About schizoaffective disorder

What is schizoaffective disorder?

Schizoaffective disorder is an illness characterized by psychotic symptoms (delusions and hallucinations) and mood problems.

  • There are two types of schizoaffective disorder: bipolar and depressive.
  • There is no specific known cause for schizoaffective disorder.
  • Schizoaffective disorder symptoms and signs include those of schizophrenia in addition to a manic episode and/or a major depressive disorder.
  • The typical treatment for schizoaffective disorder involves the individual taking an antipsychotic drug and possibly a mood stabilizer in addition to psycho-education.

What is schizoaffective disorder?

Schizoaffective disorder is an illness with persistent psychotic symptoms, like hallucinations or delusions, occurring together with mood problems of depressive, manic, or mixed episodes. Statistics on how common this disorder is range from 0.2% in the general United States population up to as much as 9% of psychiatrically hospitalized people. Schizoaffective disorder is thought to occur at least as commonly as schizophrenia and less often than bipolar disorder.

What are the different types of schizoaffective disorder?

There are two types of schizoaffective disorder: bipolar type and depressive type. The bipolar type of schizoaffective disorder is characterized by the illness including at least one manic episode. The depressive type of this illness involves only major depressive episodes as the mood disorder part of the illness.

What are the symptoms for schizoaffective disorder?

Schizoaffective disorder symptoms may vary from person to person. People with the condition experience psychotic symptoms, such as Hallucinations or delusions, as well as symptoms of a mood disorder — either bipolar type (episodes of mania and sometimes depression) or depressive type (episodes of depression).

The course of schizoaffective disorder usually features cycles of severe symptoms followed by periods of improvement with less severe symptoms.

Signs and symptoms of schizoaffective disorder depend on the type — bipolar or depressive type — and may include, among others:

  • Delusions — having false, fixed beliefs, despite evidence to the contrary
  • Hallucinations, such as hearing voices or seeing things that aren't there
  • Symptoms of depression, such as feeling empty, sad or worthless
  • Periods of Manic mood or a sudden increase in energy with behavior that's out of character
  • Impaired communication, such as only partially answering questions or giving answers that are completely unrelated
  • Impaired occupational, academic and social functioning
  • Problems with managing personal care, including cleanliness and physical appearance

When to see a doctor

If you think someone you know may have schizoaffective disorder symptoms, talk to that person about your concerns. Although you can't force someone to seek professional help, you can offer encouragement and support and help find a qualified doctor or mental health professional.

If your loved one can't provide his or her own food, clothing or shelter, you may need to call 911 or other emergency responders for help so that your loved one can be evaluated by a mental health professional.

Suicidal thoughts or behavior

Talk of suicide or suicidal behavior may occur in someone with schizoaffective disorder. If you have a loved one who is in danger of attempting suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you can do so safely, take the person to the nearest hospital emergency room.

What are the causes for schizoaffective disorder?

The exact cause of schizoaffective disorder is not known. A combination of factors may contribute to its development, such as genetics and variations in brain chemistry and structure.

What are the treatments for schizoaffective disorder?

Treatment for people living with schizoaffective disorder tends to be symptom based rather than distinctly different based on the illness itself. In terms of medication treatment, individuals with the bipolar type of the illness seem to respond best to treatment with an antipsychotic drug combined with a mood-stabilizer drug or treatment with an antipsychotic alone. For people with the depressive type of schizoaffective disorder, combining an antipsychotic medication with an antidepressant tends to work best. Since consistent treatment is important to best outcome, psycho-education of the person with the illness and their loved ones, as well as using long-acting medications can be important parts of their care.

For people who don't respond to multiple trials of treatment, electroconvulsive therapy may be an option. Treatment for people who suffer from both schizoaffective disorder and a substance-abuse disorder tends to be most effective when both conditions are specifically addressed.

Antipsychotic medications have been shown to be effective in treating acute psychosis and reducing the risk of future psychotic episodes. The treatment of schizoaffective disorder thus has two main phases: an acute phase, when higher doses of medication might be necessary in order to treat psychotic and severe mood symptoms, followed by a maintenance phase, which could be lifelong. During the maintenance phase, the medication dosage is gradually reduced to the minimum required to prevent further episodes. If symptoms reappear on a lower dosage, a temporary increase in dosage may help prevent a relapse.

Even with continued treatment, some patients experience relapses. By far, though, the highest relapse rates are seen when medication is discontinued. The large majority of patients experience substantial improvement when treated with antipsychotic agents. Some patients, however, do not respond to medications, and a few may seem not to need them. Since it is difficult to predict which patients will fall into what groups, it is essential to have long-term follow-up, so that the treatment can be adjusted and any problems addressed promptly.

What are the risk factors for schizoaffective disorder?

Factors that increase the risk of developing schizoaffective disorder include:

  • Having a close blood relative who has schizoaffective disorder, schizophrenia or bipolar disorder
  • Stressful events that trigger symptoms
  • Taking mind-altering (psychoactive or psychotropic) drugs

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