Schizoaffective depressive disorder refers to a clinical situation where symptoms of schizophrenia and depression occur together. The term schizoaffective disorder can itself cause confusion so it is worth spending a few moments illuminating its characteristics.
Schizoaffective disorder is a combination of mood symptoms, such as mania or depression, as well as symptoms of schizophrenia. There has always been some disagreement as to whether schizoaffective disorder is a unique disease or whether it is really schizophrenia with additional mood symptoms. Schizoaffective disorder is not as disabling as bipolar disorder or schizophrenia, so it is not uncommon to find people trying to get on with life, often with little or no treatment.
Schizoaffective Depressive Disorder
For a diagnosis of schizoaffective depressive disorder to be made, prominent symptoms of depression must accompany two typical symptoms of depression. The ICD-10 Criteria for schizoaffective disorder depressive type states that during an episode of depression, a loss of appetite, reduction of normal interests, feelings of hopelessness and suicidal thoughts would be representative of prominent depressive symptoms. At the same time the person may hear voices, may display paranoid beliefs such as alien forces trying to control them, or that they are being spied on or plotted against.
As with schizophrenia the current thinking around schizoaffective disorder is that it is neurodevelopmental in origin. There is likely to be some interplay between genetics and the environment. People with relatives who have schizoaffective disorder are more likely develop the disorder themselves. Equally, people who have a relative with a mood disorder have a higher risk of developing the disorder. Younger people have a greater risk of developing bipolar type symptoms whilst older people are at greater risk of developing schizoaffective depressive disorder. The main environmental trigger appears to be stress. Stress is the most likely risk factor for relapse.
Moods may be labile. That is, they may move from a point of deep depression to one of elation during one cycle of the disorder. And, as previously indicated, symptoms of schizophrenia will be present throughout. More people have symptoms associated with depression than they do mania.
Clinical Tests and Diagnosis
The most common diagnostic method is the in-depth clinical interview. This may be carried out by your family doctor or a specialist in mental health such as a psychiatrist or psychologist. Because mood disorders can result from physical problems such as thyroid conditions, it is likely these will first be ruled out. Blood tests will need to be taken to check for any physical abnormalities. Once ruled out, and if it is established that symptoms are not related to drug or alcohol abuse, then a diagnosis will be made on the basis of criteria established in the Diagnostic and Statistical Manual of Mental Disorders (DSM).
The treatment for schizoaffective depressive disorder is likely to include antidepressant medication as well as other drugs to control psychotic symptoms. One problem with antidepressants is they can trigger a manic episode. For this reason the medical staff may have to exercise judgment as to whether the depression is severe enough to take the risk, or whether a mood stabilizer such as lithium or valproic acid is more appropriate.
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