Schizoaffective disorder: causes, symptoms and treatment

the Schizoaffective disorder it is a theoretically controversial disorder, but a clinical reality that affects 0.3% of the population. Knowing 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, very disorganized behavior, or negative symptoms such as decreased emotional expression or bullying) and mood disorders (mania-depression).

Thus, schizoaffective disorder fundamentally affects emotional perception and psychological processes.

Symptoms and diagnosis of schizoaffective disorder

Schizoaffective disorder is usually diagnosed during the period of psychotic illness by the onset 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 symptoms and mood symptoms, schizoaffective disorder can often be mistaken for other disorders, such as bipolar disorder with psychotic features, major depressive disorder with psychotic features … path, the limits of this diagnostic category are confusing, And this is what provokes a debate as to whether this is an independent clinical entity or the coexistence of various disorders.

To distinguish it from other disorders (such as bipolar disorder), psychotic features, delusions or hallucinations should be present for at least 2 weeks in the absence of a major episode of the disease. Thus, the criterion used to distinguish schizoaffective disorder from other types of mental disorder is essentially time (duration, frequency of onset of symptoms, etc.).

The difficulty in diagnosing this disorder lies in knowing whether mood symptoms have been present for most of the total active and residual duration of the disease, determining when there were symptoms of the mood condition. significant accompanied by psychotic symptomatology. To know these data, the healthcare professional must have a thorough knowledge of the clinical history of the subject..

Who suffers from this type 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 in women compared to men, which may have genetic as well as cultural and social causes.

When does it usually start to develop?

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 stages of adulthood. 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, schizoaffective disorder of the bipolar type usually prevails, while in older adults, schizoaffective disorder of the depressive type usually prevails.

How Does Schizoaffective Disorder Affect People With It?

The way in which schizoaffective disorder leaves its mark on the daily lives of those who experience it affects virtually every area of ​​life. however, some main aspects can be highlighted:

  • The ability to continue working at the job level is generally affectedAlthough, with schizophrenia, this is not a determining factor.

  • Social contact is diminished for schizoaffective disorder. The ability to take care of oneself is also affected although, as in previous cases, symptoms are generally less severe and persistent than in schizophrenia.

  • Anosognosia or lack of introspection it is common in schizoaffective disorder, being less severe than in schizophrenia.

  • It is possible that alcohol-related disorders are associated with or other substances.


Schizoaffective disorder generally has a better prognosis than schizophrenia. On the contrary, his prognosis it is usually worse than that of mood disorders, Among other things because the symptoms related to perception problems assume a very abrupt qualitative change from what one would expect in a person without this disorder, while mood alterations can be understood as a more typical problem soon quantitative.

In general, the improvement that occurs is understood from both a functional and neurological point of view. It can then be placed 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 disease also affects. The longer the duration, the greater the chronicity.

Treatment and psychotherapy

To date, no biological test or measurement can help us diagnose schizoaffective disorder. There is no certainty that there is a neurobiological difference between schizoaffective disorder and schizophrenia in terms of their associated characteristics (such as their brain, structural or functional abnormalities, cognitive deficits and genetic factors). Therefore, in this case, planning high-efficacy therapies is very difficult.

Clinical intervention therefore focuses on the ability to alleviate symptoms and train patients to accept new standards of living and to manage their emotions, self-care and social behaviors.

For the pharmacological treatment of schizoaffective disorder, antipsychotics, antidepressants and euthymisers are generally used, while the most indicated psychotherapy for schizoaffective disorder would be cognitive-behavioral. In order to implement this last action, the two pillars of the disorder must be addressed.

  • On the one hand, the treatment of mood disorders, help the patient to detect and work on depressive or manic symptoms.

  • On another side, treating psychotic symptoms may help reduce and control delusions and hallucinations. We know that belief in the latter fluctuates over time and can be modified and diminished by cognitive-behavioral interventions. Combating delirium, for example, can help clarify how the patient constructs their reality and makes sense of their experiences based on cognitive errors and their life history. This approach can be done in the same way as hallucinations.

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