Schizoaffective Disorder: Causes, Symptoms And Treatment

What is this disorder and how to act to minimize its effects?

The Schizoaffective Disorder is a controversial disorder at a theoretical level, but a clinical reality that affects 0.3% of the population. Knowing its symptoms, effects and characteristics that can explain its causes is to know this diagnostic category.

What is Schizoaffective Disorder?

Broadly speaking, we can understand Schizoaffective Disorder as a mental disorder that combines  psychotic symptoms (delusions, hallucinations, disorganized speech, very disorganized behavior or negative symptoms such as decreased emotional expression or apathy) and mood disorders (mania -depression).

Thus, Schizoaffective Disorder fundamentally affects perception and emotional psychological processes.

Symptoms and diagnosis of Schizoaffective Disorder

Schizoaffective Disorder is usually diagnosed during the period of psychotic illness due to its spectacular symptoms. Episodes of  depression or mania are present for most of the duration of the illness.

Due to the wide variety of psychiatric and medical conditions that can be associated with psychotic symptoms and mood symptoms, Schizoaffective Disorder can be confused on many occasions with other disorders, such as bipolar disorder with psychotic characteristics. , major depressive disorder with psychotic characteristics … In a way, the limits of this diagnostic category are confusing, and this is what leads to a debate about whether it is an independent clinical entity or the coexistence of several disorders.

To distinguish it from other disorders (such as bipolar ), psychotic features,  delusions, or hallucinations must be present for at least 2 weeks in the absence of a major mood episode (depressive or manic). Thus, the criterion used to distinguish between Schizoaffective Disorder and other types of mental disorders is, fundamentally, time (duration, frequency of appearance of symptoms, etc.).

The difficulty in diagnosing this disorder lies in knowing whether mood symptoms have been present for most of the total active and residual duration of the disease, determining when there were significant mood symptoms accompanied by psychotic symptoms. To know these data, the health professional must thoroughly know the subject’s medical history.

Who suffers from this type of psychopathology?

The prevalence of Schizoaffective Disorder in the population is 0.3%. It is estimated that its frequency is one third of the population affected by schizophrenia.

Its incidence is higher in the female population. This is mainly due to the higher incidence of depressive symptoms among women compared to men, something that possibly has genetic but also cultural and social causes.

When does it usually start to develop?

There is a consensus in stating that the age of onset of Schizoaffective Disorder usually occurs in early adult life, although this does not prevent it from occurring during adolescence or in the later stages of life.

In addition, there is a differentiated pattern of appearance according to the age of the person who begins to experience symptoms. Schizoaffective Disorder of the bipolar type tends to prevail in young adults, while in older adults the depressive-type Schizoaffective Disorder tends to prevail.

How does Schizoaffective Disorder influence people who suffer from it?

The way in which Schizoaffective Disorder leaves a mark on the daily lives of those who experience it has to do with practically all areas of life. However, some main aspects can be highlighted :

  • The ability to continue functioning at the work level is normally affected, although, unlike what happens with schizophrenia, this is not decisive as a defining criterion.
  • Social contact is diminished by Schizoaffective Disorder. The capacity for self-care is also affected, although as in the previous cases, the symptoms are usually less severe and persistent than in schizophrenia.
  • Anosognosia or lack of introspection is common in Schizoaffective Disorder, being less severe than in schizophrenia.
  • There is the possibility of being associated with disorders related to alcohol or other substances.

Forecast

Schizoaffective Disorder usually has a better prognosis than  schizophrenia. On the contrary, its prognosis is usually worse than that of mood disorders, among other things because the symptoms related to the perception problems represent a very abrupt qualitative change to what would be expected in a person without this disorder, while mood alterations can be understood as a rather quantitative problem. 

In general, the improvement that occurs is understood from both a functional and a neurological point of view. We can then place it in an intermediate position between the two.

The higher the prevalence of psychotic symptoms, the more chronic the disorder. The duration of the disease course also plays a role. The longer the duration, the greater the chronicity.

Treatment and psychotherapy

To date, there are no tests or biological measures that can help us diagnose Schizoaffective Disorder. There is no certainty as to whether there is a neurobiological difference between Schizoaffective Disorder and schizophrenia in terms of their associated characteristics (such as their brain, structural or functional abnormalities, cognitive deficits and genetic factors). Therefore, in this case planning highly effective therapies is very difficult.

Clinical intervention, therefore, focuses on the possibility of mitigating symptoms and training patients in accepting new standards of life and managing their emotions and self-care and social behaviors.

For the pharmacological treatment of Schizoaffective Disorder, antipsychotics, antidepressants and mood stabilizers are usually used, while the most indicated psychotherapy for Schizoaffective Disorder would be the cognitive-behavioral type. In order to implement this last action, the two pillars of the disorder must be treated.

  • On the one hand, the treatment of mood disorders, helping the patient to detect and work on depressive or manic symptoms.
  • On the other hand, the treatment of psychotic symptoms could help reduce and control delusions and hallucinations. It is known that the conviction in these fluctuates over time and that they can be modified and diminished by cognitive-behavioral interventions. To address delirium, for example, it can help to clarify the way in which the patient constructs her reality and gives meaning to her experiences based on cognitive errors and her life history. This approach can be done in a similar way with hallucinations.

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