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In the course of schizoaffective disorders, patients simultaneously experience disorders typical of two different entities, namely symptoms of schizophrenia and symptoms of affective disorders. Although almost a century has passed since their distinction in psychiatric classifications, the causes of schizoaffective disorders are still quite unclear. The most important thing seems to be the correct diagnosis of schizoaffective disorders, because medicine has effective methods of treating this problem.

Schizoaffective disorderis a problem on the borderline between schizophrenia and affective disorders. It is a rather heterogeneous entity, because patients diagnosed with schizoaffective disorder may present various ailments and problems. Generally speaking, it can be said that in the course of this unit, patients experience both symptoms of schizophrenia and mood disorders (in the form of episodes of depression or mania), but they are so severe that it is not possible to diagnose "pure" schizophrenia or any specific disorder. affective.

For the first time the term " schizoaffective psychosis " appeared in the medical world in 1933, it was proposed by Jakub Kasanin. Schizoaffective disorders still remain a rather mysterious problem, for example, their exact frequency remains unknown. The reason for this situation is probably, inter alia, the fact that patients may have different diagnoses, e.g. schizophrenia or mood disorders. So far, it has been noted that children rarely suffer from schizoaffective disorders, and it is noticeable that the problem more often affects women. The first symptoms in the course of the disease usually appear around 30-40. years of age.

Schizoaffective disorder: symptoms

There are basically three groups of symptoms among all possible symptoms of schizoaffective disorders.

Ailments from the schizophrenia spectrum can be mentioned:

  • productive symptoms (such as delusions of various contents or hallucinations of various sensory organs),
  • disorganization of thinking,
  • unusual, bizarre behavior,
  • movement disorders (e.g. slowness or even complete stillness),
  • shallow affect (disturbances in showing emotions, e.g. the patient's facial expressions may beextremely impoverished),
  • indifference and apathy,
  • speech disorder (usually in the form of impaired speech).

Mood disorders in the course of schizoaffective disorder are usually presented in two forms. One of the distinguished isdepressive type , in the course of which the following may appear:

  • depressed mood,
  • sleep and appetite disorders,
  • energy loss,
  • anhedonia (inability to feel pleasure),
  • guilt,
  • loss of previous interests,
  • sense of hopelessness and meaninglessness in life and the world,
  • concentration, attention and memory disorders,
  • thoughts about death or committing suicide.

The reverse form of mood disorders in people with schizoaffective disorder isthe manic form , which may be evidenced by symptoms such as:

  • extremely elevated mood,
  • psychomotor agitation,
  • increase the overall level of activity,
  • acceleration of thinking, racing thoughts,
  • engaging in risky behavior (e.g. gambling),
  • reduced need for sleep,
  • irritation,
  • accelerated speech.

In view of the above,schizoaffective disorderscan run asdepressive or bipolar subtype- in the latter type, patients apart from episodes of elevated mood they also experience depressive episodes.

Schizoaffective disorder: causes

The causes of schizoaffective disorders have not yet been discovered. There are, however, some hypotheses, including the one concerning the role of genes in the pathogenesis of these disorders. It is noticeable that people whose relatives suffer from the same disorder, schizophrenia or bipolar disorder more often suffer from schizoaffective disorders.

The contribution of factors potentially involved in the development of "classic" schizophrenia is also taken into account, such as exposure to infections or malnutrition in utero, as well as the impact of perinatal complications on the possibility of mental disorders.

In turn, the factors that may be associated with the onset of schizoaffective disorders and which patients experience during their lives are stressful life events (e.g. death of a loved one, change of residence or divorce) and the abuse of psychoactive substances .

Schizoaffective disorder: recognition

In the diagnosis of schizoaffective disorders, it is initially primarilyexclude all possible organic causes of the patient's symptoms. The differential diagnosis takes into account, inter alia, thyroid dysfunction, side effects of steroid treatment or syphilis of the central nervous system, but also HIV infection and various metabolic disorders.

It should also be ruled out that the patient's ailments are caused by the use of drugs or other psychoactive substances.

Final diagnosis is made after a complete psychiatric examination. In order to be able to make a diagnosis of schizoaffective disorders, a patient cannot meet the criteria for diagnosis of schizophrenia itself, nor the mood disorders themselves.

It is also worth mentioning that among the criteria for diagnosing schizoaffective disorders it is mentioned that during the course of the disorder, the patient should have an episode of at least two weeks of psychotic symptoms without accompanying mood disorders.

Schizoaffective disorder: treatment

Treatment of schizoaffective disorders is aimed at improving the quality of life of patients and preventing them from developing problems such as impaired ability to be active or worsening family relationships.

In the treatment of these disorders, drugs from three different groups are used - for example, antipsychotics (neuroleptics, mainly atypical) are used here. Paliperidone is a particular neuroleptic, which among the indications for use is, among others, schizoaffective disorder (patients may, however, also be recommended other antipsychotics).

In the treatment of schizoaffective disorders, mood stabilizers (e.g. carbamazepine or lithium s alts) and antidepressants are also used.

The exact combination of preparations recommended to the patient depends on which ailments predominate - bipolar patients usually receive mood stabilizing agents together with neuroleptics, while in people with predominant depressive symptoms, a combination of antipsychotic drugs and antidepressants is used.

Other interactions implemented in people with schizoaffective disorder include psychotherapy and psychoeducation.

In the case of this disorder, hospitalization is rarely necessary, hospital treatment (in accordance with Polish law) can be implemented even against the patient's will when the patient is life-threatening or when the patient poses a threat to the he alth or life of other people.

In a situation where, despite the use of the above-mentioned methods of treating schizoaffective disorder, it is not possible to improve the patient's condition,electroconvulsive therapy may be used.

Worth knowing

Schizoaffective disorders - is there really a need to isolate them?

Distinguishing schizoaffective disorders from other entities is important, if only for the purposes of predicting patients' prognosis. There is an opinion that the prognosis of people with schizoaffective disorders is worse than that of suffering from mood disorders, at the same time such patients have a better prognosis than those who suffer from schizophrenia.

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Psychiatry