Schizoaffective Disorder is a controversial disorder at a theoretical level, but a clinical reality that affects 0.3% of the population. To know its symptoms, effects and characteristics that can explain its causes is to know this diagnostic category.

What is Schizoaffective Disorder?

Broadly speaking, we can understand Schizoaffective Disorder as a mental disorder that combines psychotic symptoms (delusions, hallucinations, disorganized speech, highly disorganized behavior or negative symptoms such as diminished emotional expression or abulia) and mood disorders (mania-depression).

Thus, Schizoaffective Disorder primarily affects perception and psychological processes of an emotional nature.

Symptoms and Diagnosis of Schizoaffective Disorder

Schizoaffective Disorder is usually diagnosed during the period of psychotic illness because of the sheer scale of its symptoms. Episodes of depression or mania are present for most of the duration of the illness.

Due to the wide variety of psychiatric and medical conditions that can be associated with psychotic symptomatology and mood symptoms, Schizoaffective Disorder can often be confused with other disorders, such as bipolar disorder with psychotic features, major depressive disorder with psychotic features… In a way, the limits of this diagnostic category are confusing , and this is what makes a debate exist about whether it is an independent clinical entity or the coexistence of several disorders.

To distinguish it from other disorders (such as bipolar), psychotic features, delusions, or hallucinations must be present for at least 2 weeks in the absence of a major mood episode (depressive or manic). Thus, the criterion used to distinguish between Schizoaffective Disorder and other types of mental disorders is, fundamentally, time (duration, frequency of appearance of symptoms, etc).

The difficulty in diagnosing this disorder lies in knowing whether the mood symptoms have been present during most of the total active and residual duration of the illness, determining when significant mood symptoms accompanied the psychotic symptomatology. In order to know this data, the health professional must have exhaustive knowledge of the subject’s clinical history .

Who suffers from this kind of psychopathology?

The prevalence of Schizoaffective Disorder in the population is 0.3%. It is estimated that its frequency is one third of the population affected by schizophrenia .

Its incidence is higher in the female population. This is mainly due to the higher incidence of depressive symptoms among women compared to men, something that possibly has genetic causes but also cultural and social ones.

When does it usually start developing?

There is a consensus that the age of onset of Schizoaffective Disorder usually occurs in early adulthood, although this does not prevent it from occurring during adolescence or later in life.

In addition, there is a differentiated pattern of onset depending on the age of the person who begins to experience symptoms. In young adults, bipolar-type schizoaffective disorder is usually prevalent, while in older adults, depressive-type schizoaffective disorder is usually prevalent.

How does Schizoaffective Disorder influence people who suffer from it?

The way in which Schizoaffective Disorder leaves a mark on the daily lives of those who experience it has to do with practically all areas of life. However, some main aspects can be highlighted :

  • The ability to continue to function at work is normally affected , although, unlike what happens with schizophrenia, this is not a determining criterion.
  • Social contact is diminished by Schizoaffective Disorder. The capacity for self-care is also affected although, as in the previous cases, the symptomatology is usually less severe and persistent than in schizophrenia.
  • Anosognosia or lack of introspection is common in Schizoaffective Disorder, being less severe than in schizophrenia.
  • There is the possibility of association with alcohol-related disorders or other substances.

Prognosis

Schizoaffective Disorder usually has a better prognosis than schizophrenia. On the contrary, its prognosis is usually worse than that of mood disorders , among other things because the symptoms related to problems of perception represent a very abrupt qualitative change to what would be expected in a person without this disorder, while mood disorders can be understood as a problem of a rather quantitative type.

In general, the improvement that occurs is understood from both a functional and a neurological point of view. We can then place it in an intermediate position between the two.

The higher the prevalence of psychotic symptoms, the more chronic the disorder . The duration of the course of the illness also plays a role. The greater the duration, the greater the chronicity.

Treatment and psychotherapy

To date, there are no tests or biological measures that can help us diagnose Schizoaffective Disorder. It is not certain whether there is a neurobiological difference between Schizoaffective Disorder and schizophrenia in terms of their associated characteristics (such as brain, structural or functional abnormalities, cognitive deficits and genetic factors). Therefore, in this case planning highly effective therapies is very difficult .

Clinical intervention, therefore, focuses on the possibility of mitigating symptoms and training patients in the acceptance of new standards of living and management of their emotions and self-care and social behaviors.

For the pharmacological treatment of Schizoaffective Disorder, antipsychotics, antidepressants and euthymizers are usually used, while the psychotherapy of Schizoaffective Disorder would be the most indicated of the cognitive-behavioral type. In order to implement this last action, both pillars of the disorder must be treated.

  • On the one hand, the treatment of the mood disorder, helping the patient to detect and work on the symptoms of the depressive or manic type .
  • On the other hand, the treatment of psychotic symptoms could help to reduce and control delusions and hallucinations . It is known that belief in these fluctuates over time and that they can be modified and diminished by cognitive-behavioral interventions. To address delirium, for example, it may help to clarify the way in which the patient constructs his reality and gives meaning to his experiences based on cognitive errors and his life history. This approach can be done in a similar way with hallucinations.