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- [Voiceover] So schizoaffective disorders are those
where someone meets the criteria for both schizophrenia
and a major mood disorder, and both sets of symptoms
are enough so that they cause some kind of distress
or are interfering with normal daily life.
So what exactly is a major mood disorder though?
Well, it's a bit of a broad umbrella, or category,
for illnesses that involve a serious change in mood.
And I don't just mean like feeling sad
or irritable from time to time,
not just like having a bad day or something.
Mood disorders affect your everyday emotional state,
and they're more intense, and more difficult to manage
compared to just a bad mood, or just feelings of sadness.
This might be persistent sadness that doesn't go away.
And so there's sort of a spectrum of mood disorders,
where we put a normal mood right in the middle.
And then all the way over on this side
there's this severe depression,
which seriously interferes with your ability to enjoy life,
and then there's varying degrees of depression in between.
And then all the way on the other side there's mania,
which is like this abnormally elevated mood.
So maybe things like feeling very irritable,
or having insomnia, and having very fast
and energetic speech, or racing thoughts.
And just like major depression, this would be enough
such that it interferes with your daily life.
And then you've also got these varying degrees
in between normal and mania.
So a major mood disorder might be out here
at severe depression, or out here at severe mania,
or you might have these, like, huge swings in mood
between depression and mania,
which is sometimes called bi-polar disorder.
Okay, so let's say you've got this circle
for major mood disorders like depression,
mania, or bi-polar disorder,
and then this circle represents schizophrenia,
and symptoms of psychosis like hallucinations and delusions.
If we combine these two sets, this middle chunk
is what we call schizoaffective disorder,
which as we can see, has both a major mood disorder
and also symptoms of schizophrenia.
Now just like schizophrenia and mood disorders though,
there have yet to be any imaging or lab tests
that we've developed to definitely tell us that,
hey, this person has schizophrenia,
or hey, this person has severe depression,
or this person has both, meaning that they would
have schizoaffective disorder.
That being the case, we have to look for symptoms
of both schizophrenia and a mood disorder
to come up with a diagnosis of schizoaffective disorder.
So what's pretty much used to help psychiatrists
diagnose mental disorders is a book called the
Diagnostic and Statistical Manual of Mental Disorders,
the 5th Edition, which is also frequently
just called the DSM 5.
Now this guide helps psychiatrists look for
certain specific criteria for patients to meet
to be diagnosed with a particular disorder.
So if we page to the section on schizoaffective disorder
we'll find several pieces of criteria to meet
in order to be diagnosed.
First, the patient has to have symptoms of psychosis,
so things like delusions and hallucinations,
without a major mood disorder for a period of two weeks
in order to meet he criteria for the schizophrenic portion.
If this doesn't ever happen, if we don't meet this criteria,
then the symptoms are probably more likely
to be in line with psychotic depression,
as opposed to schizoaffective disorder.
And secondly, a major mood episode,
which is a mood disorder like depression,
mania, or both, that lasts greater than two weeks
has to be present along side schizophrenia
for an uninterrupted period of time
to be classified as schizoaffective disorder.
But doesn't schizophrenia sometimes
include depressive symptoms?
Whats the difference between schizophrenia
and depressive symptoms and schizoaffective disorder?
Well, in order to be diagnosed with schizoaffective disorder
you have to meet the criteria for
major mood disorders as well,
so if they were diagnosed with schizophrenia
with depressive symptoms, the depressive symptoms
must not be meeting the criteria
to constitute a major mood disorder.
Additionally, the patient has to be
experiencing impairments in functioning
due to both the schizophrenia
and the major mood disorder.
Alright, so let's pose the million dollar question,
what causes schizoaffective disorder?
Well, by now you might be able to guess
that we don't exactly know, but it's thought to involve
an imbalance in several neurotransmitters in your brain,
like dopamine, or norepinephrine.
Although genetics likely plays a role,
there have yet to be any genes identified.
But with that said, we know that having
family members with schizophrenia,
bi-polar disorder, or schizoaffective disorder itself,
all increases your risk of developing
schizoaffective disorder.
And when we're treating schizoaffective disorder,
we're usually gonna use medications,
but we need to be careful because now
there's both symptoms of schizophrenia and mood disorders.
Currently there's only one antipsychotic drug
that's been approved by the FDA
for treatment of schizoaffective disorder, specifically,
and it's called paliperidone, or invega.
But there are other antipsychotics that may be used as well
to target symptoms of schizophrenia
and help manage psychotic symptoms.
For the mood disorder symptoms,
it depends on the mood disorder present.
If they have depression, then antidepressants
will probably be prescribed.
If they have mania, then it's likely they'll receive
antipsychotics and mood stabilizers, like lithium.
Apart from drugs and medications though,
the patient may undergo some sort of psychotherapy.
And the outlook, or prognosis,
of someone diagnosed with schizoaffective disorder varies,
and it's thought to be somewhere between
that of mood disorders and schizophrenia.
With that said, there tends to be a better outlook
than for those with schizophrenia alone,
and a worse outlook for those with mood disorders alone.
So the best prognosis would be
over here with mood disorders
and then the worst prognosis
is over here with just schizophrenia.
And schizoaffective disorder is somewhere in between.
So things are risk factors that have been
shown to be associated with a worse prognosis
are things that relate to the psychosis side of it,
so being closer to schizophrenia.
Other things are things like earlier onset,
and when there's no periods of remission,
or temporary recovery, and finally,
like we mentioned before,
having a family member with schizophrenia.