Schizoaffective Disorder Symptoms
Schizoaffective disorder is a term used to describe the symptoms of patients who fall on the boundary between schizophrenia (schizo) and a form of bipolar disorder (affective). During a schizoaffective episode, the psychotic symptoms of schizophrenia partially overlap with the symptoms of either bipolar depression or bipolar disorder (involving both depression and mania). However a person with schizoaffective disorder can also experience the psychotic symptoms of schizophrenia without the affective symptoms of the mood disorder. The symptoms may cycle through severe episodes to periods of improvement (Oltmanns & Emery, 2007).
Each person will experience a unique combination of the symptoms from across a schizophrenia and bipolar disorder spectrum. A diagnosis of schizoaffective disorder occurs when a patient is seen to experience an episode involving overlap of schizophrenia and bipolar disorder symptoms, as well as an episode involving only schizophrenic symptoms. The best way to understand the symptoms of schizoaffective disorder is to take a look at the individual symptoms involved in schizophrenia and bipolar disorder.
Symptoms of Schizophrenia
Schizophrenia involves hallucinations, delusional beliefs, emotional disturbances, blunted affect, malfunction of interpersonal relationships and disorganization.
Hallucinations and delusional beliefs are things that are not real. Hallucinations are sensory experiences not caused by real external stimuli. Most often, the hallucinations are of an auditory nature. Many patients hear voices that are judging and demeaning, or instructing them to do things. Delusional beliefs are false beliefs, or incorrect inferences about reality. A patient will uphold a delusional belief, even when presented with contradictory evidence. Common delusional beliefs include thinking thoughts are being inserted into the person’s head, or that the person is being controlled by mysterious external forces.
Emotional disturbances involve a restriction of a person’s non-verbal display of emotional responses. This restriction in emotional response is referred to as blunted affect. If a person is experiencing a blunted affect they will have difficulty expressing any outward emotions. Another disturbance in emotional expression is anhedonia, which refers to a person’s inability to experience positive subjective feelings. A person suffering anhedonia will also lose interest in recreational and social activities, and become unable to experience pleasure from physical sensations, such as taste and touch.
A person exhibiting schizophrenic symptoms in a schizoaffective episode may experience malfunctions in interpersonal relationships. The person may become withdrawn and exhibit apathy towards the situation. This means that he or she won’t care what is happening. The person may also exhibit avolition, which encompasses indecisiveness, ambivalence and a loss of will power. Interest is lost in achieving personal goals and the person cannot function independently. Speech disturbances, such as a lack of speech and interruption in speech patterns may also be exhibited by a person suffering schizophrenic symptoms in a schizoaffective episode.
Disorganization in thinking and behavior are common schizophrenic symptoms in schizoaffective disorder. A common thinking disturbance is disorganized speech. A person may say things that don’t make sense, such as irrelevant responses to questions, expressing disconnected ideas and using words in peculiar ways. Behavioral disturbances include unusual motor behaviour such as rigidity (also referred to as catatonia), overexcitement and over activity. Some patients are known to pace for no reason or to repeat an action such as rubbing his or her hands together. Inappropriate affect is also a bizarre behavior involving the displaying of an emotion inappropriately. For example a person may find something tragic incredibly funny.
Symptoms of Bipolar Disorder
The symptoms of bipolar disorder (also referred to as manic depression) take the form of major depression and manic episodes. A person will cycle through periods of depression and mania. The cycles can be rapid, which means four cycles within a 12 month period, or ultra-rapid, which means many cycles within a one month period or less.
Symptoms of bipolar depression include sleep disturbances, changes in body weight, feelings of sadness, worthlessness and guilt, the inability to experience pleasure or happiness (anhedonia), feeling agitated, withdrawing from social situations, experiencing concentration and short-term memory problems, being indecisive, losing their sex drive, experiencing headaches, fatigue and suicidal ideation. If bipolar depression escalates, a person can experience symptoms involving hallucinations, delusional beliefs and rigidity of movement (catatonia).
Bipolar mania symptoms include inflated self-esteem, grandiose ideas, decreased need for sleep, being talkative or talking at a very fast pace, having racing thoughts and ideas, distractibility, increased involvement in high risk behavior with painful consequences such as sexual promiscuity, spending sprees or risky business investments.
A person experiencing a manic episode can also display psychotic symptoms such as delusional beliefs and hallucinations. Grandiose delusions involve the person believing he or she possesses special and unique gifts or powers. For example, a person may believe they are a king, or Jesus, or that they have special powers to help cure the sick. Hallucinations in bipolar disorder can occur in any sense organ. As in schizophrenia, the most common form of hallucination is auditory. A person experiencing a hallucination will find a way to explain it, regardless of whether or not it is true, hence the development of delusional beliefs.
For a person suffering schizoaffective disorder symptoms, they will experience the psychotic symptoms of schizophrenia with both the presence and absence of the affect symptoms of bipolar disorder.
Bipolar Disorder: Symptoms, Diagnosis and Treatment https://www.healthnetwork.com.au/diseases-conditions/bipolar-disorder.asp
Mania and Hypomania Defined https://www.blackdoginstitute.org.au/public/bipolardisorder/bipolardisorderexplained/maniahypomaniadefined.cfm
Oltmanns, T. F., Emery, R. E., 2007. Abnormal Psychology. 5th ed. New Jersey: Pearson Education, Inc
Recognising Bipolar Disorder https://www.bipolar.com.au/understanding/recognising.cfm
Schizoaffective Disorder https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001927/