Schizoaffective Disorder: Symptoms and Treatment

Schizoaffective Disorder is a mental illness in which patients suffer from a combination of schizophrenia symptoms such as hallucinations and delusions in addition to mood disorders with either depressed or elevated mood. Schizoaffective disorder is less common than independent schizophrenia or mood disorders and is not very well understood. About 0.3% of the population is affected by this illness with an equal occurrence in men and women although an earlier age of onset is noted in men.

Types of Schizoaffective disorder

There are two types:

• Bipolar type: In this, the person experiences both elevated mood or mania and depressive episodes.
• Depressive type: In this, the person experiences only depressive episodes.

Symptoms of Schizoaffective Disorder

Due to its unpredictable nature, different individuals experience a unique combination of symptoms. Psychotic Symptoms which are typical of schizophrenia:

• Hallucinations: These include hearing voices or seeing objects and people that are not present.
• Delusions: These are false, fixed and unshakable beliefs which may include paranoid beliefs or may be bizarre.
• Disorganization: This includes impairment of daily functioning with regard to self care and fulfilling responsibilities to work and family.

Symptoms related to mood disturbance include:

• Depression or low mood
• Suicidal ideation or attempts
• Elevated mood or manic episodes: these maybe be marked with excessive cheerfulness and energy and grandiose ideas with decreased need for sleep.

Diagnosis of Schizoaffective disorder

The diagnosis is made by a psychiatrist after a complete evaluation which will include taking a history of symptoms from the individual, their family and friends if required. A mental state examination is done to assess for hallucinations and delusions.

According to the DSM-5, the diagnosis is made if the following criteria are met:

• The individual experiences abnormalities in mood only during psychotic symptoms
• Their psychotic symptoms have occurred for at least 2 weeks alone without a simultaneous mood disturbance.

If the symptoms described above occur alongside utilization of any medicines or substances like alcohol and drugs, the diagnosis of schizoaffective disorder is not considered.

Treatment of Schizoaffective disorder

There is no cure for this illness. It is managed similarly to the management of schizophrenia and mood disturbances with a combination of medications, psychotherapy and patient and family education. The medicines are tailored to the patients’ requirements based on prevalent symptoms. The following modalities are used:

• Antipsychotic medicines
• Antidepressants
• Mood stabilizers
• Cognitive-behavioral therapy
• Family focussed therapy

Prognosis of Schizoaffective Disorder

This is a chronic illness which requires lifelong treatment to control. The use of medications and therapy help in bringing down the severity and frequency of episodes and helps individuals lead reasonably normal lives.

References:

• Schizoaffective Disorder | NAMI: National Alliance on Mental Illness [Internet]. [cited 2018 Jul 3].
• American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders [Internet]. Fifth Edition. American Psychiatric Association; 2013.