Schizoaffective disorder is one of the more common and disabling mental illnesses. This illness manifests itself through a combination of symptoms of schizophrenia and an affective (mood) disorder. Today, many believe that this disorder is a form of schizophrenia, though this may be somewhat of an ad hoc assessment.
The diagnosis entails that a person needs to have primary symptoms of schizophrenia (such as delusions, hallucinations, disorganized speech, and disorganized behavior) along with a period of time with symptoms of major depression or a manic episode. There may be two subtypes of schizoaffective disorder:
- Depressive - characterized by major depressive episodes only
- Bipolar - characterized by manic episodes with or without depressive symptoms or depressive episodes
Diagnosing Schizoaffective Disorder
Differentiating schizoaffective disorder from schizophrenia and from other mood disordesr is difficult. The mood symptoms in schizoaffective disorder are more prominent, and last for a substantially longer time than those in schizophrenia. Schizoaffective disorder may be distinguished from a mood disorder by the fact that delusions or hallucinations must be present in persons with schizoaffective disorder for at least two weeks in the absence of prominent mood symptoms. The diagnosis of a person with schizophrenia or mood disorder may change later to that of schizoaffective disorder.
Treatment for Schizoaffective Disorder
The most difficult aspect of treatment is getting the patient to acknowledge the disease. Until they have insight into this disorder, treatment is very difficult and sometimes only possible via court order. One of the more effective treatments of schizoaffective disorder is a combination of drug treatment and psychosocial interventions. Medications include anti-psychotics combined with antidepressants or mood stabilizers. The newer atypical anti-psychotics are safer than the older typical or conventional anti-psychotics. The newer drugs may also have better effects on mood symptoms. Like most drugs these medications have some side effects, especially at higher doses. The side effects may include excessive sleepiness, weight gain, elevation of liver enzymes, and sometimes diabetes. Different anti-psychotic drugs have somewhat different side effect profiles. Changing from one anti-psychotic to another one may help if a person with schizoaffective disorder does not respond well or develops distressing side effects with the first medication. The same principle applies to the use of antidepressants or mood stabilizers.
Studies suggest that cognitive behavior therapy, brief psychotherapy, and social skills training are likely to have a beneficial effect. Most people with schizoaffective disorder require long-term therapy with a combination of medications and psychosocial interventions in order to avoid relapses, and maintain an appropriate level of functioning and quality of life. Read more about schizoaffective disorder.
