Schizoaffective Disorder
Schizoaffective disorder symptoms look like a mixture of two
kinds of major mental illnesses that are usually thought to run in
different families, involve different brain mechanisms, develop in
different ways, and respond to different treatments: mood
(affective) disorders and schizophrenia.
Symptoms of Schizoaffective Disorder
The two major mood disorders are unipolar depression and bipolar
or manic-depressive illness.
Seriously depressed people:
People experiencing a manic mood are:
People with chronic schizophrenia:
Difficulty In Distinguishing Illnesses
People with affective disorders usually appear normal between
episodes of illness and do not become more seriously disabled with
time.
People with schizophrenia rarely seem normal, and their condition
tends to deteriorate, at least in the early years of the
illness.
This distinction is not always as obvious as the description
suggests. Emotion and behavior are more fluid and less easy to
classify than physical symptoms. Seriously depressed and manic
people often have hallucinations and delusions. Mania can be
impossible to distinguish from an acute schizophrenic reaction, and
psychotic or delusional depression is important enough to rate its
own classification by some psychiatrists. Mood changes occur both
as symptoms of schizophrenia and as reactions to its devastating
effects; for example, depression after a schizophrenic episode
(post-psychotic depression) is common and often severe, and it is
during this time that a person suffering from schizophrenia is most
likely to commit suicide.
Schizophrenic apathy and an incapacity for pleasure can also be
mistaken for depression. Often a diagnosis has to be changed from
one kind of major mental disorder to the other. In a recent study
of more than 936 people with a severe psychiatric disorder who were
hospitalized at least four times in a seven-year period,
investigators found that about 25% of those originally given other
diagnoses (including bipolar disorder) and 33% of those originally
given other diagnoses (including bipolar disorder) had a final
diagnosis of schizophrenia.
Signs That May Help Define Schizoaffective as the
Diagnosis
However, the research is inadequate and the results have been
confused by varying definitions.
Choice of Therapies
If a person is in a psychotic state, a neuroleptic
(antipsychotic) drug is most often used, since antidepressants and
lithium (used for bipolar disorder) take several weeks to start
working. Antipsychotic drugs may cause tardive dyskinesia, a
serious and sometimes irreversible disorder of body movement, so
people are asked to take them for long periods only when there is
no other alternative. After the psychosis has ended, the mood
symptoms may be treated with antidepressants, lithium,
anticonvulsants, or electroconvulsive therapy (ECT). Sometimes a
neuroleptic is combined with lithium or an antidepressant and then
gradually withdrawn, to be restored if necessary. The few studies
on drug treatment of this disorder suggest that antipsychotic drugs
are most effective. The greater effectiveness of these new drugs
may be partly due to their activity at receptors for the
neurotransmitter serotonin, which is not influenced as strongly by
standard antipsychotic drugs.
For more information contact your local Mental Health Association,
community mental health center, or for additional resources, please
call 1-800-969-NMHA.
National Mental Health Association
2001 N. Beauregard Street, 12th Floor
Alexandria, VA 22311
Phone 703/684-7722
Fax 703/684-5968
Mental Health Resource Center 800/969-NMHA
TTY Line 800/433-5959
National Alliance for Research on Schizophrenia and Depression
(NARSAD)
60 Cuttermill Rd, Suite 404
Great Neck, NY 11021
Phone: (800) 829-8289
National Institute of Mental Health Information Resources and
Inquiries Branch
5600 Fishers Lane, Room 7C-02
Rockville, MD 20857
Phone: (301) 443-4513
11/25/97 3:21 PM
NMHA's Campaign for America's Mental Health works to raise
awareness that mental illnesses are common, real and treatable
illnesses and ensure that those most at-risk receive proper, timely
and effective treatment.
