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Schizoaffective disorder is a psychiatric diagnosis that describes a mental disorder characterized by recurring abnormal mood and psychotic components. The mood component may be elevated or depressed (bipolar or depressive subtype), or simultaneously elevated and depressed (mixed episode), and these abnormal mood components alternate with, or occur together with, psychotic symptoms.

Signs and symptoms [edit]

As the diagnosis schizoaffective disorder represents an attempt to encompass individuals who have features of both schizophrenia and mood disorders, it does not consist of unique symptoms.[3] Instead, patients experience some combination of symptoms of the two types of disorders. This lack of characteristic symptoms can make diagnosis difficult.
One of the DSM-IV criteria for schizoaffective disorder is that the individual experiences symptoms that meet criterion A for schizophrenia.[2] These symptoms include delusions, hallucinations, disorganized speech or behaviour, and negative symptoms.[2] Delusions and hallucinations are classic psychotic symptoms which involve a disruption in the boundaries between the patient and the outside world.[3] Delusions are false beliefs which are strongly held despite evidence to the contrary.[3] Beliefs should not be considered delusional if they are in keeping with cultural beliefs. The delusional beliefs may or may not reflect mood symptoms (e.g. someone with depressive symptoms may experience delusions of guilt). Hallucinations are disturbances in perception involving any of the five senses, although auditory hallucinations (or “hearing voices”) are the most common.[3] Negative symptoms include lack of spontaneous speech, reduced intensity of outward emotional expression, avolition (loss of motivation), and anhedonia, or inability to experience pleasure.[3] Negative symptoms can potentially be quite debilitating.
Mood symptoms can correspond to symptoms of either mania or depression, and tend to be episodic rather than continuous. A mixed episode represents a combination of symptoms of mania and depression at the same time. Symptoms of mania include elevated or irritable mood, grandiosity (inflated self-esteem), agitation, risk-taking behavior, decreased need for sleep, poor concentration, rapid speech, and racing thoughts.[2] Symptoms of depression include low mood, apathy, changes in appetite or weight, disturbances in sleep, changes in motor activity, fatigue, guilt or worthlessness, and suicidal thinking.
Two individuals with schizoaffective disorder may experience quite different symptoms, and any given individual will experience fluctuations in the types and intensity of symptoms he or she experiences. 20-30% of people with schizoaffective disorder have a deteriorating course of illness with persistent psychotic symptoms.[3] However, others may achieve full symptom control.

Subtypes [edit]
Two subtypes of schizoaffective disorder exist and may be noted in a diagnosis based on the mood component of the disorder:
Bipolar type, when the disturbance includes a manic episode or a mixed episode, with or without a major depressive episode;
Depressive type, when the disturbance includes major depressive episodes exclusively (without manic or mixed episodes).[2]

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