Summary
Definition
History and exam
Key diagnostic factors
- positive symptoms
- negative symptoms
- disorder of perception
- delusions
- disturbances in emotions
- incongruent affect
- disorders of stream and form of thought
- cognitive abnormalities
- deficit symptoms
- major depressive episodes
- manic episodes
Other diagnostic factors
- neurologic deficit
- family history
- functional impairment
- disorders of behavior
Risk factors
- family history of schizophrenia
- substance use
- age of the father at patient's birth
- psychological stress
- environment
Diagnostic tests
1st tests to order
- urine drug screen
- sexually transmitted disease screening
- complete blood count
- thyroid function tests
Tests to consider
- laboratory studies to exclude organic causes
- CT/MRI head
- electroencephalogram (EEG)
Treatment algorithm
acute psychotic episode
multiple-episode disorder
Contributors
Authors
Adrian Preda, MD
Professor of Clinical Psychiatry
Department of Psychiatry and Human Behavior
University of California, Irvine School of Medicine
Irvine
CA
Disclosures
AP was paid for consultancy work for GLG and Guidepoint.
Robert G. Bota, MD
Associate Clinical Professor of Psychiatry
University of California
Irvine
CA
Disclosures
RGB declares that he has no competing interests.
Acknowledgements
Dr Adrian Preda and Dr Robert G. Bota would like to gratefully acknowledge Dr Bao-Nhan Benjamin Nguyen, who contributed to the updating of this topic.
Disclosures
BN declares that he has no competing interests.
Peer reviewers
Kemal Sagduyu, MD
Professor of Psychiatry
University of Missouri Kansas City
Kansas City
MO
Disclosures
KS declares that he has no competing interests.
William T. Regenold, MDCM
Associate Professor of Psychiatry
University of Maryland School of Medicine
Baltimore
MD
Disclosures
WTR declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Abrams DJ, Rojas DC, Arciniegas DB. Is schizoaffective disorder a distinct categorical diagnosis? A critical review of the literature. Neuropsychiatr Dis Treat. 2008 Dec;4(6):1089-109.Full text Abstract
Harrow M, Grossman LS, Herbener ES, et al. Ten-year outcome: patients with schizoaffective disorders, schizophrenia, affective disorders and mood-incongruent psychotic symptoms. Br J Psychiatry. 2000 Nov;177:421-6.Full text Abstract
Cheniaux E, Landeira-Fernandez J, Versiani M. The diagnoses of schizophrenia, schizoaffective disorder, bipolar disorder and unipolar depression: interrater reliability and congruence between DSM-IV and ICD-10. Psychopathology. 2009;42(5):293-8. Abstract
Jäger M, Haack S, Becker T, et al. Schizoaffective disorder: an ongoing challenge for psychiatric nosology. Eur Psychiatry. 2011 Apr;26(3):159-65. Abstract
Turner DT, van der Gaag M, Karyotaki E, et al. Psychological interventions for psychosis: a meta-analysis of comparative outcome studies. Am J Psychiatry. 2014 May;171(5):523-38. Abstract
National Institute for Health and Care Excellence. Psychosis and schizophrenia in adults: prevention and management. March 2014 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Schizophrenia
- Substance-induced psychotic disorder
- Dementia with psychosis
More DifferentialsGuidelines
- Diagnostic and statistical manual, 5th edition, text revision (DSM-5-TR)
- International statistical classification of diseases and related health problems, 11th revision (ICD-11)
More GuidelinesPatient information
Schizoaffective disorder
More Patient information
Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer