Schizoaffective Disorder

Schizoaffective Disorder

1. DefinitionA disorder with concurrent features of both schizophrenia and mood disorder that cannot be diagnosed as either one separately.

2. Diagnosis, sign and symptoms

A. An uninterrupted period of illness during which, at some time there is either a major depressive episode, a manic episode, or mixed episode concurrent with symptoms that meet criterion A for schizophrenia.

B. During that same period of illness, there have been delusions or hallucinations for at least two weeks in the absence of prominent mood symptoms.

C. Symptoms that meet the criteria for a mood episode are present for a substantial portion of the total duration of the active and residual periods of the illness.

D. The disturbance is not due to the direct physiological effects of a substance or a general medical condition.

3. EpidemiologyLifetime prevalence is less than 1%; it occurs equally in men and women.

4. EtiologyThe cause of schizoaffective is unknown. The disorder may be a type of

schizophrenia, a type of mood disorder or simultaneous expression of each. Schizoaffective disorder also may also be a distinct type of psychosis; one is unrelated to schizophrenia or a mood disorder. The most likely possibility is that schizoaffective disorder is a heterogeneous group of disorders encompassing of all these disorders.

5. Course and prognosisPoor prognosis is associated with positive family history of schizophrenia, early

and insidious onset without precipitating factors, predominance of psychotic symptoms, and poor premorbid history. Schizoaffective patients have a better prognosis than schizophrenic patients and a worse prognosis in mood disorder patients. Schizoaffective patients respond more often to lithium and are less likely to have a deterioting course than are schizophrenic patients.

5. TreatmentMood stabilizers such as carbamazepine and lithium are a mainstay of treatment

for bipolar disorders and patients with schizoaffective disorders. A recent study indicates that between carbamazepine and lithium, carbamazepine was more superior for schizoaffective disorders, depressive type but found no difference in the two agents for the bipolar type.

Since schizoaffective patients also by definition suffer from depressive episodes, then treatment with antidepressant mirror treatment are also required. Selective serotonin uptake inhibitors are often used as first line agents because they have less effect on cardiac status and have a favorable overdose profile.

As in all cases of intractable mania, the use of electro convulsion therapy (ECT) should also be considered.

III. Status Psikiatrikus

Roman muka : senangKesadaran : compos mentisKontak/rapport : adekuatOrientasi : tempat : baik

waktu : baik orang : baik

Perhatian : baikPersepsi : Ingatan : masa kini : baik

: masa dulu : baik: segera : baik

Intelegensia : rata-rataFikiran : bentuk :

: jalan : koheren: isi

Penilaian : norma sosial : cukupIOI : baikEmosi : baikDekorum : sopan santun : baik

: cara berpakaian : baik: kebersihan : baik

Tingkah laku : normoaktif, relevan dan bicara