Schizoaffective disorder

Last reviewed: 24 Aug 2022
Last updated: 27 Jul 2022

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
More key diagnostic factors

Other diagnostic factors

  • neurological deficit
  • family history
  • functional impairment
  • disorders of behaviour
Other diagnostic factors

Risk factors

  • family history of schizophrenia
  • substance use
  • age of the father at patient's birth
  • psychological stress
  • environment
More risk factors

Diagnostic investigations

1st investigations to order

  • urine drug screen
  • sexually transmitted disease screening
  • full blood count
  • thyroid function tests
More 1st investigations to order

Investigations to consider

  • laboratory studies to exclude organic causes
  • CT/MRI head
  • electroencephalogram (EEG)
More investigations to consider

Treatment algorithm

ACUTE

acute psychotic episode

ONGOING

multiple-episode disorder

Contributors

Authors

Adrian Preda, MD
Adrian Preda

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
Robert G. Bota

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.

  • Differentials

    • Schizophrenia
    • Substance-induced psychotic disorder
    • Dementia with psychosis
    More Differentials
  • Guidelines

    • International statistical classification of diseases and related health problems, 11th revision (ICD-11)
    • Diagnostic and statistical manual, 5th edition, text revision (DSM-5-TR)
    More Guidelines
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer