Schizoaffective disorder Health Article

Definition

One of the most challenging mental disorders to identify accurately and treat appropriately is schizoaffective disorder. This condition involves both psychotic symptoms and conspicuous, long-enduring, severe symptoms of mood disorder. The cluster of symptoms experienced by persons with schizoaffective disorder can resemble—at various times in its course—bipolar disorder, major depressive episode with psychotic features, or schizophrenia.

The schizoaffective disorder classification is applied when a mental health client meets diagnostic criteria for both schizophrenia and an "affective" (mood) disorder— depression or bipolar disorder. In schizoaffective disorder, the experiencing of mood and psychotic symptoms occurs predominantly simultaneously and the mood disturbance is long lasting. However, periods of experiencing serious psychotic symptoms without serious mood disturbance are also a definitive feature. In bipolar disorder and depression with psychotic features, psychotic symptoms only occur during an active episode of mania or severe clinical depression. Schizoaffective disorder is characterized by periods during which psychotic symptoms are experienced without simultaneous severe mood changes. If the patient is encountered for the first time during such a period of psychotic symptoms in the absence of mood changes, it can appear that the individual has schizophrenia. However, in a person who has psychotic symptoms, the presence of long-standing severe mood disturbance suggests possible schizoaffective disorder if there are also periods of psychotic symptoms without concurrent mood fluctuations.

Schizoaffective disorder is typically identified by a process of lengthy observation and elimination of another diagnostic alternative over a long course of care. Because of the need for longitudinal observation and collection of a wealth of information before an accurate diagnosis is possible, most people with schizoaffective disorder have borne other diagnostic labels prior to the schizoaffective diagnosis (usually, bipolar disorder).

Psychotic symptoms

Both psychotic symptoms and mood disorder symptoms are experienced by the individual with schizoaffective disorder. In schizoaffective disorder, at least two of the major symptoms of psychosis are evident in the client. Classic psychotic symptoms can occur during mood disturbances as well as in periods without extreme mood changes. Hallucinations, delusions, and strange bodily movements or lack of movements (catatonic behavior) are all psychotic symptoms that may be observed. Additionally, minimal or peculiar speech, lack of drive to act on one's own behalf, bizarre or primitive (socially inappropriate or immature) behavior, a wooden quality to one's emotions, or near-absent emotionality are also typical psychotic symptoms that may occur. Of course, not all of the possible psychotic symptoms will occur concurrently in a single person with schizoaffective disorder. Importantly, to meet the criteria for the schizoaffective disorder diagnosis, delusions or hallucinations (the most "prototypical" of the psychotic symptoms) must be observed within a fairly lengthy period of time during which there is no form of mood disturbance.