Introduction:
- Schizoaffective disorder has features of both schizophrenia and mood disorders (bipolar and depression).
- Two sub types: depressed type and bipolar type
- The diagnosis can get complicated because primary mood disorders can have psychotic features (MMD with psychotic features or bipolar disorder with psychotic features), patients with schizophrenia can have mood symptom most commonly depression.
Epidemiology:
- The lifetime prevalence is less than 1%, the most recent data indicates 0.3% but I would say there is a range between 0.5-0.8%
- More women have the depressed type greater than 2:1 ratio
- Equal number of men and women have the bipolar type
- The cause of schizoaffective disorder is unknown. It may be a type of schizophrenia, a type of mood disorder, but most likely it’s a spectrum that combines all these things.
- Schizoaffective disorder has a better prognosis than schizophrenia but a worse prognosis than primary mood disorders.
- Patients are said to have a nondeteriorating course and respond better to lithium than patients with schizophrenia.
Diagnosis:
- Schizoaffective disorder combines the features of both schizophrenia and affective mood disorders.
- If the mood is primarily manic, it’s called schizoaffective disorder bipolar type
- If the mood is primarily depressed it’s called depressed type
- The mood component should be present for the majority > 50% of the total illness
- You must have a two-week period where psychotic symptoms and are present in the absence of mood symptoms
Treatment:
- Treatment will depend on the predominant symptoms. If the patient has more mania than a mood stabilizer will be used (e.g., lithium)
- For psychotic symptoms, dopamine blocking medications will be used (e.g., risperidone)
- For depressive symptoms serotonin reuptake inhibitors will be used (e.g., sertraline)
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