Schizoaffective disorder

Question 1

criterion A for schizoaffective disorder

Answer 1

an uninterrupted period of illness during which there is a major MOOD episode (major depressive or manic) CONCURRENT with criterion A of SCHIZOPHRENIA

Question 2

criterion B of schizoaffective disorder

Answer 2

delusions or hallucinations for TWO OR MORE WEEKS in the ABSENCE of a major mood episode during the LIFETIME DURATION of the illness

Question 3

criterion C of schizoaffective disorder

Answer 3

symptoms that meet criteria for a major mood episode are present for a MAJORITY of the total duration of the active and residual portions of the disease

Question 4

criterion D for schizoaffective disorder

Answer 4

disturbance not attributable to the effects of a substance or another medical condition

Question 5

what are the two subtypes of schizoaffective disorder

Answer 5

bipolar subtype and depressive subtype

Question 6

what specifier is there other than the two subtype specifiers for schizoaffective disorder

Answer 6

with catatonia

and then the first episode/acute etc ones

Question 7

what criteria for schizophrenia do NOT have to be met in order to make a dx of schizoaffective disorder

Answer 7

criterion B–> social dysfunction

and

criterion F–> rule out ASD or other communication disorder of childhood

are criteria are criteria that do not have to be met

Question 8

why must schizoaffective disorder–depressed type necessarily include “depressed mood” and not just anhedonia in order to make a diagnosis?

Answer 8

because anhedonia is common in schizophrenia so we ALSO need depressed mood in order to make a schizoaffective disorder diagnosis

Question 9

in occupational dysfunction a defining criterion for schizoaffective disorder

Answer 9

no (unlike schizophrenia)

Question 10

what is anosognosia

Answer 10

poor insight

Question 11

how common is schizoaffective disorder compared to schizophrenia

Answer 11

about 1/3 as common

Question 12

what is the lifetime prevalence of schizoaffective disorder

Answer 12

0.3%

Question 13

is schizoaffective disorder more prevalent in men or women

Answer 13

in women–> mainly due to an increased incidence of the depressive type among females

Question 14

what is the typical age at onset for schizoaffective disorder

Answer 14

early adulthood

but can occur anywhere from adolescence to late in life

Question 15

how does the prognosis for schizoaffective disorder compare to the prognosis for schizophrenia

Answer 15

prognosis is better in schizoaffective disorder

**but worse than the prognosis for primary mood disorders

Question 16

if someone has three months of depression, followed by three months of psychotic symptoms (but the two do not overlap) can they be dx with schizoaffective disorder

Answer 16

no–> it is the co-occurrence of mood and psychotic symptoms that is diagnostic

Question 17

which schizoaffective disorder subtype is more prominent in young adults? which is more prominent in older people?

Answer 17

bipolar type more common in young adults

depressed type more common in older people

Question 18

list risk factors for schizoaffective disorder

Answer 18

1. increased risk of schizoaffective disorder in first degree relatives of those with schizophrenia, bipolar disorder or schizoaffective disorder

Question 19

what is the lifetime risk of suicide in those with schizoaffective disorder or schizophrenia

Answer 19

5%

*presence of depressive symptoms confers higher risk of suicide

Question 20

in what geographic population is rate of suicide in those with schizoaffective disorder/schizophrenia higher

Answer 20

suicide rates higher in north american vs other populations (i.e european)

Question 21

what are other mental disorders that should be considered in the ddx for schizoaffective disorder

Answer 21

1. psychotic disorder due to another medical conditions
2. delirium
3. major neurocognitive disorder
4. substance/med induced psychotic disorder or neurocognitive disorder
5. bipolar disorders with psychotic features
6. MDD with psychotic features
7. schizotypal, schizoid or paranoid personality disorder
8. brief psychotic disorder
9. schizophreniform disorder
10. schizophrenia
11. delusional disorder

Question 22

what other two psychiatric conditions are notably common amongst those with schizoaffective disorder (i.e which are commonly comorbid)

Answer 22

anxiety disorders

substance use disorders

Question 23

who first described the term “schizoaffective psychosis”

Answer 23

Jacob Kasanin (russian american psychiatrist) in 1933

Question 24

how was schizoaffective disorder first conceptualized

Answer 24

as a middle ground diagnosis between schizophrenia and mood disorders

as an episodic illness with good outcomes

Question 25

what is one of the problems with the diagnostic criteria for schizoaffective disorder

Answer 25

assumes that clinicians have access to longitudinal clinical data (criterion C) which is not always the case

also–> there is poor inter-rater reliability for schizoaffective disorder as a diagnostic entity

Question 26

do we understand the pathophysiology of schizoaffective disorder? what are some ideas?

Answer 26

not really (due to uncertainty of schizoaffective disorder as a diagnostic construct)

very old studies from 1980s–> suggest changes in dopamine, norepinephrine, serotonin

white matter changes also thought to be involved