Schizoaffective Disorder
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Schizoaffective disorder is a serious mental illness that has features of two different conditions, schizophrenia and an affective (mood) disorder, either major depression or bipolar disorder.
Schizophrenia is a brain disorder that distorts the way a person thinks, acts, expresses emotions, perceives reality and relates to others. Depression is an illness that is marked by feelings of sadness, worthlessness or hopelessness, as well as problems concentrating and remembering details. Bipolar disorder is characterized by cycling mood changes, including severe highs (mania) and lows (depression).
Schizoaffective disorder is a life-long illness that can impact all areas of daily living, including work or school, social contacts and relationships. Most people with this illness have periodic episodes, called relapses, when their symptoms surface. While there is no cure for schizoaffective disorder, symptoms often can be controlled with proper treatment.
What Are the Symptoms of Schizoaffective Disorder?
A person with schizoaffective disorder has severe changes in mood and some of the psychotic symptoms of schizophrenia, such as hallucinations, delusions and disorganized thinking. Psychotic symptoms reflect the person's inability to tell what is real from what is imagined. Symptoms of schizoaffective disorder may vary greatly from one person to the next and may be mild or severe. Symptoms may include:
Depression
Poor appetite
Weight loss or gain
Changes in sleeping patterns (sleeping very little or a lot)
Agitation (excessive restlessness)
Lack of energy
Loss of interest in usual activities
Feelings of worthlessness or hopelessness
Guilt or self-blame
Inability to think or concentrate
Thoughts of death or suicide
Mania
Increased activity, including work, social and sexual activity
Increased and/or rapid talking
Rapid or racing thoughts
Little need for sleep
Agitation
Inflated self-esteem
Distractibility
Self-destructive or dangerous behavior (such as going on spending sprees, driving recklessly or having unsafe sex)
Schizophrenia
Delusions (strange beliefs that are not based in reality and that the person refuses to give up, even when presented with factual information)
Hallucinations (the perception of sensations that aren't real, such as hearing voices)
Disorganized thinking
Odd or unusual behavior
Slow movements or total immobility
Lack of emotion in facial expression and speech
Poor motivation
Problems with speech and communication
What Causes Schizoaffective Disorder?
While the exact cause of schizoaffective disorder is not known, researchers believe that genetic, biochemical and environmental factors are involved.
Genetics (heredity): A tendency to develop schizoaffective disorder may be passed on from parents to their children.
Brain chemistry: People with schizophrenia and mood disorders may have an imbalance of certain chemicals in the brain. These chemicals, called neurotransmitters, are substances that help nerve cells in the brain send messages to each other. An imbalance in these chemicals can interfere with the transmission of messages, leading to symptoms.
Environmental factors: Evidence suggests that certain environmental factors -- such as a viral infection, poor social interactions or highly stressful situations -- may trigger schizoaffective disorder in people who have inherited a tendency to develop the disorder.
Who Gets Schizoaffective Disorder?
Schizoaffective disorder usually begins in the late teen years or early adulthood, often between the ages of 16 and 30. It seems to occur slightly more often in women than in men and is rare in children.
How Common Is Schizoaffective Disorder?
Because people with schizoaffective disorder have symptoms of two separate mental illnesses, it is often misdiagnosed. Some people may be misdiagnosed as having schizophrenia, and others may be misdiagnosed with a mood disorder. As a result, it is difficult to determine exactly how many people actually are affected by schizoaffective disorder. However, it is believed to be less common than either schizophrenia or affective disorder alone. Estimates suggest that about one in every 200 people (0.5%) develops schizoaffective disorder at some time during his or her life.
How Is Schizoaffective Disorder Diagnosed?
If symptoms are present, the doctor will perform a complete medical history and physical examination. Although there are no laboratory tests to specifically diagnose schizoaffective disorder, the doctor may use various tests -- such as X-rays or blood tests -- to rule out physical illness as the cause of the symptoms.
If the doctor finds no physical reason for the symptoms, he or she may refer the person to a psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a psychotic disorder. A diagnosis of schizoaffective disorder is made if a person has periods of uninterrupted illness and has, at some point, an episode of mania, major depression or mix of both while also having symptoms of schizophrenia. In addition, to diagnose the illness, the person must display a period of at least two weeks of psychotic symptoms without the mood symptoms.
How Is Schizoaffective Disorder Treated?
Treatment typically involves medication to stabilize the mood and treat the psychotic symptoms. In addition, psychotherapy (a type of counseling) and skills training may be useful for improving interpersonal, social and coping skills.
Medication: The choice of medication depends on the mood disorder associated with the illness. The primary medications used to treat the psychotic symptoms associated with schizophrenia, such as delusions, hallucinations and disordered thinking, are called antipsychotics. The mood-related symptoms may be treated with an antidepressant medication or a mood stabilizer such as lithium. These medications may or may not be used in combination with an antipsychotic medication.
Psychotherapy: The goal of therapy is to help the patient learn about the illness, establish goals and manage everyday problems related to the disorder. Family therapy can help families deal more effectively with a loved one who has schizoaffective disorder, enabling them to better help their loved one.
Skills training: This generally focuses on work and social skills, grooming and hygiene, and other day-to-day activities, including money and home management.
Hospitalization: Most people with schizoaffective disorder are treated as outpatients. However, people with particularly severe symptoms, or those in danger of hurting themselves or others may require hospitalization to stabilize their conditions.
What Is the Outlook for People With Schizoaffective Disorder?
There is no cure for schizoaffective disorder, but treatment has been shown to be effective in minimizing the symptoms, and in helping the person better cope with the disorder and improve social functioning.
Can Schizoaffective Disorder Be Prevented?
There is no known way to prevent schizoaffective disorder. However, early diagnosis and treatment can help avoid or reduce frequent relapses and hospitalizations, and help decrease the disruption to the person's life, family and friendships.