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Schizoaffective disorder: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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Schizoaffective disorder is characterized by pronounced mood changes and psychotic symptoms of schizophrenia. This disorder differs from schizophrenia by the presence of one or more episodes with depressive or manic symptoms.
The presence of schizoaffective disorder should be assumed if a patient with psychotic symptoms also exhibits symptoms of a mood disorder. The diagnosis requires that severe symptoms of mood disturbance (depressive or manic) occur throughout a significant part of the episode of the illness and simultaneously symptoms of schizophrenia are present. Differential diagnosis between schizoaffective disorder, schizophrenia and mood disorders requires a follow-up assessment of symptoms and their progression. The prognosis is somewhat better than for schizophrenia, but worse than for mood disorders.
Since schizoaffective disorder in a significant part of cases is associated with long-term dysfunctions, complex treatment (including drugs, psychotherapy, self-help groups) is often needed. In the treatment of the manic type of this disorder, the combined use of antipsychotics with lithium, carbamazepine or valproate is more effective than monotherapy with antipsychotics. To treat a depressive variant of this disorder, a combination of antipsychotics with antidepressants is usually used. Usually, antidepressants should be prescribed after the stabilization of positive psychotic symptoms. SSRIs are more preferable because of a favorable safety profile. Antipsychotics of the second generation may be more effective than traditional neuroleptics in the treatment of depression associated with psychosis.
