Schizoaffective disorder

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Teoría 
Diagnóstico 
Manejo 
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Última revisión: 11 Dec 2025

Última actualización: 27 Jul 2022

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 nondeteriorating course and to have better response to mood stabilizer medications than patients with schizophrenia.

Patients with schizoaffective disorder are a heterogeneous group with a variable predominance of schizophrenia and affective disorder symptoms.

Definición

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 bipolar type (when manic symptoms are prominent; major depressive episodes may also occur) or depressive type (when only schizophrenia and major depressive symptoms have been present).[1]

The World Health Organization International statistical classification of diseases and related health problems, 11th revision (ICD-11) definition requires the presence of prominent affective and psychotic symptoms, either at the same time or within a few days of each other.[2] A schizoaffective episode is diagnosed only when the patient does not meet criteria for either schizophrenia or a depressive or manic episode.

Anamnesis y examen

Principales factores de diagnóstico

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

Todos los datos

Otros factores de diagnóstico

neurologic deficit
family history
functional impairment
disorders of behavior

Todos los datos

Factores de riesgo

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

Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

urine drug screen
sexually transmitted disease screening
complete blood count
thyroid function tests

Todos los datos

Pruebas diagnósticas que deben considerarse

laboratory studies to exclude organic causes
CT/MRI head
electroencephalogram (EEG)

Todos los datos

Algoritmo de tratamiento

Agudo

acute psychotic episode

En curso

multiple-episode disorder

Colaboradores

Autores

Adrian Preda, MD

Professor of Clinical Psychiatry

Department of Psychiatry and Human Behavior

University of California, Irvine School of Medicine

Irvine

Divulgaciones

AP was paid for consultancy work for GLG and Guidepoint.

Robert G. Bota, MD

Associate Clinical Professor of Psychiatry

University of California

Irvine

Divulgaciones

RGB declares that he has no competing interests.

Agradecimientos

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.

Divulgaciones

BN declares that he has no competing interests.

Revisores por pares

Kemal Sagduyu, MD

Professor of Psychiatry

University of Missouri Kansas City

Kansas City

Divulgaciones

KS declares that he has no competing interests.

William T. Regenold, MDCM

Associate Professor of Psychiatry

University of Maryland School of Medicine

Baltimore

Divulgaciones

WTR declares that he has no competing interests.

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Referencias

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Artículos principales

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.Texto completo Resumen

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.Texto completo Resumen

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. Resumen

Jäger M, Haack S, Becker T, et al. Schizoaffective disorder: an ongoing challenge for psychiatric nosology. Eur Psychiatry. 2011 Apr;26(3):159-65. Resumen

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. Resumen

National Institute for Health and Care Excellence. Psychosis and schizophrenia in adults: prevention and management. March 2014 [internet publication].Texto completo

Artículos de referencia

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 Differentials
Guidelines
- 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 Guidelines
Patient information
Schizoaffective disorder
More Patient information
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Schizoaffective disorder

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

Otros factores de diagnóstico

Factores de riesgo

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

Pruebas diagnósticas que deben considerarse

Algoritmo de tratamiento

acute psychotic episode

multiple-episode disorder

Colaboradores

Autores

Adrian Preda, MD

Divulgaciones

Robert G. Bota, MD

Divulgaciones

Agradecimientos

Divulgaciones

Revisores por pares

Kemal Sagduyu, MD

Divulgaciones

William T. Regenold, MDCM

Divulgaciones

Agradecimiento de los revisores por pares

Divulgaciones

Referencias

Artículos principales

Artículos de referencia

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

Differentials

Guidelines

Patient information

Log in or subscribe to access all of BMJ Best Practice

Log in or subscribe to access all of BMJ Best Practice

Log in to access all of BMJ Best Practice