Signs and Symptoms of Schizoaffective Disorder

Learn about schizoaffective disorder and mental illness

Schizoaffective disorder is a mental health disorder in which a person experiences a combination of symptoms of schizophrenia, such as hallucinations or delusions, and symptoms of a mood disorder, such as depression or mania. People who have schizoaffective disorder may have symptoms that lead to disruption in daily activities including maintaining a job, attending school or work, participating in fulfilling interpersonal relationships, and functioning in family life. Schizoaffective disorder is characterized by periodic episodes– called relapses – in which symptoms reappear and cause problems in the individual’s life. Schizoaffective disorder is not currently well-understood or defined by professionals in the mental health field in large part because the symptomatology of the combination of schizophrenia symptoms plus bipolar or depressive features present quite differently in each person with the disorder. There exist two subtypes of schizoaffective disorder: schizoaffective disorder, bipolar-type, in which a person experiences episodes of mania (depression may or may not be present) in addition to the symptoms of schizophrenia. Schizoaffective disorder, depressive type, occurs if symptoms of major depressive disorder are evident alongside symptoms of schizophrenia.

The psychotic features coupled with mood alterations may co-occur or they may appear in distinct, separate cycles. Generally, the sequence of schizoaffective disorder features cycles of extreme symptomatology followed by a more improved, positive outlook. In order to obtain a diagnosis of schizoaffective disorder, a person must have – at some point in his or her past – experienced hallucinations or delusions for at least two weeks even after the symptoms of depression or mania are well-controlled.

Currently, there is no cure for schizoaffective disorder, however, with proper medication, therapies, and self-care strategies, people who have this disorder are able to lead happy, normal, productive lives. Treatment for schizoaffective disorder usually involves treating both the symptoms of schizophrenia and the symptoms of depression or bipolar disorder concurrently. This is why many experts in the mental health field believe schizoaffective disorder is actually the manifestation of two disorders – schizophrenia and bipolar or depressive disorders.

Schizoaffective disorder statistics

Schizoaffective disorder is about one-third as common as schizophrenia. The lifetime prevalence for schizoaffective disorder is between about 0.5% to 0.8%. The incidence rate of schizoaffective disorder appears to be higher in women, who generally experience the depressive-type of the disorder.

Causes and risk factors for schizoaffective disorder

It’s generally agreed upon that schizoaffective disorder does not develop as a result of a single factor – rather it is the complex interplay of genetic, physical, and environmental risk factors working concurrently. The most commonly accepted causes and risk factors for schizoaffective disorder include:

Genetic: Much like schizophrenia, bipolar disorder, or depression, schizoaffective disorder is thought to have a genetic component. People who have a first-degree relative with the disorder are more likely than others to develop schizoaffective disorder. However, many people who have no family history do go on to develop the family history while others who have a strong familial component do not develop the disorder.

Physical: Neuroimaging studies such as CT scans, MRIs, and PET scans do show that people who have schizoaffective disorder have structural changes in the brain, although the role is unsure. Additionally, imbalances of the neurotransmitters dopamine and serotonin which help regulate mood may contribute to the symptoms of the disorder.

Environmental: Prenatal exposure to certain viruses or toxins are thought to play some sort of role in the development of schizoaffective disorder. In addition, trauma during childbirth including fetal hypoxia may increase the likelihood of development for this disorder.

Risk Factors:

• Prenatal drug or alcohol use
• Advanced paternal age
• Presence of other mental health disorders
• Substance abuse or alcoholism
• Stressful life circumstances

Signs and symptoms of schizoaffective disorder

As schizoaffective disorder is largely understood and appears to be the result of a combination of two separate illnesses – schizophrenia and depression or bipolar disorder – the presentation of symptoms will vary tremendously from person to person. This can make the diagnosis of schizoaffective disorder very challenging for clinicians, which accounts for the large amount of people with this disorder who are improperly and misdiagnosed. Symptoms of schizoaffective disorder are based upon individual genetic makeup, co-occurring disorders, presence of manic or depressive episodes, as well as past or present substance abuse. The most common symptoms of schizoaffective disorder include:

Schizophrenia Symptoms:

• Hallucinations: the perception of visual, auditory, tactile, olfactory or other hallucinations that are only perceived by the individual (most commonly, people who have schizoaffective disorder hear “voices” in absence of external stimuli)
• Delusions are strange, bizarre beliefs that are not reality-based that the person refuses to give up even after being presented with factual information that contradicts the delusion(s)
• Disorganized thinking
• Odd, unusual behavior
• Slow movements or total immobility
• Lack of emotion in speech and facial expressions
• Poor motivation
• Challenges with speech and motivation

Depressive Symptoms:

• Poor or changed appetite and eating patterns
• Related weight loss or gain
• Changes in sleeping pattern, such as sleeping a lot or very little
• Extreme restlessness and agitation
• Lack of energy
• Loss of interest in once-enjoyed activities
• Feelings of worthlessness or hopelessness
• Feelings of guilt
• Self-blame
• Inability to concentrate or think clearly
• Self-harming behaviors
• Recurrent thoughts of suicide or death
• Suicidal behaviors

Mania Symptoms:

• Little need for sleep
• Agitation
• Inflated, grandiose sense of self-esteem
• High levels of distractibility
• Increased activity in work, school, or sexual activity
• Increased, rapid thoughts
• Racing speech
• Rapid, racing thoughts
• Increased self-destructive or risk-taking behaviors (including massive spending sprees, driving recklessly, practicing unsafe sex)

Effects of schizoaffective disorder

The effects of untreated, misdiagnosed schizoaffective disorder can lead to damage in nearly every aspect of an individual’s life. These effects will vary based upon type of schizoaffective disorder – manic or depressive symptoms – as well as individual makeup, presence of co-occurring disorders, substance abuse, and other factors and may include:

• Increased social isolation and loss of important relationships, friendships, and strained family bonds
• Job loss and unemployment based upon erratic work behaviors
• Anxiety
• Financial insecurity based upon joblessness and/or effects of manic behaviors
• Development of alcohol or substance abuse which may be used as a way to self-medicate untreated symptoms
• Major health-related problems
• Difficulty adhering to treatment regime including medication management
• Aftereffects of reckless, manic behaviors
• Self-harming behaviors
• Early death
• Suicidal ideation and behaviors

Schizoaffective disorder and co-occurring disorders

Schizoaffective disorder often occurs with a number of additional disorders. The most frequently co-occurring mental illnesses include:

• Alcoholism
• Substance abuse
• Anxiety disorders