Global InformationSchizoaffective disorder information
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| Schizoaffective disorder | |
|---|---|
| Specialty | Psychiatry |
| Symptoms |
|
| Complications |
|
| Usual onset | 16–30 years of age |
| Types |
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| Causes | Unknown[3] |
| Risk factors |
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| Diagnostic method | Psychiatric assessment |
| Differential diagnosis |
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| Medication |
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| Prognosis | Depends on the individual, medication response, and therapeutic support available |
| Frequency | 0.3% |
Schizoaffective disorder (SZA, SZD) is a mental disorder characterized by abnormal thought processes and an unstable mood.[4][5] This diagnosis requires symptoms of both schizophrenia (usually psychosis) and a mood disorder: either bipolar disorder or depression.[4][5] The main criterion is the presence of psychotic symptoms for at least two weeks without any mood symptoms.[5] Schizoaffective disorder can often be misdiagnosed[5] when the correct diagnosis may be psychotic depression, bipolar I disorder, schizophreniform disorder, or schizophrenia. This is a problem as treatment and prognosis differ greatly for most of these diagnoses.[5][6]
There are three forms of schizoaffective disorder: bipolar (or manic) type (marked by symptoms of schizophrenia and mania), depressive type (marked by symptoms of schizophrenia and depression), and mixed type (marked by symptoms of schizophrenia, depression, and mania).[4][5][7] Common symptoms include hallucinations, delusions, and disorganized speech and thinking.[8] Auditory hallucinations, or "hearing voices", are most common.[9][10] The onset of symptoms usually begins in adolescence or young adulthood.[11] On a ranking scale of symptom progression relating to the schizophrenic spectrum, schizoaffective disorder falls between mood disorders and schizophrenia in regards to severity.[12]
Genetics (researched in the field of genomics); problems with neural circuits; chronic early, and chronic or short-term current environmental stress appear to be important causal factors.[13][14][15] No single isolated organic cause has been found, but extensive evidence exists for abnormalities in the metabolism of tetrahydrobiopterin (BH4), dopamine, and glutamic acid in people with schizophrenia, psychotic mood disorders, and schizoaffective disorder.[16]
While a diagnosis of schizoaffective disorder is rare, 0.3% in the general population,[17] it is considered a common diagnosis among psychiatric disorders.[18] Diagnosis of schizoaffective disorder is based on DSM-5 criteria, which consist principally of the presence of symptoms of schizophrenia, mania, and depression, and the temporal relationships between them.
The main current treatment is antipsychotic medication combined with either or both of mood stabilizers and antidepressants. There is growing concern by some researchers that antidepressants may increase psychosis, mania, and long-term mood episode cycling in the disorder.[citation needed] When there is risk to self or others, usually early in treatment, hospitalization may be necessary.[19] Psychiatric rehabilitation, psychotherapy, and vocational rehabilitation are very important for recovery of higher psychosocial function[citation needed]. As a group, people diagnosed with schizoaffective disorder using DSM-IV and ICD-10 criteria (which have since been updated[clarification needed]) have a better outcome,[4][5] but have variable individual psychosocial functional outcomes compared to people with mood disorders, from worse to the same.[5][20][non-primary source needed] Outcomes for people with DSM-5 diagnosed schizoaffective disorder depend on data from prospective cohort studies, which have not been completed yet.[5] The DSM-5 diagnosis was updated because DSM-IV criteria resulted in overuse of the diagnosis;[19] that is, DSM-IV criteria led to many patients being misdiagnosed with the disorder. DSM-IV prevalence estimates were less than one percent of the population, in the range of 0.5–0.8 percent;[21] newer DSM-5 prevalence estimates are not yet available.
- ^ "Schizoaffective disorder, bipolar type". www.icd10data.com.
- ^ "Schizoaffective disorder, depressive type". www.icd10data.com.
- ^ a b "Schizoaffective Disorder Overview – Causes". www.nami.org.
- ^ a b c d "F25 Schizoaffective disorders". ICD-10 Version:2010. World Health Organization.
- ^ a b c d e f g h i Malaspina D, Owen MJ, Heckers S, Tandon R, Trump D, Schultz S, Barch DM, Gaebel W, Gur RE, Tsuang M, Van Os J, Carpenter W (May 2013). "Schizoaffective disorder in the DSM-5". Schizophrenia Research. 150 (1): 21–5. doi:10.1016/j.schres.2013.04.026. PMID 23707642. S2CID 14770729.
- ^ Kaplan, HI; Saddock, VA (2007). Synopsis of Psychiatry. New York: Lippincott, Williams & Wilkins. ISBN 978-0-7817-7327-0.
- ^ "Schizoaffective disorder". Royal College of Psychiatrists. Retrieved 30 September 2022.
- ^ Brannon, Guy E; Bienenfeld, David; Talavera, Francisco (9 September 2013). "Schizoaffective Disorder". Medscape Drugs & Diseases. WebMD.
- ^ Cite error: The named reference
pmid18056246was invoked but never defined (see the help page). - ^ Startup H, Freeman D, Garety PA (19 June 2006). "Persecutory delusions and catastrophic worry in psychosis: developing the understanding of delusion distress and persistence". Behaviour Research and Therapy. 45 (3): 523–537. doi:10.1016/j.brat.2006.04.006. PMID 16782048.
- ^ "Schizoaffective Disorder in Children and Adolescents". www.mindyra.com. Retrieved 30 September 2022.
- ^ Vardaxi, Chrysoula Ch.; Gonda, Xenia; Fountoulakis, Konstantinos N. (1 February 2018). "Life events in schizoaffective disorder: A systematic review". Journal of Affective Disorders. 227: 563–570. doi:10.1016/j.jad.2017.11.076. ISSN 0165-0327. PMID 29172048.
- ^ Kempf, L. (11 July 2009). "Mood disorder with psychotic features, schizoaffective disorder, and schizophrenia with mood features: Trouble at the borders". International Review of Psychiatry. 17 (1): 9–19. doi:10.1080/09540260500064959. PMID 16194767. S2CID 21422704 – via Taylor & Francis.
- ^ American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. ISBN 9780890425558.
- ^ Munk Laursen, Thomas (16 June 2009). "Bipolar Disorder, Schizoaffective Disorder, and Schizophrenia Overlap: A New Comorbidity Index". The Journal of Clinical Psychiatry. 70 (10) – via Psychiatrist.com.
- ^ Archibald, Luke (20 December 2019). "Alcohol Use Disorder and Schizophrenia or Schizoaffective Disorder". Alcohol Research: Current Reviews. 40 (1). doi:10.35946/arcr.v40.1.06. PMC 6927747. PMID 31886105 – via NIH.
- ^ Marneros, Andreas (30 June 2012). "Schizoaffective Disorder". Korean Journal of Schizophrenia Research. 15 (1): 5–12. doi:10.16946/kjsr.2012.15.1.5 – via KoreaMed Synapse.
- ^ Joshi, Kruti; Lin, Jay; Lingohr-Smith, Melissa; Fu, Dong-Jing; Muser, Erik (October 2016). "Treatment Patterns and Antipsychotic Medication Adherence Among Commercially Insured Patients With Schizoaffective Disorder in the United States". Journal of Clinical Psychopharmacology. 36 (5): 429–435. doi:10.1097/JCP.0000000000000549. ISSN 0271-0749. PMC 5017269. PMID 27525965.
- ^ a b Cite error: The named reference
BeckerKilian2006was invoked but never defined (see the help page). - ^ Jäger M, Bottlender R, Strauss A, Möller HJ (2004). "Fifteen-year follow-up of ICD-10 schizoaffective disorders compared with schizophrenia and affective disorders". Acta Psychiatrica Scandinavica. 109 (1): 30–7. doi:10.1111/j.0001-690x.2004.00208.x. PMID 14674956. S2CID 43303750.
- ^ Jeffrey, Susan (26 May 2009). "APA 2009: DSM on Track for 2012, But Difficult Decisions Lie Ahead". Medscape Medical News. WebMD. Retrieved 3 August 2009.