Schizoaffective Disorder Defined, Symptoms, & Treatment

Schizoaffective disorder is a mental illness characterized by symptoms of schizophrenia and a mood disorder. The person with schizoaffective disorder will have symptoms of...

Schizophrenia combined with symptoms of:

• Mania
• Hypomania and/or
• Depression

The symptoms of schizophrenia and mood disorder do not have to occur at the same time for a diagnosis to be made. In fact, the person with schizoaffective disorder will have periods when there are only symptoms of schizophrenia present. The symptoms of schizophrenia are many, but the broad categories include:

• Hallucinations
• Delusions
• Disorganized thinking and/or speech
• Social dysfunction
• Occupational dysfunction

Hallucinations are usually auditory in nature, but can involve any of the five senses: hearing, sight, taste, touch, and smell. The table (below) defines each of the types of hallucinations and provides one example of each. There are many possible examples.

Delusions are fixed, false beliefs. People who have delusional thinking cannot be persuaded out of their false thoughts. Delusions can have many different emotional bases.

In addition to hallucinations and delusions, disorganized thinking also includes:

Loss of abstract thinking (concrete thought only)

E.g. If the person has lost the ability to think abstractly, he/she will no longer be able to interpret metaphors or determine meaning from stories. If you said, “It is raining cats and dogs,” the person would expect to look outside and see cats and dogs falling from the sky.

Impaired reality testing

E.g. The person is no longer able to discredit odd or strange irrational thoughts, such as, “I didn’t get that raise. My boss must hate me. He probably wants to fire me.” Impaired reality testing is the beginning of delusional thinking.

Disorganized speech encompasses a great variety of symptoms as well, including:

1. Flight of ideas: The person jumps from topic to topic easily and quickly. The mind has difficulty lighting and staying on any idea.
2. Thought blocking: The person literally stops sentences without finishing them. The person may return to the thought later or never again.
3. Loose associations: The person connects ideas that are not readily connectable to others.
4. Neologisms: The person makes up words that have no meaning to other people or assigns new meanings to words.
5. Word salad: The person strings together unrelated words to make what sounds like a meaningless statement.
6. Clang association: The person speaks poetically, often rhyming or in a singsong voice.
7. Echolalia: The person repeats what is said over and over.

Other symptoms of schizophrenia that may be present in schizoaffective disorder include:

• Catatonic behavior
• Echopraxia
• Motor agitation or retardation
• Stereotyped behaviors
• Automatic obedience
• Waxy flexibility
• Negativism
• Impaired impulse control
• Boundary impairment
• Depersonalization
• Derealization
• Command hallucinations
• Difficulty remembering recent events
• Difficulty paying attention
• Poor decision-making

In addition to symptoms of schizophrenia, the person with schizoaffective disorder will experience symptoms of:

• Mania
• Hypomania and/or
• Depression

At times, the person may experience a mixed mood state where he/she is both sad and hyperactive. This is an extremely dangerous mood state, as the person may have suicidal ideations and enough energy to complete a suicide plan.

I have a very thorough article on Depression and Bipolar Disorders here, but briefly, these are some of the symptoms you may see in each:

Mania

• Pressured, rapid speech
• Grandiosity
• Delusions of grandeur
• Hypersexual
• Excessive spending
• Gambling
• Risky behaviors
• Decreased need for sleep
• Decreased appetite or forgetting to eat
• Hyperactivity/fidgety
• Occupational dysfunction
• Social dysfunction

Hypomania

In hypomania, the person has milder symptoms of mania, but is still able to function at work and in social settings.

Depression

• Suicidal ideation
• Depressed mood
• Lack of energy
• Lack of motivation
• Anhedonia (lack of pleasure in life)
• Psychomotor retardation
• Fidgety behavior/pacing
• Insomnia
• Hypersomnia
• Increased or decreased appetite, can be accompanied by weight loss or weight gain
• Social withdrawal and sometimes complete social isolation
• Poor hygiene
• Lack of facial emotional responses
• Monotone voice
• Poor eye contact
• Slumped posture
• Increased sighing
• Feelings of guilt
• Irritability
• Decreased self confidence
• Decreased self worth
• Decreased libido
• Occupational dysfunction
• Pain and other physical complaints
• Constipation

Schizoaffective disorder is treated with a combination of psychotherapy, cognitive-behavioral therapy, and medications. The medication types that may be given for schizoaffective disorder include:

Typical antipsychotics

E.g. Haldol, Thorazine, Trilafon

Atypical antipsychotics

E.g. Risperdal, Zyprexa, Fanapt, Saphris, Clozaril

Mood stabilizers

E.g. Lithium, Depakote, Tegretol, Trileptal

Antidepressants

E.g. Paxil, Prozac

**For a more thorough look at antipsychotic medications, see my article on these drugs and their uses and side effects here.**

Schizoaffective disorder can be severely debilitating without treatment. However, with proper treatment some people are able to have complete symptom remission and fully functional, fulfilling lives. If you believe you or a loved one may suffer from schizoaffective disorder or another mental illness, please seek help from your primary care provider, local hospital, or psychiatrist. Mental illness is serious and sometimes fatal. There is help and hope for recovery!