An Overview Of Schizoaffective Disorder
Manouchehr Saljoughian, PharmD, PhDAlta Bates Summit Medical CenterBerkeley, California
US Pharm. 2019 44:10-12.
Schizoaffective disorder, a perplexing and chronic mental-health condition, is a hybrid of two mental illnesses in that it incorporates features of schizophrenia and mood disorders . Symptoms may occur simultaneously or at different times. Cycles of severe symptoms are often followed by periods of improvement or high energy. This mental condition causes both a loss of contact with reality and mood problems.1 It is not known whether schizoaffective disorder is related mainly to schizophrenia or to mood disorder. Although schizoaffective disorder can be managed, it cannot be cured, and most patients will experience relapses.1
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, defines the disorder as the presence of schizophrenia symptoms concurrent with mood symptoms that last for a considerable portion of a 1-month period.1 Schizoaffective disorder is classified into two kinds: type 1 , which involves some schizophrenia symptoms and episodes of mania and bipolar disorders, and type 2 , which includes schizophrenia symptoms and major depressive episodes.1
Schizoaffective disorder usually begins in an individuals late teens or in early adulthood, often between the ages of 16 and 30 years. It appears to occur slightly less often in men than in women, and it is rare in children.1
What Is The Difference Between Schizophrenia And Schizoaffective Disorder
Mental health disorders are highly misunderstood. Most people dont know the difference between even the most common conditions. Two conditions that are often confused are schizophrenia and schizoaffective disorder.
Schizophrenia causes patients to see things that do not exist and hear voices that arent real, referred to as hallucinations and delusions. Schizoaffective disorder comes in two forms: bipolar type and depressive type. These schizoaffective disorder types cause both schizophrenia symptoms, as well as symptoms associated with their respective mood disorder.
Lets discuss the differences in causes, symptoms, and treatments between these conditions.
Finding Mental Health Treatment
While theres clearly a difference between schizoaffective disorder and schizophrenia, both conditions can be properly managed with professional treatment. At our inpatient mental health rehab, we offer various forms of mental health care for individuals diagnosed with mood or psychotic disorders.
Included in our Boca behavioral health services is therapy of all kinds, including top-rated programs like dialectical and cognitive behavioral therapy. Patients receiving treatment at our mental therapy center will have the opportunity to work with our trained and highly-skilled team of professionals to understand their conditions, learn how to manage their symptoms, and develop the skills they require to live happy and fulfilling lives.
Our mental treatment center is here to help. Call Banyan Mental Health today at to learn how you or a loved one can get started today.
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Challenges In Diagnosis And Treatment
The overlapping symptomatology of schizophrenia and schizoaffective disorder often presents significant diagnostic challenges for clinicians. In some cases, mood disturbances are missed altogether due to a singular focus on psychotic symptoms. In other cases, the nature of mood disturbances is misunderstood, resulting in incorrect or missed identification of a mood disorder. This may happen for a number of reasons, including a clients reluctance to disclose mood symptoms or inability to recognize such symptoms, particularly when overwhelmed by the experience of psychosis. Meanwhile, clinicians may fail to ask about mood episodes in a way that will clarify their origin. As the authors of the European Archives of Psychiatry and Clinical Neuroscience European Archives of Psychiatry and Clinical Neuroscience study note, there is also evidence that clinicians choose the less severe diagnosis for psychotic patients, which is commonly understood to be schizoaffective disorder.
What Are The Symptoms Of Schizoaffective Disorder
Symptoms of schizoaffective disorder vary from one person to the next. They can range from mild to severe.
Someone with schizoaffective disorder experiences psychotic symptoms. They also experience severe mood changes, with symptoms of depression, mania or both. A person with schizoaffective disorder will have psychotic symptoms that occur alone and with mood changes.
- Hallucinations .
- Inability to tell real from imaginary.
- Disorganized speech .
- Unclear thinking.
- Lack of emotion in facial expression and speech.
- Poor motivation.
- Self-destructive or dangerous behavior .
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Treatment For Schizoaffective Disorder
The first step in helping your adult child live a normal life is to get an accurate diagnosis. Many people with schizoaffective disorder are first diagnosed with bipolar disorder or schizophrenia and may not get the most effective treatment as a result. Make sure your child gets an updated diagnosis, especially if there are signs of both psychotic symptoms and mood symptoms, including mania and depression.
Once you have the right diagnosis, your child will need to be prepared to accept treatment. A good treatment plan for schizoaffective disorder should be tailored to the individuals needs, and it may need to include time in a residential setting followed by outpatient care.
Schizoaffective disorder treatment includes two major types of care: medications and therapy. Medications that can help manage symptoms and minimize or prevent mood episodes include antipsychotics, antidepressants, and mood stabilizers. It requires some time and patience to find the right balance of medications that are effective and cause the least amount of side effects.
Causes And Risk Factors For Delusional Disorder
Research suggests that people who have family members with schizophrenia or schizotypal personality disorder are at greater risk of developing delusional disorder, suggesting that genetics may play a causal role in determining a persons risk of developing the disorder. In addition, people who are older are more likely than younger individuals to develop delusional disorder as well.
- Family history of schizophrenia or schizotypal personality disorder
- Being of older age
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Schizoaffective Disorder: A Hybrid Condition
The schizoaffective disorder vs. schizophrenia comparison reveals pronounced overlap but clear differences. In fact, schizoaffective disorder is a hybrid condition that combines the characteristics of schizophrenia with those of mood disorders, such as depression and bipolar disorder. It is this blending of different mental health conditions that sets schizoaffective disorder apart from its more well-known cousin, since the standard schizophrenia definition classifies it as a disorder that affects thought, feelings, and behavior but not mood, at least not directly.
Some mental health experts prefer a spectrum model to explain the two conditions, with schizophrenia and bipolar disorder occupying the two extreme ends and schizoaffective disorder found somewhere in the middle. This idea makes some sense, since people with schizoaffective disorder do generally exhibit the same mood swings that are experienced by individuals with bipolar disorder, either the lows of depression or the highs of mania.
However, schizoaffective disorder, bipolar type is only one variety of the condition. Schizoaffective disorder, depressive type includes the symptoms of major depression without the mania, and is just as likely to be diagnosed as bipolar schizoaffective disorder.
Schizoaffective disorder ICD 10 classifications are recognized as authoritative everywhere, including in the United States, even though the American Psychiatric Associations DSM-5 classification system is more well-known.
What Is The Difference Between Schizoaffective Disorder And Schizophrenia
Schizophrenia and schizoaffective disorder have a significant overlap in symptoms. But schizoaffective disorder also involves symptoms of mood disorders like major depression or bipolar disorder, which makes it a more complicated condition to diagnose and treat. Both conditions are manageable, and no one who is diagnosed with either should be prevented from living a normal life over the long-term.
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How Can You Tell The Difference Between Schizophrenia And Depression
Schizophrenia and depression are hard to tell apart, which makes diagnosis complicated. There is even debate among experts about how to classify these disorders. Some feel depressive symptoms should be a symptom of schizophrenia, and others feel it should be considered a co-existing condition.
The official diagnostic manual recognizes that depression can be part of schizophrenia, but it lists them as separate conditions.
The key difference between the disorders, and especially between psychotic depression and schizophrenia, is that psychosis in depression is sporadic and only occurs during a period of depression. In cases of schizophrenia, you experience psychotic symptoms even when you dont have a mood problem.
Schizophrenia also causes more problems with self-care and lack of personal hygiene.
Additionally, there are also differences in emotions between schizophrenia and depression. Where you might be sad and tearful during an episode of major depression, schizophrenia often causes a lack of emotion. This is called emotional flattening.
- Speak in a monotone voice
- Avoid eye contact with others
- Not change your facial expressions
- Have a total lack of response to things around you
Schizophrenia also causes extremely disorganized behavior, thinking, and speech. When you talk, you might put random words together that make no sense, which is called word salad. You might sit in bizarre postures or not move at all, resist instructions, or become agitated or childlike.
How Common Is Schizoaffective Disorder
Schizoaffective disorder is rare. Research estimates that 3 in every 1000 people will develop schizoaffective disorder in their lifetime.Still, its difficult to know exactly how many people have the condition because of the challenging diagnosis. People with schizoaffective disorder have symptoms of two different mental health conditions. Some people might get misdiagnosed with schizophrenia. Others might get misdiagnosed with a mood disorder.
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Difference Between Schizophrenia And Schizoaffective Disorder
If you have schizophrenia, then you may hear voices that arent real and see things that dont actually exist. If you have schizoaffective disorder, then you may feel detached from reality and struggle to manage your mood. These two disorders often sound similar and have some things in common. However, understanding the difference between schizophrenia and schizoaffective disorder is important to finding the right treatment and managing these conditions effectively.
How Is Schizoaffective Disorder Diagnosed
If someone is showing symptoms of schizophrenia and a mood disorder, see a healthcare provider. The provider will do a medical history and physical examination. There are no lab tests to diagnose schizoaffective disorder. But the provider may use X-rays and blood tests to rule out other illnesses that may be causing the symptoms.
If there is no physical cause for the symptoms, the provider may refer the person to a psychiatrist or psychologist. These professionals specialize in diagnosing and treating conditions tied to mental and behavioral health.
A Brief Look At Schizophrenia
Though schizophrenia and depersonalization might share some similar symptoms, they are vastly different in their nature. Lets briefly go over what this illness is. Schizophrenia is a mental disorder that is characterized by a failure to understand consensus reality. Consensus reality is a term that denotes the reality that is generally agreed upon by you, me, and everyone else in the world. People with schizophrenia tend to feel confused about reality. This can lead to the development of delusions, hallucinations , and aberrant social behavior.
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What Causes Schizoaffective Disorder
Researchers dont know the exact cause of schizoaffective disorder. They believe several factors are involved:
- Genetics: Schizoaffective disorder might be hereditary. Parents may pass down the tendency to develop the condition to their children. Schizoaffective disorder can also occur in several members of an extended family.
- Brain chemistry: People with the disorder may have an imbalance of brain chemicals called neurotransmitters. These chemicals help nerve cells in the brain communicate with each other. An imbalance can throw off these connections, leading to symptoms.
- Brain structure: Abnormalities in the size or composition of different brain regions may be associated with developing schizoaffective disorder.
- Environmental factors: Certain environmental factors may trigger schizoaffective disorder in people who inherited a higher risk. Factors may include highly stressful situations, emotional trauma or certain viral infections.
- Drug use: Using psychoactive drugs, such as marijuana, may lead to the development of schizoaffective disorder.
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Can Bipolar Turn To Schizophrenia
Some mental illnesses share identical symptoms, such as mood swings and depression. Such overlaps occur in bipolar disorder and schizophrenia, sometimes making it difficult to differentiate between the two. However, these conditions are distinct from one another, and they do not always co-occur.
While bipolar disorder cannot develop into schizophrenia, its possible to experience symptoms of both. Before you consult a mental health professional, here are a few things you should know about the two conditions.
What Medications Treat Schizoaffective Disorder
The provider will figure out the right medicine based on the type of mood disorder the person has:
- Antipsychotics: This is the primary medicine used to treat the psychotic symptoms that come with schizophrenia for example, delusions, hallucinations and disordered thinking.
- Antidepressants: An antidepressant or mood stabilizer such as lithium can help treat mood-related symptoms. Sometimes, a person needs both an antidepressant and an antipsychotic.
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How Schizoaffective Disorder Is Treated
Despite advanced symptom tracking technologies and data collection, there is no apparent cause of schizoaffective disorder. Despite this, professionals have come up with successful treatment plans that improve patients quality of life.
The following methods can help alleviate symptoms:
- Medication: Currently, the only FDA-approved drug for treating schizoaffective disorder is Invega, which helps subdue episodes and reduce erratic moods that may lead to suicide attempts. If youre considering a new type of medication, always consult with a doctor first.
- Psychotherapy: Patients can undergo all forms of talk therapy, whether on their own, with family, or with other people who share similar experiences.
- Life Skills Training: Through vocational rehabilitation and social skills training, a person improves their ability to participate in all activities, from daily tasks to social settings. Patients can learn how to prevent an episode through lifestyle adjustments and additional tools such as a meditation app or exercise program.
How Does Psychotherapy Treat Schizoaffective Disorder
During therapy, the person talks to a trained mental health professional. The goal of psychotherapy is for the person to:
- Learn about the illness.
- Establish goals.
- Manage everyday problems related to the disorder.
Family therapy can also help. A therapist can help families learn how to cope with the illness and support their loved one. Family therapy helps improve symptoms and quality of life for the person with the disorder.
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Schizoaffective Disorder Signs And Symptoms
Living with schizoaffective disorder is difficult in any circumstance, but the trials and tribulations are sometimes made worse by a false schizophrenia diagnosis. In other instances, the disorder is incorrectly classified as major depression or bipolar disorder, which can lead to treatment choices that dont address all of the disruptive and debilitating symptoms of this complicated medical condition.
In its schizophrenic aspects, schizoaffective disorder often mimics either paranoid schizophrenia or disorganized schizophrenia. Schizoaffective disorder vs. schizophrenia comparisons reveal that each demonstrates the so-called positive symptoms of conventional schizophrenia, which are common to the paranoid and disorganized varieties of the disorder schizophrenia. Those positive symptoms tend to involve psychotic breaks with reality that can make normal functioning difficult, if not impossible.
- Disorganized behavior
- Negative symptoms of schizophrenia
One symptom may be enough to make a diagnosis, if it is: a). delusions that are especially bizarre or out of touch with reality, or b). auditory hallucinations that are continuous and/or involve multiple voices having conversations or issuing instructions.
Generally, the schizophrenia symptoms and the mood disorder will not be present simultaneously, at least not at equal strength, and that is another reason why a schizoaffective disorder diagnosis cannot be given when the disorder is in the initial stage.
Religious Delusion: When Faith Turns Into Psychosis
In earlier times when a person would behave in a way that is not normal or natural people would begin to think that the person might be processed. Experts never believed in the demonic possession, they termed this condition a religious delusion.
Did you know an increased focus religion or presumed religious activities can be considered as a symptom of mania or bipolar disorder? Anything in excess is bad. Being blindly religious can turn your faith into psychosis.
There are so many superstitious beliefs around us and so many of us hold on to them. It is quite possible that sometimes our thought process is possessed by irrational beliefs. Lets get to know about it in detail.
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Does Depression Cause Psychosis
Major depression can cause psychosis and delusional thinking. This is called psychotic depression or major depressive disorder with psychotic features. It usually reflects the persons deeply depressed mood.
For example, if you have major depression, you might have a feeling of deep guilt and become convinced youve done something wrong or committed a crime. Alternatively, you might have paranoia or a suspicious belief that something bad is about to happen. You might even hear voices.
These things feel very real while youre experiencing them, and its hard to tell that these are symptoms of depression. While you can have hallucinations and delusions during a period of psychotic depression, its not the same thing as schizophrenia and doesnt lead to schizophrenia. Studies show that brain activity is different in those who have schizophrenia.
Studies also show that having a family history of schizophrenia doesnt give you a higher risk of having psychotic depression, so having one disorder or the risk of one disorder doesnt necessarily mean that youll be at greater risk of having the other.
What Is Schizophrenia
Schizophrenia is also a mental health disorder in which a person interprets their reality abnormally. Schizophrenia may lead to a combination of symptoms, including hallucinations, delusions, and disordered thinking and behavior.
Individuals with this condition may experience impaired thinking and daily functioning. They may also exhibit incoherent speech and disorganized behavior, which generally leads to a flat emotional affect in which the person shows little to no emotion and tends to speak less than the average person.
Other signs of schizophrenia include deficits in memory, attention, ability to process new information, and difficulty problem-solving. This can be a distressing and debilitating condition when it goes untreated.
Like people with schizoaffective disorder, those diagnosed with schizophrenia often require lifelong care. Therefore, the earlier one seeks schizophrenia treatment, the higher their chances of recovery and independent living despite their symptoms.
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