- Introduction to Schizophrenia and Related Disorders
- Delusional Disorder
- Brief Psychotic Disorder
- Schizophreniform Disorder
- Schizophrenia
- Schizoaffective Disorder
- Substance- or Medication-Induced Psychotic Disorder
- Psychotic Disorder Due to Another Medical Condition
- Other Schizophrenia Spectrum and Psychotic Disorders
- Antipsychotic Medications
Psychosis refers to symptoms such as delusions, hallucinations, disorganized thinking and speech, and bizarre and inappropriate motor behavior (including catatonia) that indicate loss of contact with reality.
Schizoaffective disorder is considered when psychosis and mood symptoms coexist. The diagnosis requires that significant mood symptoms (depressive or manic) be present concurrent with symptoms of schizophrenia. The symptoms of a major mood episode must be present for the majority (ie,> 50%) of the total duration of illness, including the active and residual phases. The diagnosis also requires the presence of psychotic symptoms such as delusions and hallucinations for 2 or more weeks in the absence of a major mood episode during the lifetime course of the illness (1).
Differentiating schizoaffective disorder from schizophrenia and mood disorders may require longitudinal assessment of symptoms and symptom progression.
Reference
1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision, DSM-5-TR (DSM-5-TR). American Psychiatric Association Publishing, Washington, DC, 2022, 122-126.
Treatment of Schizoaffective Disorder
Antipsychotic and/or antidepressant medications
Psychotherapy
Community support
Because schizoaffective disorder often leads to long-term disability, comprehensive treatment (including medications, psychotherapy, and community support) is required.
For treatment of the manic type, a second-generation antipsychotic may be sufficient but if not, it may help to add a mood stabilizer such as lithium, carbamazepine, or valproate. may be sufficient but if not, it may help to add a mood stabilizer such as lithium, carbamazepine, or valproate.
For treatment of the depressive type, a second-generation antipsychotic is given first. Then, once positive psychotic symptoms are stabilized, an antidepressant should be introduced if depression requires treatment; selective serotonin reuptake inhibitors (SSRIs) are preferred because of their safety profile (1).
Treatment reference
1. Miller JN, Black DW. Schizoaffective disorder: A review. Ann Clin Psychiatry. 2019;31(1):47-53.
Drugs Mentioned In This Article
