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Schizoaffective disorder

Schizoaffective disorder is characterized by a curious mixture of symptoms, which can masquerade as other disorders or diseases, making the disorder difficult to diagnose. Doctors have come to believe that schizoaffective disorder may run in families. The exact cause is a mystery, though some research indicates that it may come from an imbalance of dopamine and serotonin in the brain. Other research points to exposure to viruses, or malnutrition before birth, or even to complications of delivery during birth.

Whatever the cause, it is difficult to diagnose because it involves not one, but multiple brain mechanisms, and that the disorder can develop in numerous ways, and may respond differently to different treatments.

The two distinct states of schizoaffective disorder are ‘unipolar depression’ and ‘bipolar disorder’, otherwise known as manic-depression. Those diagnosed with schizoaffective disorder can expect a prognosis similar to that of a classic schizophrenic, or at the other end of the spectrum, that of a patient with a mood disorder. The prognosis depends on symptoms, and the way the disorder expresses itself in a particular individual.

What are the symptoms?

The symptoms of schizoaffective disorder fall into two categories – Manic and Depressive.

Manic Symptoms

• Agitation, nervousness, irritability, feeling edgy, or restless
• Rage, aggression or combative behavior
• Inability to focus
• Euphoria, or feeling ‘high’
• Extreme talkativeness or rapid speech
• Feeling you can ‘do no wrong’, inflated sense of self
• Dressing or speaking in an extreme, or unusual manner
• Sleeplessness, insomnia
• Increased sex drive or desire
• Reckless spending, engaging in high risk activities
• Delusions or hallucinations

Depressive Symptoms

• Abnormally low, listless mood and energy
• Extreme increase or decrease in appetite or weight
• thoughts, talk, plans or attempts of suicide (which can be as high as 10% in diagnosed patients; more prevalent in women than in men)
• Constant fatigue, increase or decrease in sleep like insomnia or excessive sleep
• Inability to concentrate or focus, or to make everyday decisions
• Sadness, hopelessness, an attitude of ‘what’s the use?’

How is it diagnosed and treated?

Doctors often have trouble differentiating schizoaffective disorder from classic schizophrenia and, even sometimes from mood disorders. Mood symptoms are more noticeable in this disorder, and will last longer than those seen in classic schizophrenia. Schizoaffective disorder is sometimes distinguished from mood disorders by using the following criteria:

• Delusions or hallucinations and disorganized though will appear in patients with schizoaffective disorder for at least two weeks without any coincident mood symptoms.
• Major depressive phases or a manic episode will also occur separately from delusions and other bipolar symptoms

However, some people do not follow this pattern, and experience mood symptoms at the same time as bipolar symptoms, thereby making the diagnosis more difficult. Distinguishing between bipolar disorder and schizophrenia is also difficult during adolescence, because this age group exhibits psychotic symptoms during manic periods. The diagnosis of schizophrenia or mood disorder is sometimes changed to schizoaffective disorder, as the doctor observes the patient over time. The reverse may also be true.

Because of the complex array of symptoms in this disorder, doctors may prescribe one or some of the following treatments:

• Social Rehabilitation
• Vocational Rehabilitation
• Psychotherapy
• Family Therapy
• Cognitive behavior therapy
• Group Therapy
• Medication – antipsychotic, antidepressant or mood stabilizing medicines e.g. clozapine, risperidone, haloperidol or fluphenazine, tardive or neuroleptic drugs or lithium, and others

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