Schizoaffective Disorder: Information, Symptoms, Treatment and More

Schizoaffective Disorder is a severe mental health condition. The illness is characterised by symptoms of both psychosis and mood disorders.

Psychosis refers to a loss of understanding of reality, while mood disorders include a state of either depression or mania. With these symptoms combined, the condition can be difficult to live with.

Schizoaffective Disorder shares many similarities with Schizophrenia, albeit with the addition of a mood disorder present. It forms part of the Schizophrenic Spectrum.

Schizoaffective Disorder isn’t a very common disorder – being diagnosed much less than mood disorders, and slightly less than Schizophrenia.

Despite its severity, with the right treatment, support and lifestyle, many people with Schizoaffective Disorder will be able to control their symptoms much more – aiding their quality of life. In some cases, recovery is possible.

What are the symptoms of Schizoaffective Disorder?

Schizoaffective Disorder is a mental health condition that can interfere significantly with life. The condition encompasses symptoms seen in a variety of other mental illnesses – such as Depression, Schizophrenia and Bipolar Disorder.

Individuals experiencing Schizoaffective Disorder will largely witness similar symptoms, though there can be slight differences. The actual term ‘Schizoaffective’ is made up of two parts, which helps to differentiate the symptoms:

• ‘Schizo’ – symptoms of psychosis
• ‘Affective’ – symptoms of a mood disorder

In general, someone who is depressed feels hopeless, sad, and loses interest in activities that were once enjoyable. Meanwhile, someone who is in a manic state will feel euphoric, excitable, and may take unnecessary risks. Symptoms can be grouped by psychotic and mood disorder symptoms.

Psychosis

Some of the typical psychotic symptoms are:

• Hallucinations: These involve a person seeing or heating something that doesn’t exist outside of their mind. They may hallucinate based on other senses too, such as smell, feel, or even taste. A common hallucination is hearing voices.
• Delusions: These involve a person having a belief that they steadfastly believe in, although it isn’t true. Delusions can include paranoia – such as a person believing they are being spied on, or someone on TV is communicating secretly with them.
• Disorganised speech: This is where a person’s speech will become noticeably different. They may make up words, struggle to concentrate on one topic, or switch topics rapidly.
• Disorganised behaviour: This involves someone acting impulsively or unpredictably.
• Catatonia: A person in a catatonic state will often appear immobile – not moving or speaking. They may look unconscious, but they actually aren’t.

Other symptoms include unusual motor behaviour, blunted affect, poverty of speech, avolition, depersonalisation and derealisation.

Mood Disorder

The above symptoms will be joined by some of the symptoms below:

Mania

• Excessively happy feeling, euphoria
• Uncontrollably excited
• Racing thoughts
• Very confident
• Not needing much sleep
• Feelings of grandiosity
• Acting impulsively and taking risks
• Irritable
• Symptoms of psychosis

Depression

• Continuous low mood or sadness.
• Hopelessness and helplessness
• Low self-esteem
• Lack of emotion or excessive crying
• Concentration Difficulties
• Numbness
• Anxiety
• Suicidal or Self-Harm Ideation

Someone with Schizoaffective Disorder will often exhibit these symptoms concomitantly, or straight after one another. The length of an episode length can vary from case to case. Symptoms can start at any time, though they usually begin during early adulthood.

These symptoms will typically lead to an individual behaving in a different way. Their behaviour may change rapidly.

Due to the huge range of symptoms, experiences of Schizoaffective Disorder can differ from person to person. This isn’t an exhaustive list of symptoms.

What are the causes of Schizoaffective Disorder?

Schizoaffective Disorder is a very complex mental health condition. It involves multiple facets – not only involving psychosis, but also mood disorders. It is unsurprising therefore – given the complexity of the condition, that it isn’t known what causes the condition.

As with many other mental health conditions, genetics appears to play a role, with past research suggesting Schizoaffective Disorder can run in families [1].

Abnormalities in the brain have also been linked to the onset of Schizoaffective Disorder. For example, this includes how amino acids are processed, as well as the chemical levels of dopamine [2].

Past trauma and stressful situations are also common triggers for mental health problems. Moreover, substance abuse is also associated with the onset of mental health conditions.

For example, past research has suggested that the loss of a family member, parental loss, and divorce are all risk factors [3]. This same study found that females were likelier to have the condition.

It is believed that there are a range of potential causes of Schizoaffective Disorder. The complexity of the condition makes it difficult to draw conclusions.

Diagnosis of Schizoaffective Disorder

When a person is exhibiting the signs or symptoms of any psychosis-related disorder, it is important to seek help as soon as possible.

If a person suspects they have Schizoaffective Disorder, they should see their doctor immediately. The sooner that treatment starts, the better.

A doctor will refer the patient to the local Community Mental Health Team (CMHT) if they suspect that Schizoaffective Disorder is present.

CMHTs consist of a range of mental health professionals whose role is to assist those with severe mental health conditions.

A mental health professional will carry out a full assessment, and aim to make a diagnosis based off of a range of questions, their symptoms, and general mood.

In order for Schizoaffective Disorder to be diagnosed, the patient will normally:

• Have experienced at least two episodes of psychosis.
• At least one of these episodes has featured an overlap of mood disorder and psychotic symptoms
• If an individual’s mood disorder includes mania, hypomania or a mixed episode, sometimes with depression, they will be diagnosed with Schizoaffective Disorder Bipolar Type.
• If an individual’s mood disorder includes depression, but not elevated mood, they will be diagnosed with Schizoaffective Disorder Depressive Type.
• When Psychotic symptoms are purely confined to an episode of mania or depression, an individual could be diagnosed with Bipolar Disorder or Psychotic Depression.
• Schizophrenia and Schizophreniform Disorder have both been ruled out.
• Substance abuse has not caused the symptoms.

Given its close similarities to other conditions, it can be easy to misdiagnose Schizoaffective Disorder. There are slight differences between several conditions, meaning it isn’t always clear which condition someone is suffering from.

Unfortunately, this means that Schizoaffective Disorder is commonly misdiagnosed. But once a proper diagnosis has been made, treatment can take place.

How is Schizoaffective Disorder treated?

Schizoaffective Disorder is a very serious mental health condition. Treatment is available for the condition and in many cases, symptoms will be controlled much more, leading to an improvement in quality of life for sufferers.

Treatment for Schizoaffective Disorder generally involves some form of talking therapy, and at least one type of medication.

Talking Therapy

Normally, a form of talking therapy can prove helpful when treating Schizoaffective Disorder. Therapy offers a person the chance to speak their mind and understand their symptoms more – which can be particularly helpful in cases of low mood or past trauma. Different types exist.

Cognitive Behavioural Therapy (CBT): CBT is a type of therapy that is used to treat a range of mental health conditions. CBT involves an individual talking face-to-face with a therapist, although sometimes CBT can be conducted in a group setting. CBT attempts to improve an individual’s wellbeing and mood. The therapy focuses on the link between thoughts, feelings and actions. This can be useful for those with low self-esteem, anxiety, unhelpful personality traits or intrusive thoughts. CBT can help an individual understand their feelings more, and in the long run should lead to an improvement in quality of life.

Psychoanalytical Psychotherapy: Psychoanalytical Psychotherapy is a talking therapy that aims to help uncover and resolve unconscious beliefs that cause psychiatric conditions. Traumatic experiences that may or may not be buried in the unconscious mind can be highlighted and processed. Psychoanalytical psychotherapy involves talking to a trained therapist. The therapist can show the individual how early memories and past traumas have affected their thinking, behaviour and attitude in the modern day. Psychoanalytical psychotherapy is especially useful for any condition that involves past trauma. Renowned neurologist Sigmund Freud developed this therapy, which is typically completed over a long-term basis.

Along with the above, there are a range of other types of talking therapy available, with talking therapy being helpful for many people. For further information, see our Therapy section.

Medication

Numerous types of medication are used to treat Schizoaffective Disorder. The exact approach depends on the symptoms that the person is exhibiting.

Someone who has hypomanic or manic symptoms will normally be treated with both a mood stabiliser and an antipsychotic. In some cases, certain antipsychotic can act as a mood stabiliser – and may be prescribed alone.

For those with more depression-related symptoms, a mood stabiliser and antidepressant are normally prescribed. Each individual case will be tailored to, meaning the above combinations aren’t always prescribed.

Mood Stabilisers: Mood stabilisers can help level out moods, meaning fewer lows, and fewer euphoric highs are felt. Lithium Carbonate is the best-known mood stabiliser. Others include Lamotrigine and Sodium Valproate, which are anticonvulsant medicines that have mood stabilising properties. These medicines are generally taken on a long-term basis.

Antipsychotics: Antipsychotics (also known as neuroleptics) block the effect of dopamine – a chemical in the brain that is heavily linked to psychotic symptoms like hallucinations. They can also be useful for stabilising mood, and treating anxiety. They are not suitable for everyone however, and are often associated with many side effects like weight gain, dizziness and dry mouth.

Antidepressants: Antidepressants can help to improve and regulate mood. They should improve motivation and restore energy. SSRI Antidepressants are the most commonly prescribed. They act on the brain chemical serotonin – which is thought to help in regulating mood and emotion. They may include side-effects such as a dry mouth, sexual problems and nausea, though these should hopefully be short-term. Other classes of antidepressants are available in the event of an inadequate reaction.

Other

In most cases, Schizoaffective Disorder will be able to take place normally, without the need for any inpatient care. However, in extreme cases, a person may need to receive care in a psychiatric hospital. This is only reserved for serious cases.

If other interventions have failed, or if a person is experiencing a long episode of severe depression or psychosis, Electroconvulsive Therapy (electric shock treatment) may be used:

Electroconvulsive Therapy (ECT): Electroconvulsive Therapy (commonly referred to as shock treatment) is a treatment that sees an electric current sent through the brain of an individual. The aim is to trigger an epileptic seizure, with the ultimate objective to relieve symptoms of a mental health problem. The human body is fully restrained during the procedure, which also involves a general anaesthetic. Electroconvulsive therapy is normally a last resort. Despite this, ECT actually has an impressive efficacy rate, with many people finding it helps immeasurably.

Summary

Schizoaffective Disorder is a very severe mental illness, with treatment crucial. Anyone suffering from symptoms associated with this condition should seek treatment as soon as possible.

The hope is always for full recovery, or at least an improvement in quality of life. For more information on mental health, take a look around our website!

See Also

• Schizophrenic Spectrum Section
• What is the Prognosis for Schizophrenic Spectrum Disorders?
• Therapy Homepage
• Medicine Homepage