Schizoaffective Disorder - Overview

Overview

The lifetime prevalence of the disorder is probably less than 1 percent, in the range of 0.5 to 0.8 percent. Diagnosis is based on the patient's self-reported experiences and observed behavior. No laboratory test for schizoaffective disorder currently exists, though extensive evidence exists for abnormalities in the metabolism of tetrahydrobiopterin (BH4), dopamine, and glutamate in people with schizophrenia and schizoaffective disorders. As a group, individuals with schizoaffective disorder have a more favorable prognosis than those with schizophrenia, but a worse prognosis than those with other mood disorders.

Genetics, early environment, neurobiology, psychological and social processes are important contributory factors. Some recreational and prescription drugs may cause or worsen symptoms. Current research is focused on the role of neurobiology, but no single organic cause has been found.

The mainstay of current treatment is antipsychotic medication combined with mood stabilizer medication or antidepressant medication, or both. Psychotherapy, vocational therapy and social/psychiatric rehabilitation are also important for recovery. In cases where there is risk to self and others, brief involuntary hospitalization may be necessary.

People with schizoaffective disorder are likely to have comorbid conditions, including anxiety disorders and substance abuse. Social problems such as long-term unemployment, poverty and homelessness are common. The average life expectancy of people with the disorder is shorter than those without, due to increased physical health problems and a higher suicide rate.

The diagnosis was introduced in 1933 and will be moderately amended in the next iteration of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) because current diagnostic criteria are unreliable. The DSM-5 changes are intended to increase reliability and to reduce the frequency with which the diagnosis is used. The DSM-5 is scheduled to be published in May 2013.