Schizoaffective Disorder Factsheet

7/30/2019 Schizoaffective Disorder Factsheet

1/6

1

Schizoaffective disorder is a mental illness that has symptoms of bothschizophrenia and bipolar disorder. This factsheet aims to provideinformation on the condition and possible causes and treatments.

Schizoaffective disorder is a condition with symptoms ofschizophrenia and bipolar disorder (also known as manicdepression).

It involves a combination of symptoms of psychosis and maniaand/or depression.

Because of the close overlap with bipolar disorder andschizophrenia, the diagnosis can be changeable.

The cause of the condition is still unknown. However, it seems thatthere are genetic and environmental links.

Schizoaffective disorder is often treated with medication. There area variety of types of medication that may be used. Talking therapiesare also helpful in treatment, such as Cognitive BehaviouralTherapy (CBT).

This factsheet covers

1. What is schizoaffective disorder?2. What causes schizoaffective disorder?3. How is schizoaffective disorder treated?4. Risk associated with schizoaffective disorder?

1. What is schizoaffective disorder?

Schizoaffective disorder is a condition in which there are symptoms ofbipolar disorder (depression and/or mania) and schizophrenia. Diagnosis

Schizoaffective Disorder


2/6

2

is not a clear cut process so this diagnosis can be changeable. This is alsodue to the overlap of schizoaffective disorder with schizophrenia andbipolar disorder.

More women than men tend to suffer from schizoaffective disorder, withsymptoms usually beginning at the age of early adulthood. About 1 in 200

(0.5%) people develop schizoaffective disorder at some time during theirlife.1 Some people believe that this low statistic does not represent the truelevel of the condition, and that many people are misdiagnosed withsomething else. One study interviewed a group of people with psychosisand around 30% were given a diagnosis of schizoaffective disorder. Ofthese people, around 40% already had a current schizoaffective disorderdiagnosis.2

Most of the time symptoms of mania or depression occur at the same timeas psychotic symptoms, but there must be at least one two-week period inwhich there are only psychotic symptoms without any symptoms of mania

or depression.

The symptoms below are typical of mania, depression and psychosis -

ManiaElevated or irritable mood, inflated sense of self-importance, decreasedneed for sleep, being more talkative, racing thoughts, being easilydistracted, being over-involved in activities for pleasure that can have verynegative consequences (e.g. sexual behaviour or spending sprees),increased activity.

DepressionLasting sad or empty mood, feeling hopeless and worthless, loss ofpleasure in activities once enjoyed, disturbed sleep, changes in weightand appetite, thoughts of suicide, decreased energy, difficulty makingdecisions and concentrating.

PsychosisDelusions (fixed false beliefs), hallucinations (sensing something that isnot there, which can affect all of the senses), confused or disturbedthoughts and speech, change in behaviour, becoming withdrawn.People with psychosis can often be unaware of being unwell and

believe that what they are experiencing is real.

Top

2. What causes schizoaffective disorder?

The causes of schizoaffective disorder are unknown but it is thought thatboth genetic and environmental factors are involved. It seems that inpeople with schizoaffective disorder there may be a chemical imbalance inthe chemical messengers of the brain (neurotransmitters). However, it isunclear as yet whether that is caused by the environment or as a result ofa genetic predisposition.


3/6

3

Genetic causes

Schizoaffective disorder occurs more often in families where othermembers have been diagnosed with schizophrenia, schizoaffectivedisorder or bipolar disorder.3 This suggests that genetics have a role to

play in the development of schizoaffective disorder, although no singlegene has been identified as being responsible.

Environm ental causes

Stress seems to play a key role in triggering schizoaffective disorder andsubsequent relapses.4 It is important for people with schizoaffectivedisorder to live in an environment with a low degree of stress and tomonitor the types of stress that cause relapses.

Top

3. How is schizoaffective disorder treated?

Drug and psychosocial therapies (such as talking treatments) are oftennecessary to successfully treat schizoaffective disorder. As with manyother forms of mental illness, schizoaffective disorder is oftenaccompanied by social problems such as unemployment, poverty andhomelessness and as such drug therapy alone is often insufficient.

Drug therapy can usually stop someones psychosis, but often only socialand occupational rehabilitation therapies can overcome the associatedproblems.

Medicat ion

There is no specific treatment for schizoaffective disorder. It is oftentreated with medication to treat the symptoms of schizophrenia and bipolardisorder.5 This may include a combination of antipsychotics,antidepressants, mood stabilisers and anti-anxiety medication.6

There are some points regarding medication that are worth noting -

Some people given oral antipsychotic medication may not take themedication regularly or at all in some cases. In these situations,long acting depot injections can be helpful.

Antidepressants can often be used as part of the medicationtreatment. The newer Selective Serotonin Reuptake Inhibitor SSRIantidepressants are generally used, with the tricyclic andMonoamine Oxidase Inhibitor (MAOI) antidepressants usuallyavoided. Antidepressant use should be monitored carefully as theycan trigger manic episodes, known as switching.7

For further information on medication, please see the Rethink Advice &Information Services factsheets Antipsychotics, Antidepressants, Mood


4/6

4

stabilisers and Benzodiazepenes (anti-anxiety medication). It has alsoproduced a medication guide called Only the Best, which has informationon antipsychotic and mood stabiliser medication. The Rethink Advice &Information Service can provide you with a copy of these (contact detailsat the end of the factsheet) or they can be downloaded for free fromwww.rethink.org.

Psycho socia l treatments

NICE (National Institute for Health and Clinical Excellence) producesguidelines about how particular conditions should be treated in the NHS.Its guideline on schizophrenia states that people with schizoaffectivedisorder should be offered the psychological intervention of CognitiveBehavioural Therapy (CBT). A review has found that CBT can reduce therate of going back to hospital, and hospital stays tend to be shorter.8Research has found that group CBT may not be effective in treating thesymptoms of schizoaffective disorder (such as hallucinations and

delusions). However, it did find that group therapy can improve peoplesnegative feelings of themselves and help with low self-esteem.9

The NICE guidelines also recommend that family interventions should alsobe offered when the family lives with or are in close contact with theperson. Family therapy has been found to possibly reduce the risk ofrelapse and also possibly reduce hospital admission.10

NICE guidance recommends that supportive psychotherapy andcounselling arent offered routinely as specific interventions. However,peoples preferences should be taken into account as well as theavailability of other treatments such as CBT. When a patient withschizoaffective disorder is no longer experiencing psychosis, behaviourtherapy can successfully teach necessary social and occupational skills.

Self help groups, in which family members of schizoaffective patientsdiscuss and share issues, may also be helpful.

For further information about talking treatments, please see the RethinkAdvice & Information Services factsheet Talking treatments and

psychological therapies. Top

4. Risk associated with schizoaffective disorder:

Between 30-40% of people with schizoaffective disorder will attemptsuicide during their lifetime and 10% of them will succeed.11

Clozapine is a type of antipsychotic medication that is used in treatingschizophrenia. It is recommended to be used when other antipsychoticshavent been effective.12 Should it be appropriate, treatment with clozapine

can reduce the chance of suicide in people with schizoaffective disorder.13

Symptoms in schizoaffective disorder may be improved with a combination
http://www.rethink.org/http://www.rethink.org/http://www.rethink.org/


5/6

5

treatment of clozapine and lithium.14 Lithium is a mood stabilisingmedication.

Top

The Hearing Voices Network provides support and understanding forthose who hear voices and their significant others.

HVN, 79 Lever Street, Manchester, M1 1FLHelpline - 0845 122 8642 (Open Tuesday, 1pm 4pm)Email [email protected] Web -www.hearing-voices.org

1 Mental Health Care. Schizoaffective disorder[Online]Available at:http://www.mentalhealthcare.org.uk/schizoaffective_disorder[Accessed 12 February 2010]2 Canuso, C. et al., (2008) Frequency of schizoaffective disorder diagnosis

in patients with psychotic disorders using the mini-internationalneuropsychiatric interview. Schizophrenia Research, 98, p.67-683 Laursen, T.M. et al (2005) Family history of psychiatric illness as a riskfactor for schizoaffective disorder:a Danish register-based cohort study.Archive of General Psychiatry, 62(8), p.841-8484 Nuechterlein, K.H. et al (1994) The vulnerability/stress model ofschizophrenic relapse: a longitudinal study.Acta PsychiatricaScandinavica. 89 (s382), p.58-645 Mental Health Care. Schizoaffective disorder[Online]Available at:http://www.mentalhealthcare.org.uk/schizoaffective_disorder[Accessed 12 February 2010]6

Taylor, D., Paton C., & Kapur, S., 2009. The Maudsley PrescribingGuidelines. 10th ed. Informa Healthcare.7 Taylor, D., Paton C., & Kapur, S., 2009. The Maudsley PrescribingGuidelines. 10th ed. Informa Healthcare.8 National Institute of Health and Clinical Excellence. Core interventions inthe treatment and management of schizophrenia in primary and secondarycare (update). Clinical Guidance 82, http://www.nice.org.uk. 2009.9 Barrowclough, C. et al (2006). Group cognitive-behavioural therapy forschizophrenia. The British Journal of Psychiatry. 189, p.527-53210 Pharoah, F. et al. Family intervention for schizophrenia. CochraneDatabase of Systematic Reviews 2006, Issue 4

11 Mental Health Foundation. Schizoaffective disorder[Online]Available at:http://www.mentalhealth.org.uk/information/mental-health-a-z/schizoaffective-disorder/[Accessed 12 February 2010]12 National Institute of Health and Clinical Excellence. Core interventions inthe treatment and management of schizophrenia in primary and secondarycare (update). Clinical Guidance 82, http://www.nice.org.uk. 2009.13 Reid, W.H. et al. (1998) Suicide prevention effects associated withclozapine therapy in schizophrenia and schizoaffective disorder.Psychiatric Services, 49, p.1029-103314 Small et al. (2003) Tolerability and efficacy of clozapine combined with

lithium in schizophrenia and schizoaffective disorder. Journal of ClinicalPsychopharmacology, 23, p.223-228
mailto:[email protected]:[email protected]:[email protected]://www.hearing-voices.org/http://www.hearing-voices.org/http://www.hearing-voices.org/http://www.mentalhealthcare.org.uk/schizoaffective_disorderhttp://www.mentalhealthcare.org.uk/schizoaffective_disorderhttp://www.mentalhealthcare.org.uk/schizoaffective_disorderhttp://www.mentalhealthcare.org.uk/schizoaffective_disorderhttp://www.mentalhealthcare.org.uk/schizoaffective_disorderhttp://www.mentalhealthcare.org.uk/schizoaffective_disorderhttp://www.mentalhealth.org.uk/information/mental-health-a-z/schizoaffective-disorder/http://www.mentalhealth.org.uk/information/mental-health-a-z/schizoaffective-disorder/http://www.mentalhealth.org.uk/information/mental-health-a-z/schizoaffective-disorder/http://www.mentalhealth.org.uk/information/mental-health-a-z/schizoaffective-disorder/http://www.mentalhealth.org.uk/information/mental-health-a-z/schizoaffective-disorder/http://www.mentalhealth.org.uk/information/mental-health-a-z/schizoaffective-disorder/http://www.mentalhealthcare.org.uk/schizoaffective_disorderhttp://www.mentalhealthcare.org.uk/schizoaffective_disorderhttp://www.hearing-voices.org/mailto:[email protected]


6/6

6

Last updated 01/10/2010

The content of this product is available in LargePrint (16 point). Please call 0300 5000 927.

RET0111 Rethink Mental Illness 2011

Last updated July 2011

Next update July 2013

Documents

Schizoaffective Disorder Factsheet