People with this condition often seek treatment for mood problems (mania, depression, symptoms of both simultaneously or rapidly alternating) which shifts towards symptoms of schizophrenia or may display symptoms of both conditions simultaneously, although the schizophrenic symptoms dominate.

To be diagnosed with this disorder, someone must experience psychotic symptoms (hallucinations and delusions) for at least 2 weeks in the absence of mood disorder.

The exact cause of the condition is unknown, but factors that affect the development of both schizophrenia and affective disorders may play a role, including a strong genetic component and other biochemical factors. Risk factors include a family history of schizophrenia or affective disorder.

It is not known how commonly schizoaffective disorder occurs, but it is believed to be less common than schizophrenia or mood disorders. Women may be affected more often than men. While mood disorders are relatively common in children, schizophrenia is not. Therefore schizoaffective disorder tends to be rare in children.

The clinical signs and symptoms of schizoaffective disorder include all the signs and symptoms of schizophrenia, manic episodes, and depressive disorders. The schizophrenic and mood disorder symptoms can appear together or in an alternating fashion. The course can vary from one of exacerbations and remissions to one of a long-term deteriorating pattern. The symptoms of schizoaffective disorder vary greatly from person to person.

• Symptoms of a major depressive, manic, or mixed episode, include:
  • elevated, inflated, or depressed mood
  • irritability and poor temper control
  • symptoms that could be seen during a manic or depressed state (i.e., changes in appetite, energy, sleep)
• Symptoms of schizophrenia that persist for at least two weeks in the absence of prominent mood symptoms:
  • hallucinations (particularly auditory hallucinations, "hearing voices")
  • delusions of reference (for example, believing that someone on TV or the radio is speaking directly to you or that secret messages are hidden in common objects)
  • paranoia (a feeling that everyone or a particular person or agency is out to get you)
  • deteriorating concern with hygiene, grooming
  • incoherent speech

• psychological evaluation for identification of symptoms
• history of current behavior and symptoms

The combination of psychotic and affective symptoms seen in schizoaffective disorder can be seen in other illnesses, particularly in episodes of bipolar disorder with psychotic features. In these illnesses, as well as in schizoaffective disorder, the mood disturbance is a prominent part of the illness.

However, in schizoaffective disorder, the psychotic symptoms do not necessarily remit with effective treatment of the mood symptoms as they do in mood disorders with psychotic features. Also, they usually persist for at least two weeks without symptoms of mania or major depression.

Any medical, psychiatric, or drug related condition that causes psychotic or mood symptoms must be considered. Patients undergoing treatment with steroids, abusers of cocaine, amphetamines and phencyclidine (PCP), and some patients with temporal lobe epilepsy are particularly likely to have concurrent schizophrenic and mood disorder symptoms.

The treatment of people with schizoaffective disorder varies, but generally involves agents to stabilize mood and to treat psychosis. Neuroleptic medications (antipsychotics) are used to treat psychotic symptoms.

These medications may take up to three weeks to relieve symptoms. Lithium may be used to manage mania and to stabilize mood. Anti-seizure medications such as valproic acid and carbamazepine are effective mood stabilizers.

Usually the combination of antipsychotic and mood-stabilizing medication controls both depressive and manic symptoms, but antidepressants may need to be used in some cases.

People with schizoaffective disorder may have a fairly favorable prognosis, with more likelihood of returning to a previous level of functioning than schizophrenics. However, this severe and persistent disorder requires long-term treatment and may have variable outcomes.

• problems complying with therapeutic regimens
• risk of developing substance use problems in an attempt to self-medicate symptoms
• problems resulting from manic behavior (for example, spending sprees, sexual indiscretions)
• risk of suicidal behavior due to depressive and/or psychotic symptoms

Call your health-care provider or mental health professional if you or someone you know is experiencing any of the following:

• strange or unusual thoughts or perceptions
• inability to care for basic personal needs
• bouts of depression; feelings of hopelessness and/or helplessness
• increase in energy and involvement in risky behavior that is sudden in onset and out of character. This often includes going days without sleeping and feeling no need for sleep.
• symptoms worsening or not improving with treatment
• feelings and thoughts of suicide