Schizoaffective Disorder

What Is Schizoaffective Disorder?

Schizoaffective disorder describes a condition that includes features of both schizophrenia and a mood disorder (either major depressive disorder or bipolar disorder).

Scientists don’t know for sure if schizoaffective disorder is related mainly to schizophrenia or a mood disorder. But it’s usually viewed and treated as a hybrid, or combination of both conditions.

Schizoaffective disorder can be managed, but most people diagnosed with it have relapses.

Types of Schizoaffective Disorder

There are two types. Each has some schizophrenia symptoms:

Symptoms of Schizoaffective Disorder

The symptoms may vary greatly from one person to the next and may be mild or severe. They may include:

  • Mania
  • Depression
  • Poor appetite
  • Weight loss or gain
  • Changes in sleeping patterns (sleeping very little or a lot)
  • Agitation (being very restless)
  • Lack of energy
  • Loss of interest in usual activities
  • Feelings of worthlessness or hopelessness
  • Guilt or self-blame
  • Trouble with thinking or concentration
  • Thoughts of death or suicide
  • Being more active than usual, including at work, in your social life, or sexually
  • Talking more or faster
  • Rapid or racing thoughts
  • Little need for sleep
  • Agitation
  • Being full of yourself
  • Being easily distracted
  • Self-destructive or dangerous behavior (such as going on spending sprees, driving recklessly, or having risky sex)
  • Delusions (false, sometimes strange beliefs that the person refuses to give up, even when they get the facts)
  • Hallucinations (sensing things that aren't real, such as hearing voices)
  • Disorganized thinking
  • Odd or unusual behavior
  • Slow movements or not moving at all
  • Lack of emotion in facial expression and speech
  • Poor motivation
  • Problems with speech and communication

Causes of Schizoaffective Disorder

Scientists don’t know the exact cause. Things that may be involved include:

  • Genetics (heredity): Someone may inherit a tendency to get schizoaffective disorder from their parents.
  • Brain structure: People with schizophrenia and mood disorders might have problems with brain circuits that manage mood and thinking.
  • Environment: Scientists think things like viral infections or highly stressful situations could play a part in having schizoaffective disorder in people who are at risk for it. How that happens isn’t clear.

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Schizoaffective disorder usually begins in the late teen years or early adulthood, often between ages 16 and 30. It seems to happen slightly more often in women than in men. It's rare in children.

Because schizoaffective disorder combines symptoms that reflect two mental illnesses, it’s easily confused with other psychotic or mood disorders. Some people may be thought to have schizophrenia, and others may be thought to have just a mood disorder. As a result, it’s hard to know how many people actually have schizoaffective disorder. It’s probably less common than either schizophrenia or mood disorders alone.

Diagnosis of Schizoaffective Disorder

There are no laboratory tests to specifically diagnose schizoaffective disorder. So doctors rely on a person's medical history -- and may use various tests such as brain imaging (like MRI scans) and blood tests -- to make sure that a physical illness isn’t the reason for the symptoms.

If the doctor finds no physical cause, he may refer the person to a psychiatrist or psychologist. These mental health professionals are trained to diagnose and treat mental illnesses. They use specially designed interview and assessment tools to evaluate a person for a psychotic disorder.

In order to diagnose someone with schizoaffective disorder, the person must have:

  • Periods of uninterrupted illness
  • An episode of mania, major depression, or a mix of both
  • Symptoms of schizophrenia
  • At least two periods of psychotic symptoms, each lasting 2 weeks. One of the episodes must happen without depressive or manic symptoms.

Treatment of Schizoaffective Disorder

Treatment includes:

  • Medication: What a person takes depends on whether they have symptoms of depression or bipolar disorder, along with symptoms that suggest schizophrenia. The main medications that doctors prescribe for psychotic symptoms such as delusions, hallucinations, and disordered thinking are called antipsychotics. All antipsychotic drugs likely have value in treating schizoaffective disorder, but paliperidone extended release (Invega) is the only drug that the FDA has approved to treat it. For mood-related symptoms, someone may take an antidepressant medication or a mood stabilizer.
  • Psychotherapy: The goal of this type of counseling is to help the person learn about their illness, set goals, and manage everyday problems related to the disorder. Family therapy can help families get better at relating to and helping a loved one who has schizoaffective disorder.
  • Skills training: This generally focuses on work and social skills, grooming and self-care, and other day-to-day activities, including money and home management.
  • Hospitalization: Psychotic episodes may require a person to be hospitalized, especially if he is suicidal or threatens to hurt others.

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Prevention of Schizoaffective Disorder

You can’t prevent the condition. But if someone gets diagnosed and starts treatment ASAP, it can help a person avoid or ease frequent relapses and hospitalizations, and help cut the disruption to the person's life, family, and friendships.

Schizoaffective Disorder vs. Schizophrenia

Schizoaffective disorder has the features of schizophrenia, like hallucinations, delusions, and disorganized thinking, along with those of a mood disorder, like mania and depression. At first, it’s often misdiagnosed as one of the two.

As a result, schizoaffective disorder treatment often pairs antipsychotics with antidepressants, while schizophrenia treatment centers on antipsychotics. Both conditions rely on therapy.

WebMD Medical Reference Reviewed by Joseph Goldberg, MD on December 19, 2018

Sources

SOURCES:

National Alliance on Mental Illness: "Schizoaffective Disorder."

PubMed Health: "Schizoaffective Disorder."

Mayo Clinic: "Schizoaffective Disorder," “Schizophrenia.”

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