Schizoaffective disorder has features of both schizophrenia and mood disorders.
The lifetime prevalence is in the range of 0.32% to 1.1%.
The depressive type of schizoaffective disorder is more common in older patients, whereas the bipolar type is more common in younger patients.
Patients have a better prognosis than patients with schizophrenia but a worse prognosis than patients with mood disorder.
Patients tend to have a non-deteriorating course and better response to mood stabiliser medications than patients with schizophrenia.
Patients with schizoaffective disorder are a heterogeneous group with a variable predominance of schizophrenia and affective disorder symptoms.
Schizoaffective disorder is an illness defined by a course that combines significant affective and psychotic symptoms. The Diagnostic and statistical manual of mental disorders (DSM) definition requires the presence of schizophrenia symptoms concurrent with the mood symptoms (depression or mania), and lasting for a considerable part of a 1-month period. Schizoaffective disorder is further classified as manic type (when manic symptoms are prominent) or depressive type (when only schizophrenia and major depressive symptoms have been present).
The WHO International statistical classification of diseases and related health problems, 10th revision (ICD-10) definition requires the presence of prominent affective and psychotic symptoms, either at the same time or within a few days of each other. A schizoaffective episode is diagnosed only when the patient does not meet criteria for either schizophrenia or a depressive or manic episode. Schizoaffective disorder is further classified as manic type when manic or mixed symptoms are prominent; or a depressive type when only schizophrenia and depressive symptoms have been present.
History and exam
Key diagnostic factors
- positive symptoms
- negative symptoms
- disorder of perception
- disturbances in emotions
- disorders of stream and form of thought
- cognitive abnormalities
- deficit symptoms
Other diagnostic factors
- neurological deficit
- family history
- disorders of behaviour
- family history of schizophrenia
- substance use
- age of the father at patient's birth
- psychological stress
1st investigations to order
- urine drug screen
- sexually transmitted disease screening
- full blood count
- thyroid function tests
Investigations to consider
- laboratory studies to exclude organic causes
- CT/MRI head
acute psychotic episode
Robert G. Bota, MD
Associate Clinical Professor of Psychiatry
University of California
RGB declares that he has no competing interests.
Adrian Preda, MD
Health Sciences Professor
Department of Psychiatry and Human Behavior
University of California, Irvine School of Medicine
AP declares that he has no competing interests.
Kemal Sagduyu, MD
Professor of Psychiatry
University of Missouri Kansas City
KS declares that he has no competing interests.
William T. Regenold, MDCM
Associate Professor of Psychiatry
University of Maryland School of Medicine
WTR declares that he has no competing interests.
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