Criteria for Schizoaffective Disorder: HealthyPlace.com Bipolar Disorder, Manic-Depression Community

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Schizoaffective Disorder

Click here to read the criteria for Schizoaffective Disorder from the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders (DSM-IV).

Click here to read the ICD-10 Classifications for Schizoaffective Disorder from the World Health Organization.

An uninterrupted period of illness during which, at some time, there is either a Major Depressive Episode, a Manic Episode, or a Mixed Episode concurrent with symptoms that meet the first criteria for Schizophrenia.

Note: The Major Depressive Episode must include depressed mood. During the same period of illness, there have been delusions or hallucinations for at least 2 weeks in the absence of prominent mood symptoms. Symptoms that meet criteria for a mood episode are present for a substantial portion of the total duration of the active and residual periods of the illness. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Schizoaffective Disorder is an often debilitating mental illness characterized by symptoms of a thought disorder (hallucinations and/or irrational thinking) and a mood disorder (depression or manic activity). This illness may present a variety of symptoms from each category, and symptoms may be mild or severe.

Schizoaffective Disorder may be difficult to treat, as the symptoms of the thought disorder are typically treated with different medications than the symptoms of depression or mania. Arriving at the proper balance of medication is often complex and may take time. This can be frustrating to the mentally ill person, as well as to the family and friends.

In terms of treatment approaches, research to date suggests that the most effective treatment for schizoaffective disorder is a continuum of care model, which has a focus on Social Rehabilitation. The Social Rehabilitation Model is aimed at assisting the diagnosed client with learning the skills necessary to live an independent life style. This includes medication management, independent living skills, socialization and vocational and a variety of other support systems.

Research suggests that a person recently diagnosed with schizoaffective disorder can best be treated and success achieved if allowed to participate in an environment in which counseling support and vocational services are offered on a 24-hour basis. It has been found to be most effective for people not to be hospitalized for too long but rather to move into a residential setting such as mentioned above. After this, we find moving into less and less restricted programs to be effective, whereby the diagnosed person eventually gets their own apartment or living arrangements and perhaps attends an outpatient program to assist with continued living skills.

Many new and profound advances have been made in the past few decades in the treatment of schizoaffective disorder . New psychotropic medications are available, and they are more effective and have fewer side effects than previously available medications. Although far from a simple illness to treat, the prognosis for a person with schizoaffective disorder is better than it has ever been.

Bipolar vs. Schizoaffective

The distinction between bipolar disorder (BD) and schizoaffective disorder (SD) is sometimes difficult, in part because SD is not well-defined or well-understood; and in part, because younger patients presenting with BD often have psychotic features, leading (or misleading) therapists to diagnose either schizophrenia or SD. This does not mean, however, that your new psychiatrist is wrong.

In bipolar disorder, the individual usually returns to a relatively high level of function in between manic and depressive bouts, though some do not. Psychotic features, if present, are confined to the manic or depressive phases.

SD is a bit different. In essence, to diagnose SD, the patient must show an uninterrupted period of illness during which there is either a major depressive episode, a manic episode or a mixed episode, along with symptoms of schizophrenia (delusions, hallucinations, disorganized speech/behavior, negative symptoms). Furthermore, during this same period, the patient must show delusions or hallucinations for at least 2 weeks in the absence of prominent mood symptoms. Finally, the mood episode symptoms must be present for a substantial portion of the total illness (usually several weeks or longer).

In practice, it is often difficult to sort out such meticulous details, since most people who are becoming psychotic do not keep careful notes on the course of their symptoms! Very often, we rely on family or spouse to help us make the diagnosis. In theory, someone with MDPF usually experiences mood and psychotic features simultaneously, with both types of symptoms coming and going over roughly the same time period. But, in fact, it is not always so clear, since some people begin with a non-psychotic depressive or manic episode and eventually develop delusional features. Generally, though, MDPF patients do not have prolonged delusional periods without mood symptoms.

There is also a good deal of heterogeneity in the SD category, with bipolar-type SD patients often resembling classic bipolar individuals and depressive-type SD patients looking more like MDPF patients.

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