  • Disorganized speech (e.g., they jump from topic to topic, or their words are gibberish and make no sense)
  • Extremely disorganized behavior, or behavior which is catatonic
  • Negative symptoms such as blunted emotions, severely impaired thinking, or inability to initiate and carry out a task
  • If the delusions are bizarre (i.e., they are completely implausible), or, if they have hallucinations which involve either hearing a voice which is providing a constant commentary on their thoughts or actions or two or more voices have a conversation, then they a second symptom is not required.
  • The person’s illness must not be directly due to a medical condition (e.g., a brain tumor) or a substance (such as drugs, alcohol, or a medication the person is taking).

Treatment

Schizoaffective disorder is treated very similarly to schizophrenia. With regards to medication, antipsychotics are usually necessary to control the psychotic symptoms (e.g., delusions or hallucinations). However, since there is a prominent mood component, an antidepressant medication or mood stabilizer (for mania) is also typically part of the medication regimen.

written by Dr. Cheryl Lane, PsyD