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What is the hybrid mental illness, schizoaffective disorder?

What is schizoaffective disorder?

Schizoaffective disorder, often abbreviated to SAD, is a chronic psychotic disorder that integrates characteristics of both schizophrenia (such as hallucinations and delusions) and mood disorders (such as mania and depression). “Schizo-” refers to the psychotic symptoms and “-affective” refers to the mood symptoms. These two types of symptoms occur simultaneously in one episode or within a short period within each other - usually around two weeks. There are three different types of schizoaffective disorder, the manic type, depressive type, and mixed type. The manic type is when a person experiences both manic and psychotic symptoms in one episode whereas the depressive type is when a person experiences both psychotic and depressive symptoms in one episode. The mixed type is when a person experiences psychotic depressive and manic symptoms however these symptoms are separate and are not necessarily dependent upon one another.

What are the symptoms?

So what are these psychotic and mood symptoms? The psychotic symptoms are similar to schizophrenic experiences. These include hallucinations and delusions. Hallucinations are when you see and experience things that others around you do not. Hallucinations can be visual such as seeing unusual things or hearing voices. They can also be any other unexplained sensations. Delusions are when you hold extreme beliefs contrary to strong evidence. For example, others can read your mind or you are always being followed. The mood symptoms are similar to those of bipolar disorder, they can be manic or depressive symptoms. Manic symptoms can include feeling uncontrollably excited about something and making unrealistic plans and risk-taking behaviour. The depressive symptoms are emotions of sadness loneliness and worthlessness. As the symptoms of schizoaffective disorder overlap with many other conditions it is therefore very difficult to diagnose and can very often be misdiagnosed. The symptoms experienced by a person who has schizoaffective disorder are different for each person.

Figure 1: The diagnostic criteria for Schizoaffective Disorder (California, 2019b)

What causes schizoaffective disorder?

These risk factors include genetics, brain chemistry, taking psychoactive drugs, and situational factors. Having a close family member such as a sibling or a parent with schizophrenia, bipolar disorder or schizoaffective disorder means that an individual could potentially inherit the characteristics associated with SAD. Although scientists have not come to clear conclusions, it is thought that those who experience SAD have a slightly different brain structure and function. Chemicals such as dopamine which helps to carry messages between brain cells seem to behave differently in a person with SAD. One idea suggests that those with SAD have more dopamine in their brains or that the dopamine affects them differently. Mind-altering drugs change your emotions behaviour and thoughts - psychoactive drugs. These drugs such as LSD are thought to enhance underlying issues, leading to SAD. Stressful live events or childhood trauma can play a key role in the development of the schizoaffective disorder.

What are the treatments?

A person with SAD can be treated in several different ways. This can be medication, hospitalisation , psychotherapy, or electroconvulsive therapy (ECT). Medication is often antipsychotics and anti-depressants and/or mood stabilisers. Hospitalisation only occurs in serious circumstances. For example when the patient is at risk to hurt themselves or others. If other non-restrictive options are available they will always be exercised. Psychotherapy can come in many forms such as cognitive behavioural therapy or family therapy. The aim of this is for the patient to understand their illness and learn to deal with it in their daily life. ECT is available for adult patients who are unresponsive to any medicine and psychotherapy. It involves sending a rapid electric current through the patient's brain under anesthesia and it is highly effective in patients with mood disorders.

References

Schizoaffective disorder. (2019). [online] Available at: https://www.mind.org.uk/media-a/2953/schizoaffective-disorder-2019.pdf [Accessed 22 Feb. 2022].

California, M.S., PharmD, PhD Department of Pharmacy Alta Bates Summit Medical Center Berkeley (2019). An Overview of Schizoaffective Disorder. [online] www.uspharmacist.com. Available at:https://www.uspharmacist.com/article/an-overview-of-schizoaffective-disorder#:~:text=Schiz oaffective%20disorder%2C%20a%20perplexing%20and [Accessed 22 Feb. 2022]

Miller, J.N. and Black, D.W. (2019). Schizoaffective disorder: A review. Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists, [online] 31(1), pp.47–53. Available at: https://pubmed.ncbi.nlm.nih.gov/30699217/ [Accessed 2 Mar. 2021].

Tsuang, M.T. and Marneros, A. (1986). Schizoaffective Psychosis: Questions and Directions. Schizoaffective Psychoses, pp.1–7.

Beck, A. T., & Alford, B. A. (2009). Depression: Causes and Treatment (2nd ed.). University of Pennsylvania Press. http://www.jstor.org/stable/j.ctt6wr94x

Mayo Clinic (2017). Schizoaffective disorder - symptoms and causes. [online] Mayo Clinic. Available at:https://www.mayoclinic.org/diseases-conditions/schizoaffective-disorder/symptoms-causes/s yc-20354504.

Tundo, A., Salvati, L., Di Spigno, D., Cieri, L., Parena, A., Necci, R., & Sciortino, S. (2012). Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder as a Comorbidity with Schizophrenia or Schizoaffective Disorder. Psychotherapy and Psychosomatics, 81(1), 58–60. https://www.jstor.org/stable/48511380

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