Phenomenonology Of Schizoaffective Disorder
As noted in the preceding section, the DSM-IV-TR applies a categorical approach to the diagnosis of schizoaffective disorder, and then defines this condition according two the two major dimensions of neurobehavioral function it affects: thought and mood . The disturbance of thought must include two of the A schizophrenia symptoms for a significant portion of time during a 1-month period . The A symptoms include delusions, hallucinations, disorganized speech and grossly disorganized or catatonic behavior. The mood disorder may include episodes that meet diagnostic criteria for a major depressive episode , manic episode, or mixed episode. The symptoms that meet criteria for a mood episode are present for a substantial portion of the total duration of the active and residual periods of the illness. As noted above, schizoaffective disorder is further divided into two subtypes based on the type of mood episodes with which the patient presents: bipolar or depressed. As an additional criterion, the DSM-IV states that during the period of illness there must be delusions or hallucinations for at least 2 weeks in the absence of prominent mood symptoms. Lastly, the symptoms meeting criteria for schizoaffective disorder may not be due to the direct physiological effects of a substance or a general medical condition.
How Common Is Schizoaffective Disorder
Schizoaffective disorder is rare. Research estimates that 3 in every 1000 people will develop schizoaffective disorder in their lifetime.Still, its difficult to know exactly how many people have the condition because of the challenging diagnosis. People with schizoaffective disorder have symptoms of two different mental health conditions. Some people might get misdiagnosed with schizophrenia. Others might get misdiagnosed with a mood disorder.
Understanding The Subtle Differences
The difference between schizoaffective disorder and schizophrenia is often hard to spot. The reason is that a lot of the symptoms overlap. For example, doctors typically characterize schizoaffective disorder by the mood disorders that accompany it. However, its not uncommon for people with schizophrenia to experience manic or depressive moods as well.
If both experience mood disorders, how can specialists tell the difference? The key difference between schizoaffective disorder and schizophrenia is the prominence of the mood disorder. With schizoaffective disorder, the mood disorder is front and center. With schizophrenia, its not a dominant part of the disorder.
Another difference is the psychotic symptoms that people experience. With schizophrenia, the psychotic symptoms are dominant. With schizoaffective disorder, episodes of psychosis may occur.
However, it takes trained professionals to spot the differences between the two. After all, the symptoms typically start when people reach their 20s. Also, they can cause hallucinations and delusions.
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Symptoms Of Schizoaffective Disorder Vs Schizophrenia
A person with schizoaffective disorder has symptoms of both a psychotic disorder as well as symptoms of a mood disorder. These symptoms may overlap, but also need to appear separately in order to rule out other diagnoses including depression or bipolar with psychotic features.2, 3, 4, 5
Mood-related symptoms are more pronounced in schizoaffective disorder, while psychotic symptoms are more pronounced in schizophrenia. Someone with schizoaffective disorder may experience psychotic episodes similar to those in schizophrenia. However, these psychotic episodes tend to be shorter and less frequent in schizoaffective than in schizophrenia.7
Diagnosing Schizoaffective Disorder: Dsm
Schizoaffective disorder is, like schizophrenia, a psychotic disorder. In addition to psychotic features, schizoaffective disorder has significant mood symptoms. This rare mental illness is related to both schizophrenia and bipolar disorder or major depressive disorder and affects approximately one-third fewer people than schizophrenia.
To receive a schizoaffective disorder diagnosis, someone must meet all the primary criteria for schizophrenia and have prominent mood disorder symptoms as well. This basic description of this disorder is accurate, but it falls a bit short. Lets take a deeper look to answer the question: What is schizoaffective disorder?
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Community Mental Health Services
These services are important in keeping you out of hospital or in managing your gradual return back into the community after being discharged from hospital.
Specialist services may be needed including community psychiatric nursing, social services and occupational therapy as well as support in managing your domestic and financial affairs.
There are different teams that can support you in the community:
- Early Intervention Team: provides intensive support to young people who have recently been diagnosed with schizophrenia or schizoaffective disorder.
- Assertive Outreach Team: provides extensive help and support for people who have had a diagnosis of schizophrenia or schizoaffective disorder for quite some time, especially for people who find it difficult to work with other services or have not been able to take their medications regularly for various reasons.
- Crisis Resolution Home Treatment Team: can help at you at home, prevent a hospital admission and provide intensive support after a hospital admission.
- Vocational Rehabilitation: includes day centres, day hospital or community health centres. These facilities offer different creative activities such as back to work courses, education, art and cooking.
Frequency And Ages Affected
Bipolar disorder affects approximately 2.2 percent of people in the United States. Typically, it first appears between the late teen years and early adulthood. Children can also show signs of bipolar disorder.
Schizophrenia isnt as common as bipolar disorder. It affects 1.1 percent of the U.S. population. People usually learn they have it between the ages of 16 and 30. Schizophrenia isnt usually seen in children.
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How Does Schizoaffective Disorder Affect People
This lifelong illness can affect all areas of a persons life. A person with schizoaffective disorder can find it difficult to function at work or school. It also affects peoples relationships with family, friends and loved ones.Many people with schizoaffective disorder have periodic episodes. There are times when their symptoms surface and times when their symptoms might disappear for a while.
How Is Schizoaffective Disorder Diagnosed
If someone is showing symptoms of schizophrenia and a mood disorder, see a healthcare provider. The provider will do a medical history and physical examination. There are no lab tests to diagnose schizoaffective disorder. But the provider may use X-rays and blood tests to rule out other illnesses that may be causing the symptoms.
If there is no physical cause for the symptoms, the provider may refer the person to a psychiatrist or psychologist. These professionals specialize in diagnosing and treating conditions tied to mental and behavioral health.
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Schizoaffective Disorder Versus Other Conditions With Symptoms Of Psychosis
The key difference is that schizoaffective disorder involves mood symptoms with psychosis, followed by at least 2 weeks of symptoms of psychosis with no mood episodes.
Heres a summary:
| schizoaffective disorder | mostly mood episodes and at least 2 weeks of symptoms of psychosis with no mania or depression |
| schizophrenia |
Natural History Of Schizoaffective Disorder
Differences in the natural history of schizophrenia, bipolar disorder, and schizoaffective disorder are among the features often purported to facilitate distinctions between these conditions. However, the lack of diagnostic reliability and stability particularly in the case of schizoaffective disorder presents a serious challenge to such arguments. For example, Maj and colleagues independently interviewed 150 patients using two psychiatrist diagnosticians and reviewed reliability for individual elements of the DSM-IV criteria for schizoaffective and mood disorder diagnosis. They report lower inter-rater reliability scores for schizoaffective disorder when compared with those for manic and depressive diagnoses. Vollmer-Larsen and colleagues re-evaluated hospital records and discharge summaries of 59 patients with hospital discharge diagnoses of schizoaffective disorder and found that using an operational criteria checklist, none of the patients fulfilled lifetime diagnostic criteria for schizoaffective disorder and only six patients met possible ICD-10 criteria for schizoaffective disorder. They argued for a moratorium on the use of schizoaffective disorder as a psychiatric diagnosis on the basis of its poor stability over time.
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What Is Bipolar Disorder And Its Symptoms
First, it is essential to know there are different types of bipolar disorders. These may include symptoms like mania, hypomania, and depression. The symptoms can produce unpredictable changes in mood and behavior, which results in extreme distress and difficulty in life. Below are the different bipolar types and some of their symptoms.
Bipolar I disorder: The individual may have had at least one manic episode that might have preceded or was followed by a major depressive episode or being hypomanic. There may have been a break in reality.
Bipolar II disorder: The individual had at least one major depressive episode and one hypomanic episode but has never had a manic episode. The difference between these two is that hypomania is a milder form of mania where the energy level is higher than normal but not as extreme as in mania.
Cyclothymic disorder: The individual has had at least two years, one year as a child and one as a teenager, of having hypomania symptoms and depressive symptoms, though the depressive symptoms are less severe than major depression.
Medically Reviewed By: Audrey Kelly, LMFT
Schizoaffective disorder is one of the least understood and lesser-known types of mental illness. Many people assume that schizoaffective disorder is the same thing as schizophrenia. However, this is not the case. While schizoaffective disorder does have similarities to schizophrenia, it is a completely different diagnosis.
- What Is Schizoaffective Disorder Bipolar Type
Neurobiology Of Schizoaffective Disorder
It is reasonably well accepted that the clinical phenomena used to characterize schizophrenia, mood disorders, and schizoaffective disorder are manifestations of disturbances in multiple domains of neurobiological function. These disturbances are amenable to study using neuropsychological, neuroimaging, electrophysiologic, neurochemical, and genetic investigations. Studies investigating the neurobiology of schizoaffective disorder separate from that of schizophrenia or mood disorders are few instead, most include subjects with schizoaffective disorder among those with either schizophrenia or bipolar disorder. At first glance, the tendency to include persons with schizoaffective disorder in one of these two groups would appear to bespeak some measure of agreement among researchers regarding the difficulty of clearly distinguishing between persons with schizoaffective disorder and these other conditions on the basis of their neurobiological features. While this remains a possibility, it is also noteworthy that most investigations focus on only one or a few neurobiological disturbances that reflect a specific domain of neurobehavioral function, usually either information processing or emotional regulation but not both. In effect, studies investigating the neurobiology of schizoaffective disorder use a dimensional approach to study-group assignment.
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Diagnosing Schizophrenia And Bipolar Disorder
There is no standard blood test for either schizophrenia or bipolar disorder however, a physician could conduct a psychological and physical exam. They may want to run a full blood test, and they may want to send you in for a CT scan or MRI to be sure no other conditions are in play. You will likely be asked about any family history of mental disorders and about any symptoms you are experiencing.
It is crucial to be completely honest with your doctor about any symptoms, even if you think they are not worth mentioning or are nervous to mention them. It is also vital to be truthful about any substance use you may be engaging in, as any medication the physician may prescribe could not mix well with other drugs and alcohol. Your doctor may request you undergo a substance use screening to be sure.
You might have to return a few times to your doctor before a diagnosis is made, and you might even be referred to a doctor that specializes in mental health conditions, as most HMOs require referrals to specialists. A doctor may ask you to maintain a journal of your moods, sleep patterns, and record any symptoms you are experiencing. This will help the doctor determine any patterns that can help them make the correct diagnosis.
What Is The Difference Between Schizoaffective Disorder And Schizophrenia
Schizophrenia and schizoaffective disorder have a significant overlap in symptoms. But schizoaffective disorder also involves symptoms of mood disorders like major depression or bipolar disorder, which makes it a more complicated condition to diagnose and treat. Both conditions are manageable, and no one who is diagnosed with either should be prevented from living a normal life over the long-term.
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Computer Generated Transcript Of Schizoaffective Disorder Vs Schizophrenia Episode
Announcer: Welcome to Inside Schizophrenia, a look in to better understanding and living well with schizophrenia. Hosted by renowned advocate and influencer Rachel Star Withers and featuring Gabe Howard.
Rachel Star Withers: Welcome to Inside Schizophrenia, a Psych Central Podcast, which is proud to be with Healthline.com. Im your host, Rachel Star Withers here with my wonderful co-host, Gabe Howard.
Gabe Howard: Hey, everyone.
Rachel Star Withers: And in todays episode, we are going to be exploring the differences between schizoaffective disorder and schizophrenia, Gabe, it seems simple at first and then it got really complicated. I feel like thats like all of our episodes. Like when I first look at the topic, Im like, oh, this will be easy. And then when I like really research and get into it, what happened? This is confusing.
Gabe Howard: I think that were definitely explaining why mental illness is so difficult to understand, people think depression and sadness are the same thing, right? So lets move that aside. Its like schizoaffective and schizophrenia. They both have schizo, so therefore they must be the same thing. But, yeah, thats completely false.
Rachel Star Withers: Were going to be exploring all of that, and we also have the wonderful Dr. Michelle Maust from MindPath Care Centers, wholl be joining us to give us the doctors perspective on all of this.
Gabe Howard: And she is wonderful. Shell be coming up a little later in the show.
Gabe Howard: I do.
Schizoaffective Disorder Signs And Symptoms
Living with schizoaffective disorder is difficult in any circumstance, but the trials and tribulations are sometimes made worse by a false schizophrenia diagnosis. In other instances, the disorder is incorrectly classified as major depression or bipolar disorder, which can lead to treatment choices that dont address all of the disruptive and debilitating symptoms of this complicated medical condition.
In its schizophrenic aspects, schizoaffective disorder often mimics either paranoid schizophrenia or disorganized schizophrenia. Schizoaffective disorder vs. schizophrenia comparisons reveal that each demonstrates the so-called positive symptoms of conventional schizophrenia, which are common to the paranoid and disorganized varieties of the disorder schizophrenia. Those positive symptoms tend to involve psychotic breaks with reality that can make normal functioning difficult, if not impossible.
- Disorganized behavior
- Negative symptoms of schizophrenia
One symptom may be enough to make a diagnosis, if it is: a). delusions that are especially bizarre or out of touch with reality, or b). auditory hallucinations that are continuous and/or involve multiple voices having conversations or issuing instructions.
Generally, the schizophrenia symptoms and the mood disorder will not be present simultaneously, at least not at equal strength, and that is another reason why a schizoaffective disorder diagnosis cannot be given when the disorder is in the initial stage.
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Schizoaffective Disorder Vs Schizophrenia Diagnosis
Both schizophrenia and schizoaffective disorder are defined as psychotic disorders in the latest version of the “Diagnostic and Statistical Manual of Mental Disorders” . In order to diagnose either condition, healthcare providers assess the individual’s symptoms to see if they meet DSM-5 diagnostic criteria.
Closer Attention To The Phenotype: Clinical Covariates And Sub
As discussed elsewhere bipolar disorder researchers have been taking an interest in a variety of clinical sub-types and covariates over recent years as a way of testing subsets of cases with increased clinical homogeneity. Examples include rapid cycling , lithium responsiveness, bipolar affective puerperal psychosis , early age at onset, and occurrence of psychotic features during illness.
Consideration of the occurrence of psychotic features in bipolar disorder brings us to consider the interesting and biologically important issue of the overlap in genetic findings in bipolar and schizophrenia.
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Are There Different Types Of Schizoaffective Disorder
There are 3 main types of schizoaffective disorder:
What is manic type?
This means you have symptoms of schizophrenia and mania at the same time through a period of illness.
What is depressive type?
This means you have symptoms of schizophrenia and depression at the same time through a period of illness.
What is mixed type?
This means you have symptoms of schizophrenia, depression and mania through a period of illness.
Getting Help For Bipolar Schizoaffective Disorder
Anyone who recognizes any of these symptoms in themselves, or who is troubled by their thoughts and behaviors, or worried about hearing and seeing things that other people dont hear or see, should seek help right away. Telling a friend or a family member is a good place to start, but seeing a doctor or mental health professional is the next important step. Even just seeing ones general practitioner is a great step, because that doctor can recommend a specialist or what to do next.
Friends and family play an important role in getting help for someone who is struggling. It is common to be unaware of ones own symptoms, and it is often easier for someone else to recognize them first. It is crucial to offer help or to get someone help who is exhibiting symptoms of a mental illness or whose behaviors just dont seem right and have changed from what is normal.
Schizoaffective disorder bipolar type is not an illness to be taken lightly. Without diagnosis and treatment, there are many potential complications that can cause myriad problems and even be life-threatening. Professional diagnosis, multi-faceted treatment, and support from friends and family are crucial for helping someone with this condition return to a better way of life, with relief from difficult symptoms.
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