Psychosis refers to symptoms such as delusions, hallucinations, disorganized thinking and speech, and bizarre and inappropriate motor behavior (including catatonia) that indicate loss of contact with reality.
Schizoaffective disorder is considered when psychosis and mood symptoms coexist. The diagnosis requires that significant mood symptoms (depressive or manic) be present for > 50% of the total duration of illness, concurrent with ≥ 2 symptoms of schizophrenia (delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms).
Differentiating schizoaffective disorder from schizophrenia Schizophrenia Schizophrenia is characterized by psychosis (loss of contact with reality), hallucinations (false perceptions), delusions (false beliefs), disorganized speech and behavior, flattened affect... read more and mood disorders Overview of Mood Disorders Mood disorders are emotional disturbances consisting of prolonged periods of excessive sadness, excessive joyousness, or both. Mood disorders can occur in children and adolescents (see Depressive... read more may require longitudinal assessment of symptoms and symptom progression.
Because schizoaffective disorder often leads to long-term disability, comprehensive treatment (including drugs, psychotherapy, and community support) is often required.
For treatment of the manic type, a 2nd-generation antipsychotic Second-generation antipsychotics Antipsychotic drugs are divided into conventional antipsychotics and 2nd-generation antipsychotics (SGAs) based on their specific neurotransmitter receptor affinity and activity. SGAs may offer... read more may be sufficient but if not, it may help to add lithium, carbamazepine, or valproate.
For treatment of the depressive type, a 2nd-generation antipsychotic is given first. Then, once positive psychotic symptoms are stabilized, an antidepressant should be introduced if depression requires treatment; selective serotonin reuptake inhibitors (SSRIs) are preferred because of their safety profile.
(See also Introduction to Schizophrenia and Related Disorders Introduction to Schizophrenia and Related Disorders Schizophrenia and related psychotic disorders—brief psychotic disorder, delusional disorder, schizoaffective disorder, schizophreniform disorder, and schizotypal personality disorder—are characterized... read more .)