Schizoaffective Disorder

Written by Janelle Martel
Medically Reviewed by George Krucik, MD

What Is Schizoaffective Disorder?

Schizoaffective disorder is a psychological condition that comprises both psychosis (loss of contact with reality) and mood disorders (such as mania or depression). It is divided into two subtypes based on the type of mood disorder that is involved:

  • depressive subtype: involves major depressive episodes only
  • bipolar subtype: involves manic episodes (high energy with extreme elevated, expansive, or irritable mood) with or without depressive episodes

Symptoms of psychosis and mood disorders may occur together or separately. Oftentimes, individuals with schizoaffective disorder experience symptoms in cycles alternating with periods of improvement. Schizoaffective disorder is less common than schizophrenia and mood disorders. Unfortunately, not many studies have been done on the disorder. Estimates published in the Archives of General Psychology suggest that it is fairly rare, affecting less than 1 percent of the population. It is also thought to affect women more often than men (Perälä, et al, 2007).

What Is the Cause of Schizoaffective Disorder?

The cause may be an abnormality in the chemicals in the brain, such as an imbalance in serotonin and dopamine. This disorder appears to have a genetic link. Environmental factors, exposure to viruses or toxins while in the womb, and birth defects also may contribute. Some experts do not believe that schizoaffective disorder is a separate disorder from schizophrenia.

Signs and Symptoms

Symptoms of schizoaffective disorder can vary greatly. Many individuals also experience improvements in their symptoms from time to time. Symptoms include:

  • paranoid thoughts
  • delusions
  • hallucinations
  • confusion
  • disorganized thoughts
  • speaking too quickly
  • depression or irritability
  • hyperactive or manic mood
  • difficulty concentrating
  • changes in appetite
  • thoughts of suicide
  • poor personal hygiene
  • trouble sleeping
  • social isolation

Tests and Diagnosis

If you are experiencing symptoms, your doctor will perform a physical exam. This is to look for any physical conditions that may be causing your symptoms. Seizure disorders, for example, can cause symptoms similar to schizoaffective disorder. Your doctor will also ask you about any drugs you are taking. Steroid medications, cocaine, amphetamines, and phencyclidine (PCP) can cause symptoms of schizoaffective disorder. After a physical cause has been ruled out, your doctor will send you to a mental health professional.

A mental health professional will interview you to gain more information about your symptoms. He or she will ask you about your symptoms and the thoughts that you are having. You will also be asked about your childhood and any history you have with psychiatric disorders. The mental health professional will use your responses to create a diagnosis and treatment plan for you. Schizoaffective disorder can cause symptoms similar to other psychiatric disorders, which is why it is important to receive a diagnosis. A diagnosis of schizophrenia or mood disorder may change later to schizoaffective disorder and vice versa.

The criteria for diagnosing schizoaffective disorder, based on the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders, include:

  • an uninterrupted period of illness that includes symptoms of mood disorder (mania, depression, or a mixture)
  • during that same period of illness, symptoms of psychosis exist for two weeks while mood is normal
  • symptoms of mood disorder are present a substantial portion of the time
  • symptoms are not due to the effects of drug abuse, medication, or a general medical condition

Treatment Options

Treatment can vary. Medications that may be prescribed for treatment include:

  • antipsychotics
  • antidepressants
  • mood stabilizers

Therapy may be introduced to help you cope with the symptoms of your disorder. You will learn skills to solve problems and improve relationships. All of your sessions will apply to real-life situations. You may also learn skills to help you find a job and be successful in the workplace. You will learn how to manage your finances and living situation. Group therapy is another option for individuals with schizoaffective disorder. A group therapy setting can help increase your social interaction. You will learn how to communicate with others.

Long-Term Outlook for Schizoaffective Disorder

The outlook for someone with schizoaffective disorder is better than that for individuals with most other psychotic disorders. However, there is no cure for schizoaffective disorder, so long-term treatment is required. However, many individuals being treated for schizoaffective disorder are able to live fulfilling lives.

Complications of Schizoaffective Disorder

The complications for people with schizoaffective disorder are similar to those for schizophrenia and major mood disorders:

  • drug abuse
  • difficulty staying on a treatment regimen
  • suicidal behavior
  • manic behaviors such as spending sprees and promiscuity
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