Schizoaffective Disorder

Schizoaffective disorders are those where someone meets the criteria for both schizophrenia and a major mood disorder. Both sets of symptoms are significant enough to cause distress or interfere with normal daily life. So, what exactly is a major mood disorder? It's a broad category for illnesses that involve a serious change in mood. I'm not referring to feeling sad or irritable from time to time, but rather, mood disorders that affect your everyday emotional state. They're more intense and more difficult to manage compared to just a bad mood or feelings of sadness. This might be persistent sadness that doesn't go away. There's a spectrum of mood disorders where we put a normal mood right in the middle. On one side, there's severe depression, which seriously interferes with your ability to enjoy life. On the other side, there's mania, an abnormally elevated mood characterized by feelings of irritability, insomnia, fast and energetic speech, or racing thoughts. A major mood disorder might be severe depression, severe mania, or huge swings in mood between depression and mania, which is sometimes called bipolar disorder. Now, imagine a circle for major mood disorders like depression, mania, or bipolar disorder. Another circle represents schizophrenia and symptoms of psychosis like hallucinations and delusions. The overlap of these two sets is what we call schizoaffective disorder, which has both a major mood disorder and symptoms of schizophrenia. Just like schizophrenia and mood disorders, there are no imaging or lab tests that can definitively diagnose schizoaffective disorder. We have to look for symptoms of both schizophrenia and a mood disorder to come up with a diagnosis. The Diagnostic and Statistical Manual of Mental Disorders, the fifth edition (DSM-5), is universally used to help psychiatrists diagnose mental disorders. It provides specific criteria for patients to meet to be diagnosed with a particular disorder. For schizoaffective disorder, the patient has to have symptoms of psychosis without a major mood disorder for a period of two weeks. If this doesn't happen, the symptoms are probably more likely to be in line with psychotic depression. A major mood episode that lasts greater than two weeks has to be present alongside schizophrenia for an uninterrupted period of time to be classified as schizoaffective disorder. The cause of schizoaffective disorder is unknown, but it's thought to involve an imbalance in several neurotransmitters in your brain, like dopamine or norepinephrine. Genetics likely plays a role, but no specific genes have been identified. Treatment usually involves medications. Currently, there's only one antipsychotic drug approved by the FDA for treatment of schizoaffective disorder, specifically, called paliperidone, or Invega. Other antipsychotics may be used as well to target symptoms of schizophrenia. For the mood disorder symptoms, it depends on the mood disorder present. If they have depression, then antidepressants will probably be prescribed. If they have mania, then it's likely they'll receive antipsychotics and mood stabilizers, like lithium. Apart from drugs and medications, the patient may also undergo some sort of psychotherapy. The prognosis of someone diagnosed with schizoaffective disorder varies, and it's thought to be somewhere between that of mood disorders and schizophrenia. There tends to be a better outlook than for those with schizophrenia alone, and a worse outlook for those with mood disorders alone. Risk factors associated with a worse prognosis are things that relate to the psychosis side of it, such as earlier onset, no periods of remission or temporary recovery, and having a family member with schizophrenia.