Consider the use of mood-stabilizers if the patient has a history of manic or hypomanic symptoms.

Mood-stabilizers: Patients who have periods of distractibility, indiscretion, grandiosity, a flight of ideas, increased goal-directed activity, decreased need for sleep, and who are hyper-verbal fall under the bipolar-specifier for schizoaffective disorder. Clozapine is a consideration for refractory cases, much like in schizophrenia. Antipsychotics include but are not limited to paliperidone (FDA approved for schizoaffective disorder), risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole, and haloperidol. While second-generation antipsychotics have further actions on serotonin receptors.

Most first and second-generation antipsychotics block dopamine receptors. Other symptoms include delusions, hallucinations, negative symptoms, disorganized speech, and behavior. Prior to initiating treatment, if a patient with schizoaffective disorder is a danger to themselves or others, inpatient hospitalization should be considered this includes patients who are neglecting activities of daily living or those who are disabled well below their baseline in terms of functioning.Īntipsychotics: Used to target psychosis and aggressive behavior in schizoaffective disorder. 20% of patients received a mood-stabilizer in addition to an antipsychotic, while 19% received an antidepressant along with an antipsychotic. A study that reported obtained data on treatment regimens for schizoaffective showed that 93% of patients received an antipsychotic. The mainstay of most treatment regimens should include an antipsychotic, but the choice of treatment should be tailored to the individual. The treatment of schizoaffective disorder typically involves both pharmacotherapy and psychotherapy. A thorough mental status examination (MSE), physical examination, and neurologic examination should be completed to help rule out other differential diagnoses. The next step of evaluation is the objective and physical portion. Please see the differential diagnoses and pearls sections below for more information. It is not enough to symptoms of schizophrenia while meeting the criteria for a major mood episode. Please note the patient must meet the criteria for A-D above to be diagnosed with schizoaffective disorder. The following are specifiers based on the primary mood episode as part of the presentation.īipolar type: includes episodes of mania and sometimes major depression.ĭepressive type: includes only major depressive episodes. The disturbance is not the result of the effects of a substance (e.g., a drug of misuse or a medication) or another underlying medical condition. Symptoms that meet the criteria for a major mood episode are present for most of the total duration of both the active and residual portions of the illness.ĭ. Hallucinations and delusions for two or more weeks in the absence of a major mood episode (manic or depressive) during the entire lifetime duration of the illness.Ĭ.

Negative symptoms (i.e., diminished emotional expression or avolition.)ī. Among people with schizophrenia, there is a possible increased risk for first-degree relatives for schizoaffective disorder and vice-versa there may be increased risk among individuals for schizoaffective disorder who have a first-degree relative with bipolar disorder schizophrenia, or schizoaffective disorder. The pathogenesis of both mood disorders and schizophrenia is multifactorial and covers a range of risk factors, including genetics, social factors, trauma, and stress. Some studies show that as high as 50% of people with schizophrenia also have comorbid depression. However, investigating the potential causes of mood disorders and schizophrenia as individual disorders allows for further discussion. Therefore, there have been no conclusive studies on the etiology of the disorder. It eventually became its own diagnosis despite a lack of evidence for unique differences in etiology or pathophysiology. The term schizoaffective disorder first appeared as a subtype of schizophrenia in the first edition of the DSM.

Dsm 5 specifiers asd