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What is Schizoaffective Disorder? Some psychiatric disorders are very difficult to diagnose accurately. One of the most confusing conditions is schizoaffective disorder. This relatively rare disorder is defined as "the presence of psychotic symptoms in the absence of mood changes for at least two weeks in a patient who has a mood disorder." The diagnosis is used when an individual does not fit diagnostic standards for either schizophrenia or "affective" (mood) disorders such as depression and bipolar disorder (manic depression). Some people may have symptoms of both a depressive disorder and schizophrenia at the same time, or they may have symptoms of schizophrenia without mood symptoms. Many individuals with schizoaffective disorder are originally diagnosed with manic depression. If the person experiences delusions or hallucinations that go away in less than two weeks when the mood is "normal," bipolar disorder may be the proper diagnosis. Someone who experiences psychosis for three or four weeks while in a manic phase does not have schizoaffective disorder. However, if delusions or hallucinations continue after the mood has stabilized and are accompanied by other symptoms of schizophrenia such as catatonia, paranoia, bizarre behavior, or thought disorders, a diagnosis of schizoaffective disorder may be appropriate. Accurate diagnosis is easier once the acute psychotic episode is under control. Distinguishing between bipolar disorder and schizophrenia can be particularly difficult in an adolescent, since at that age psychotic features are especially common during manic periods. Because schizoaffective disorder is so complicated, misdiagnosis is common. Some people may be misdiagnosed as having schizophrenia. Others may be misdiagnosed as having bipolar disorder. And those diagnosed as having schizoaffective disorder may actually have schizophrenia with prominent mood symptoms. Or they may have a mood disorder with symptoms similar to those of schizophrenia. What is the treatment for this disorder? Psychiatrists often treat this disorder with an anti-psychotic medication and lithium, or with carbamazepine (an anticonvulsant medication) and lithium. As a practical matter, differentiating between schizophrenia, bipolar disorder, and schizoaffective disorder is not absolutely critical, since antipsychotic medication is recommended for all three. If a mood problem is suspected, lithium or an antidepressant should be added. What is the prognosis for those with this disorder? The prognosis for individuals diagnosed with schizoaffective disorder is generally better than for those diagnosed with schizophrenia, but not quite as good for those diagnosed with a mood disorder. (Schizophrenia is a chronic brain disorder interfering with a persons' ability to think clearly, manage emotions, make decisions, and relate to others. Persons with schizophrenia may experience hallucinations and delusions. Mood disorders, including depression and bipolar disorder, are chronic illnesses in which the person's mood may return to "normal" between depressive or manic episodes.) Those with schizoaffective disorder generally respond to lithium better than those with schizophrenia, but not as well as those with mood disorders. More research is needed to fully understand this illness and why it resists conventional treatment. New medications may be developed to treat this disorder more effectively. Further information:
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