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Schizoaffective disorder

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Illustrations

Schizoaffective disorder
Schizoaffective disorder

Definition    Return to top

Schizoaffective disorder includes elements of both psychosis and mood disorder. Psychotic symptoms mean a loss of contact with reality, and may include hallucinations (hearing voices or seeing things that are not present), and delusions (false, fixed beliefs). Symptoms of mood disorder include very low or very high mood with sleep disturbances, changes in energy and appetite, disrupted concentration, and generally poor daily function. Schizoaffective illness features a close interconnection between these 2 sets of symptoms.

Causes, incidence, and risk factors    Return to top

People with this condition often seek treatment for problems with mood, daily function or intrusive thoughts.

To be diagnosed with schizoaffective disorder, a person must experience psychotic symptoms - but normal mood - for at least 2 weeks.

The exact cause of the condition is unknown, but factors that affect the development of both psychosis and mood disorders may play a role. These factors may include a strong genetic component and other biochemical factors.

It is not known how commonly schizoaffective disorder occurs, but it is believed to be less common than schizophrenia or mood disorders. Women may be affected more often than men. While mood disorders are relatively common in children, a full syndrome of schizophrenia is not. Therefore schizoaffective disorder tends to be rare in children.

Symptoms    Return to top

The clinical signs and symptoms of schizoaffective disorder include all the signs and symptoms of psychotic and mood disorders, appearing together or in alternating fashion. The course feature cycles of worsening and improvement, or long-term deterioration. The symptoms of schizoaffective disorder vary greatly from person to person.

Signs and tests    Return to top

The combination of psychotic and mood symptoms in schizoaffective disorder can be seen in other illnesses, such as bipolar disorder. The extreme disturbance in mood is an important part of the illness.

However, the psychotic symptoms in schizoaffective disorder do not necessarily resolve with effective treatment of the mood disorder. Such symptoms usually do resolve in the treatment of mood disorders with psychotic features. Also, psychotic symptoms usually continue for at least 2 weeks with normal mood.

Any medical, psychiatric, or drug-related condition that causes psychotic or mood symptoms must be considered. Patients undergoing treatment with steroids, abusers of cocaine, amphetamines and phencyclidine (PCP), and some patients with seizure disorders, are particularly likely to have concurrent schizophrenic and mood disorder symptoms.

Treatment    Return to top

The treatment of people with schizoaffective disorder varies, but generally involves medications to stabilize mood and to treat psychosis. Neuroleptic medications (antipsychotics) are used to treat psychotic symptoms.

Lithium may be used to manage mania and to stabilize mood. Anti-seizure medications such as valproic acid and carbamazepine are effective mood stabilizers. These medications may take up to 3 weeks to relieve symptoms.

Usually the combination of antipsychotic and mood-stabilizing medication controls both depressive and manic symptoms, but antidepressants may also be needed in some cases.

Expectations (prognosis)    Return to top

People with schizoaffective disorder may have a favorable prognosis, with a greater chance of returning to a previous level of functioning than patients with other psychotic disorders. However, long-term treatment is necessary, and individual outcomes may vary.

Complications    Return to top

Complications are similar to those for schizophrenia and major mood disorders. These include:

Calling your health care provider    Return to top

Call your provider or mental health professional if you or someone you know is experiencing any of the following:

Update Date: 5/4/2004

Updated by: Ram Chandran Kalyanam, M.D., Department of Psychiatry, Western Psychiatric Institute and Clinic of the University of Pittsburgh Medical Center, Pittsburgh, PA. Review provided by VeriMed Healthcare Network.

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