Schizoaffective disorder (psychotic disorders) Flashcards
Who does schizoaffective disorder affect?
-Less common than schizophrenia
-Commonly presents in early adulthood
-Women more likely to be affected
What causes schizoaffective disorder?
-Features of both schizophrenia and mood disorders are present
-Existence as a disease entity is debated
-Cause is unknown - various factors
-Diagnostic criteria require delusions / hallucinations to be present for at least two weeks when the mood symptoms are not present
-Bipolar type = manic or mixed episodes
-Depressive type = predominantly depressive episodes
What risk factors are there for schizoaffective disorder?
-Same as schizophrenia apart from women being more susceptible
How does schizoaffective disorder present?
Major depressive episode - 5 of the following symptoms should be present for at least 2 weeks, with 1 being either low mood or anhedonia
-Weight loss / gain / appetite change
-Insomnia / hypersomnia
-Psychomotor agitation / retardation
-Fatigue
-Guilt / worthlessness
-Decreased concentration
-Recurrent thoughts of death
Manic episode - persistently elevated / irritable mood for at least one week. 3 of the following must be present:
-Inflated self-esteem / grandiosity
-Reduced need for sleep
-Pressure of speech
-Flight of ideas / racing thoughts
-Poor concentration
-Increase in goal-directed activity
-Involvement in high-risk activities
Mixed - features of both are present for 1 week
What are the differential diagnoses for schizoaffective disorder?
-Substance misuse
-Organic illness eg thyroid disease, delirium
-Medication side effects
-Rule out recent life events eg bereavement
-Other psychiatric illness eg dementia
How would you investigate a patient with schizoaffective disorder?
Rule out underlying cause:
-FBC, LFT, U+Es, TFTs, HIV
-Urine / plasma toxicology
-CXR to rule out pneumonia in elderly
What treatment would you offer someone with schizoaffective disorder?
-Antipsychotics are useful for acute exacerbations
-Psychological approach combined with a/ps used in long term
-Antidepressants may be warranted for ongoing depressive symptoms
-Lithium may be useful in bipolar type
