Schizoaffective Disorder is a chronic mental health issue that affects 1 in 300 people. It is often confused with Schizophrenia, a condition with some similar symptoms that affects an estimated 20 million people worldwide.
Both disorders affect a person’s perception of reality, judgment, thoughts, and behaviors, which can lead to conflation of the two and frequent misdiagnosis. Although the two disorders have similarities, there are vital differences that affect an individual’s appropriate treatment and ability to function in daily life.
Schizoaffective Disorder is characterized by the combination of psychosis symptoms (similar to those of Schizophrenia) such as hallucinations and delusions and mood disorder symptoms such as mania or depression.
If left untreated, Schizoaffective Disorder can have detrimental effects on a person’s life such as problems functioning at or regularly attending work or school. Relationships and other social situations are also challenging to navigate, which can result in loneliness and isolation.
Diagnosing Schizoaffective Disorder
Sufferers of Schizophrenia are more likely to experience psychosis, where they may see things that do not exist, hear voices that are not real, struggle to interpret reality, experience disorganized thinking, and struggle to behave appropriately in accordance with their environment.
While those with Schizoaffective Disorder are likely to experience the same symptoms, a key part of their diagnosis is an additional presence of mood disorder symptoms.
Depending on the types of symptoms present, Schizoaffective Disorder is diagnosed as one of two types:
- Bipolar Type: Includes episodes of mania and can include episodes of major depression
- Depressive type: Includes only depressive episodes
Studies show that the disorder is usually first diagnosed between the ages of sixteen to thirty and is more common in women.
For Schizoaffective Disorder to be diagnosed, certain symptoms need to be noted, although these vary for each individual. Defining features include:
- Periods of improvement
- A major mood episode (depressed or manic)
- A period of psychosis without a mood episode present (2 weeks or more)
The signs of Schizoaffective Disorder depend on the type diagnosed. Bipolar Schizoaffective Disorder includes all three symptomatic areas, whereas the depressive type will not experience the manic symptoms. The symptomatic categories are characterized as follows:
- Feelings of sadness,worthlessness, and hopelessness
- Lack of energy
- Loss of interest in hobbies
- Lack of focus
- Suicidal ideation
- Poor appetite
- Sleeping too much or too little
- Risky/impulsive behavior
- Racing thoughts
- Difficulty concentrating
- Increased energy
- Rapid speech
- Reduced need for sleep
- Disorganized thinking
- Impaired communication
- Decreased motivation
- Low movements or no movement (catatonia)
- Lack of self care
These symptoms are often severe and prolonged and significantly comprise both the individual’s and their loved ones’ wellbeing and life satisfaction.
Schizoaffective Disorder does not have a single direct cause; instead, it develops due to a combination of the following risk factors, which affects brain functions and processing:
- Family history of Bipolar, Schizophrenia, or Schizoaffective Disorder
- Substance use
- Trauma / Life stressors
- Viral infections including while in the womb
- Brain chemistry imbalances
Co-occurring disorders are especially common for those suffering with this condition. These co-occurring disorders can increase the severity of symptoms, exacerbate the condition, and may additionally increase the risk of development.
The most common overlapping mental health issues include post-traumatic-stress-disorder (PTSD), anxiety disorders, major depression, attention-deficit-hyperactivity-disorder, and substance use.
A co-occurring disorder can make diagnosis more challenging, and the person is likely to experience greater difficulty in adhering to a treatment plan. It is therefore crucial for a clinical diagnosis to be made and for an integrated, personalized treatment plan to be created with the individual’s needs in mind.
There are varying levels of treatment depending on the severity of symptoms. Unfortunately, there is no cure for Schizoaffective Disorder, so long-term treatment, management, and support are usually required.
An acute psychotic episode may result in hospitalization, especially if the person is in danger of hurting themselves or others.
Treatment usually consists of a combination of medication and therapeutic support to reduce symptoms, instill positive coping skills, and minimize the negative impact the disorder may have on their life or the lives of those close to them.
The most common types of therapy include Cognitive-Behavioral Therapy (CBT), family therapy, or skills training. It is often beneficial for family members to engage in the therapy sessions, as the success of treatment for this complex, chronic condition is enhanced by the support and care of loved ones.
Together, you can learn about the illness and how to manage symptoms, set goals, develop coping mechanisms for daily life, establish self-care routines, develop interpersonal skills, and receive support around employment, finances, and managing a home.
Schizoaffective Disorder is a severe and permanent condition often confused with Schizophrenia and Bipolar Disorder. It is vital for a specialist diagnosis to be made so that the individual receives effective treatment to alleviate symptoms, improve functioning, and restore a sense of wellbeing.
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 Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association, 2013.
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 “Schizoaffective Disorder | Royal College of Psychiatrists”. RC PSYCH ROYAL COLLEGE OF PSYCHIATRISTS, 2022, https://www.rcpsych.ac.uk/mental-health/problems-disorders/schizoaffective-disorder.