11 – Schizophrenia and Other Psychotic Disorders

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○ Also distinguished dementia praecox from

OUTLINE
1. Defining Schizophrenia Spectrum manic-depressive illness (now called bipolar
2. Delusion Disorder disorder)
3. Brief Psychotic Disorder ● Eugen Bleuler
4. Schizophreniform Disorder ○ Coined the term schizophrenia
5. Schizophrenia ■ Skhizein = “split”
6. Schizoaffective Disorder ■ Phren = “mind”
○ Believed that victims exhibited an associative
splitting of the basic functions of personality;
DEFINING SCHIZOPHRENIA SPECTRUM
breaking of associative threads
○ Wrote Dementia Praecox or the Group of
PERSPECTIVES ON SCHIZOPHRENIA Schizophrenias which emphasized the
complexity of the disorder
Schizophrenia – characterized by a broad spectrum ○ Highlighted what he believed to be the
of cognitive and emotional dysfunctions including universal underlying problem of
delusions and hallucinations, disorganized speech schizophrenia
and behavior, and inappropriate emotions
● Can disrupt a person’s perception, thought, KEY FEATURES OF PSYCHOTIC DISORDERS
speech, and movement
● Full recovery from schizophrenia has a low base Hallucinations – involuntary vivid and clear
rate of 1 in 7 patients perception-like experiences that occur without an
external stimulus and in the context of clear
HISTORY OF SCHIZOPHRENIA sensorium
● Auditory Hallucinations: involves hearing things
Early Figures in Diagnosing Schizophrenia that don’t exist
● John Haslam ○ 2nd most common form of hallucination
○ Wrote Observations on Madness and ● Visual Hallucinations: involve distortions of what
Melancholy one sees or visions of things that aren't there
○ Defined schizophrenia as “a form of insanity” ○ Most common form of hallucination
○ “Sensibility appears to be considerably ● Tactile Hallucinations: involve physical
blunted: they do not bear the same affection sensations on or within the body
towards their parents and relations” ○ Least common form of hallucination
○ “They become unfeeling to kindness, and ● Olfactory Hallucinations: involve smelling
careless of reproof” something that is not there
● Benedict Morel ○ Referred to as phantosmia
○ Described schizophrenia as démence (loss of ● Gustatory Hallucinations: involve false taste
mind) and précoce (early,premature) perceptions
○ Onset of the disorder was believed to be ○ Fairly prevalent in people with epilepsy and
during adolescence less frequently in schizophrenia
○ Mainly focused on early onset and poor ● Hallucination involving Sleep
outcomes ○ Hypnopompic Hallucinations: occur while
● Emil Kraeplin waking up
○ Built on Haslam’s writings and provided the ■ Indicator of narcolepsy
most enduring description and categorization ○ Hypnagogic Hallucinations: occur while
of schizophrenia falling asleep
○ Combined several symptoms of insanity that ■ Short, usually auditory
had usually been viewed as reflecting ■ Most common
separate and distinct disorders ○ Shows alpha rhythm
■ Catatonia: alternating immobility and
excited agitation Delusions – fixed beliefs not amenable to change in
■ Hebephrenia: silly and immature light of conflicting evidence
emotionality ● Delirium: causes confused thinking and a lack of
■ Paranoia: delusions of grandeur or awareness of surroundings
persecution ● Delusions of Grandeur: belief that you are
○ These underlying features were included superior to other people
under Dementia Praecox ○ Ex. the chosen one, special destiny

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● Delusions of Reference: thinking insignificant ● Asocial Behavior: lack of interpersonal
events relate directly to you relationships
○ Ex. receiving special messages from the TV ● Anergia: lack of energy
○ Thought Broadcasting: belief that others
know your thoughts Disorganized Thinking (Speech) – distortion in
○ Thought Insertion: belief that ideas are thinking observed through speech
implanted on your mind ● Also called formal thought disorder
○ Thought Withdrawal: belief that thoughts ● Derailment / Loose Associations: switching from
are being removed / stolen from your mind one topic to another
● Persecutory Delusions: belief that someone or ● Tangentiality: answering questions that are
something is "out to get you" unrelated or obliquely related
○ Most common type of delusion in ● Incoherence: word salad, resembles receptive
schizophrenia aphasia in its linguistic disorganization
○ Considered as an extreme form of paranoia ○ Echolalia: repetition of words spoken by
○ Fregoli’s Syndrome: belief that a stranger is another person
a familiar person who changes their ○ Palilalia: repetition of words / syllables
appearance or is in disguise ○ Verbigeration: repetition of last spoken part
○ Capgras’ Syndrome: belief that familiar of a sentence
people have been replaced by imposters ○ Coprolalia: use of obscene / inappropriate
● Jealous Delusions: belief that that your partner is words
unfaithful ○ Clang Association: use of rhyming words
○ Othello’s Syndrome: pathological and
morbid jealousy Grossly Disorganized or Abnormal Motor Behavior –
● Somatic Delusions: belief that something is movement that ranges from childlike "silliness" to
wrong with your body unpredictable agitation
● Erotomanic Delusions: belief that someone, ● Also called catatonic behavior
typically higher in status, is in love with you ● Catatonic Behavior: marked decrease in
○ Also called de Clerambault’s Syndrome reactivity to the environment
● Nihilistic Delusions: belief that something or ● Negativism: resistance to instructions
someone no longer exists ● Catatonic Excitement: purposeless and
○ Often occur with depression excessive motor activity without obvious cause
○ Cotard’s Syndrome: belief that the body is ● Catalepsy: assuming different positions
dead or decaying ● Stupor: lack of movement for a long period of
time
Positive Symptoms (Type 1) – additional behaviors ● Stereotypy: repetition of purposeless movement
not generally seen in people without the condition ● Inappropriate Affect: exhibit bizarre behaviors
● Bizarre Behavior: problems in performing such as hoarding objects or acting in unusual
directed daily activities; catatonia ways in public
● Hallucinations
● Ambivalence: having conflicting reactions, Historic Schizophrenia Subtypes – previously used in
beliefs, or feelings the DSM-IV-TR but dropped in the DSM-5
● Abnormal Thought Form: distortions / ● Paranoid: delusions of grandeur or persecution
disturbance in thought processes ● Disorganized: hebephrenic; silly and immature
● Delusions emotionality
● Develops over a short time ● Catatonic: alternate immobility and excited
agitation
Negative Symptoms (Type 2) – indicate the absence
or insufficiency of normal behavior
DISORDER KEY FEATURE DURATION
● Alogia: lack of logic / poverty of speech / relative
absence of speech
Schizophrenia 2+ symptoms (1+ ≥6 months (1+
● Affective Flattening: lack of range in emotional core), active)
reactions disorganized /
○ Flat/Blunted Affect: lack of emotion where negative
you normally expect them to; flat and symptoms
toneless
● Anhedonia: lack of pleasure Schizophreniform Same as 1–6 months
schizophrenia
● Attention Impairment: lack of concentration
● Avolition: lack of motivation
○ Apathy: lack of reaction to stimuli

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 ○ Delusions
Brief Psychotic 1+ psychotic 1 day to <1
Disorder symptom (core) month ○ Hallucinations
○ Disorganized speech
○ Grossly disorganized or catatonic behavior
Schizoaffective Mood episode + Variable
○ Negative symptoms
psychosis alone
≥2 weeks ● Functioning is not markedly impaired
● Duration: 1 month or more

Delusional 1+ delusion, no ≥1 month

Disorder other psychosis SPECIFIERS

Erotomanic Type Applies when the central theme of

the delusion is that another person
DELUSIONAL DISORDER is in love with the individual

Grandiose Type Applies when the central theme of

DEFINING DELUSIONAL DISORDER the delusion is the conviction of
having some great (but
unrecognized) talent or insight or
Delusional Disorder – at least 1 month of delusion(s) having made some important
but no other prominent psychotic symptoms discovery
● Folie à Deux: condition in which an individual
Jealous Type Applies when the central theme of
develops delusions simply as a result of a close the individual’s delusion is that his
relationship with a delusional individual or her spouse or lover is unfaithful
● Persistent delusion that is not the result of an
Persecutory Type Applies when the central theme of
organic factor such as brain seizures or of any
the delusion involves the
severe psychosis individual’s belief that he or she is
● Types of Delusions being conspired against, cheated,
○ Erotomanic: irrational belief that one is loved spied on, followed, poisoned or
drugged, maliciously maligned,
by another person, usually of higher status harassed, or obstructed in the
○ Grandiose: believing in one’s inflated pursuit of long-term goals
○ worth, power, knowledge, identity, or special
Most frequent subtype
relationship to a deity or famous person
○ Jealous: believes the sexual partner is Somatic Type Applies when the central theme of
unfaithful the delusion involves bodily
○ Persecutory: believing oneself (or someone functions or sensations.
close) is being malevolently treated in some
Mixed Type Applies when no one delusional
way theme predominates
○ Somatic: person feels afflicted by a physical
defect or general medical condition Unspecified Type Applies when the dominant
● Delusions are imagined events could be delusional belief cannot be clearly
determined or is not described in
happening but aren’t the specific types
● Relatively rare type of disorder
● Onset is relatively late (35-55) Ex. referential delusions without a
prominent persecutory or grandiose
● Tends to fare better in life than people with component
schizophrenia but not as well as those with some
other psychotic disorders, such as schizoaffective
disorder BRIEF PSYCHOTIC DISORDER
● Substance-Induced Psychotic Disorder:
commonly affects those who abuse
DEFINING BRIEF PSYCHOTIC DISORDER
amphetamines, alcohol, and cocaine
● Psychotic Disorder Associated with Another
Brief Psychotic Disorder – presence of one or more
Medical Condition: commonly affects those with
positive symptoms such as delusions, hallucinations,
brain tumors, Huntington’s disease, and
or disorganized speech or behavior lasting 1 month or
Alzheimer’s disease
less; may or may not be accompanied by grossly
disorganized or catatonic behavior
DIAGNOSTIC CRITERIA
● Many eventually regain their ability to function in
less than a month
Key Features
● Often precipitated by extremely stressful
● Presence of delusions ( at least 1 month or more)
situations
● Has never fully met Criteria A of Schizophrenia (at
least 2 or more; at least 1 from first 3)

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● They typically experience emotional turmoil or ○ Stereotypy (i.e., repetitive, abnormally
overwhelming confusion and have rapid shifts frequent, nongoal-directed movements)
from one intense affect to another ○ Agitation, not influenced by external stimuli
● Attenuated Psychosis Syndrome: symptoms ○ Grimacing
that are psychotic in nature but below the ○ Echolalia (i.e., mimicking another’s speech)
threshold for consideration as counting towards ○ Echopraxia (i.e., mimicking another’s
the diagnosis of a psychotic disorder movements)
○ High risk for developing schizophrenia
○ Prodromal: early stage
DIFFERENTIAL DIAGNOSIS
○ Does not meet full criteria of schizophrenia
but are good candidates for early intervention BSD Mood Disorders
● Sudden Onset: change from a nonpsychotic state
to a clearly psychotic state within 2 weeks, usually - Psychosis occurs alone - Psychosis usually
occurs with mood
without a prodrome episode

DIAGNOSTIC CRITERIA BSD Personality Disorders

- Psychotic symptoms - If psychotic symptoms

Key Features
last for 1 day to a month persist for at least 1 day,
● Presence of psychotic symptoms (at least 1 or an additional diagnosis
more) of BSD may be
○ Delusions appropriate

○ Hallucinations
○ Disorganized speech
SCHIZOPHRENIFORM DISORDER
○ Grossly disorganized or catatonic behavior
● Functioning is not markedly impaired
● Duration: 1 day to a month DEFINING SCHIZOPHRENIFORM DISORDER

Specifiers Schizophreniform Disorder – symptomatic

● With marked stressor(s) (brief reactive presentation equivalent to schizophrenia but less
psychosis): If symptoms occur in response to than 6 months duration (more than 1 month) and
events that, singly or together, would be markedly decline in functioning not required
stressful to almost anyone in similar ● Some can usually resume to normal lives
circumstances in the individual’s culture. ● Symptoms sometimes disappear as the result of
● Without marked stressor(s): If symptoms do not successful treatment for unknown reasons
occur in response to events that, singly or ● Include onset of psychotic symptoms within 4
together, would be markedly stressful to almost weeks of the first noticeable change in usual
anyone in similar circumstances in the individual’s behavior
culture. ● Confusion at the height of the psychotic episode
● With postpartum onset: If onset is during ● Good premorbid (before the psychotic episode)
pregnancy or within 4 weeks postpartum. social and occupational functioning
● With catatonia ● Absence of blunted or flat affect

Key Features for Catatonia Specifier DIAGNOSTIC CRITERIA

● At least 3 or more of the following symptoms:
○ Stupor (i.e., no psychomotor activity; not Key Features
actively relating to environment) ● Presence of psychotic symptoms (at least 2 or
○ Catalepsy (i.e., passive induction of a posture more; at least 1 from the first 3)
held against gravity) ○ Delusions
○ Waxy flexibility (i.e., slight, even resistance to ○ Hallucinations
positioning by examiner) ○ Disorganized speech
○ Mutism (i.e., no, or very little, verbal response ○ Grossly disorganized or catatonic behavior
[exclude if known aphasia]) ○ Negative Symptoms
○ Negativism (i.e., opposition or no response to ● Duration: 1 to less than 6 months
instructions or external stimuli) ● Schizoaffective disorder and depressive or bipolar
○ Posturing (i.e., spontaneous and active disorder with psychotic features have been ruled
maintenance of a posture against gravity) out
○ Mannerism (i.e., odd, circumstantial
caricature of normal actions)

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 person at high risk meets full criteria for a
SCHIZOPHRENIA
psychotic disorder
● Once treated, most go through a pattern of
DEFINING SCHIZOPHRENIA DISORDER relapse and recovery

Schizophrenia Disorder – presence of primary Risk Factors

psychotic symptoms for a continuous period of at ● Length of duration of symptoms before seeking
least 6 months accompanied by marked decline in help
functioning wherein an active phase occurred for at ● Baseline functioning
least 1 month for a significant portion of time ● Presence of negative symptoms and disorganized
● Psychotic Behavior: involves delusions (irrational symptoms
beliefs) and/or hallucinations (sensory experiences
in the absence of external events)

DIAGNOSTIC CRITERIA

Key Features
● Presence of psychotic symptoms (at least 2 or
more; at least 1 from the first 3)
○ Delusions
○ Hallucinations
○ Disorganized speech
○ Grossly disorganized or catatonic behavior
○ Negative Symptoms Cultural Factors
● Level of functioning in 1 or more major areas ● Course and outcome of schizophrenia vary from
(work, interpersonal relations, or self-care) is culture to culture
markedly below the level achieved prior to the ○ Areas such as Africa, Latin America, and Asia
onset may contribute to poorer outcomes for
● Duration: 6 months or more people with schizophrenia
● Schizoaffective disorder and depressive or bipolar ○ Associated with the significant political,
disorder with psychotic features have been ruled social, and economic problems in those areas
out ○ Also caused by the lack of an adequate
● If there is a history of autism spectrum disorder or mental health infrastructure in low- and
a communication disorder of childhood onset, the middle-income countries
additional diagnosis of schizophrenia is made ● Other cultural factors include levels of stress
only if prominent delusions or hallucinations, in associated with factors such as stigma, isolation,
addition to the other required symptoms of and discrimination
schizophrenia, are also present for at least 1
month (or less if successfully treated) Genetic Influences
● Family Studies
Development ○ A study by Kallmann showed that the severity
● Severe symptoms occur in late adolescence or of the parent’s disorder influenced the
early adulthood likelihood of the child’s having schizophrenia
● Children typically show early clinical features such ○ All forms of schizophrenia were seen within
as mild physical abnormalities, poor motor the families
coordination, and mild cognitive and social ○ This shows that people can inherit a general
problems but do not meet the criteria for predisposition for schizophrenia that
schizophrenia manifests in the same form or differently from
● Prodromal Stage: a 1- to 2-year period before the that of the parent
serious symptoms occur but when less severe yet ○ There appears to be some familial risk for a
unusual behaviors start to show themselves spectrum of psychotic disorders related to
○ Seen in schizotypal personality disorders schizophrenia
○ Include ideas of reference, magical thinking, ● Adoption Studies
and illusions ○ Even when raised away from their biological
○ other symptoms include isolation, marked parents, children of parents with
impairment in functioning, and a lack of schizophrenia have a much higher chance of
initiative, interests, or energy having the disorder themselves
● Once symptoms begin to appear, it can take ■ Adopted children with biological mothers
anywhere from 2 years to around 10 years before a that are diagnosed with schizophrenia
have 5% chance of inheriting the disorder

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 ■ If the the mother had schizophrenia or ■ Can produce too much neurotransmitter
one of the related psychotic disorders, the activity by increasing production or
risk rises to 22% release of the neurotransmitter and by
○ However, a good home environment can affecting more receptors at the dendrites
reduce the risk of schizophrenia ○ When drugs are administered that are known
● Twin Studies to increase dopamine (agonists), there is an
○ Identical twins would always have increase in schizophrenic disorder
schizophrenia (be concordant) ○ Other evidences show that schizophrenia is
○ Fraternal twins would both have it about 50% partially the result of excessive stimulation of
of the time striatal dopamine D2 receptors
○ De Novo Mutations: genetic mutations that ■ Striatum: part of the basal ganglia
can occur as a result of a mutation in a germ responsible for controlling movement,
cell of one of the parents balance, and walking; rely on dopamine
○ Unshared Environments: demonstrates that to function
even siblings who are close in every aspect of ○ Deficiency in the stimulation of prefrontal
their lives can still have considerably different dopamine D1 receptors
experiences physically and socially as they ■ People with schizophrenia display a range
grow up of deficits in the prefrontal section of the
● Offspring of Twins brain
○ If your parent is an identical (monozygotic) ■ Hypofrontality: less active / deficient
twin with schizophrenia, you have about a 17% ■ Hyperfrontality: too much activity
chance of having the disorder yourself ○ Prefrontal activity involving glutamate
○ If your parent does not have schizophrenia transmission
but your parent’s fraternal twin does, your risk ■ Glutamate: excitatory neurotransmitter
is only about 2% that is found in all areas of the brain
● Linkage and Association Studies ■ N-methyl-d-aspartate (NMDA) receptors
○ Marker Genes: location of genes that have ■ Phencyclidine (PCP) and ketamine can
the trait result in psychotic-like behavior in people
■ Chromosome 8 (Neuregulin 1 or NRG1) without schizophrenia
■ Chromosome 6 (dystrobrevin-binding ● Brain Structure
protein 1 or DTNBP1) ○ Adults who have schizophrenia show deficits
■ Chromosome 22 (catecholamine in their ability to perform certain tasks and to
O-methyltransferase or COMT) attend during reaction time exercises which
● Plays a role in dopamine metabolism suggest brain damage / dysfunction
● Endophenotypes ○ People with schizophrenia showed
○ Endophenotyping: process of finding basic abnormally large lateral and third ventricles
processes that contribute to the behaviors or ■ Dilation (enlargement) of the ventricles
symptoms of the disorder and then finding indicates that adjacent parts of the brain
the gene or genes that cause these either have not developed fully or have
difficulties atrophied
○ Smooth-Pursuit Eye Movement: a test in ■ Observed more often in men than in
which individuals track a moving pendulum women
with their eyes ■ Ventricles seem to enlarge in proportion
■ The ability to track objects smoothly to age and to the duration of the
across the visual field is deficient in many schizophrenia
people who have schizophrenia ○ Lower white matter volume and larger third
ventricular volume were associated with the
Neurobiological Influences risk for schizophrenia
● Dopamine
○ Schizophrenia is caused by highly active Psychological and Social Influences
dopamine systems ● Stress
○ Antagonistic Agents: slow or stop messages ○ Healthy people who engage in combat
from being transmitted by during a war often display temporary
■ Preventing the release of the symptoms that resemble those of
neurotransmitter schizophrenia
■ Blocking uptake at the level of the ○ Simple vulnerability can develop into a severe
dendrite disorder from the interchange between
■ Causing leaks that reduce the amount of gene–environment
neurotransmitter released ● Families and Relapse

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 ○ Schizophrenic Mother: used to describe a ● Native Chinese
mother whose cold, dominant, and rejecting ○ Hold more religious beliefs about both the
nature was thought to cause schizophrenia in causes and treatments of schizophrenia
her children
○ Double Bind Communication: used to Biological Interventions
portray a communication style that produced ● Insulin Coma Therapy
conflicting messages, which, in turn, caused ○ Thought to be helpful
schizophrenia to develop ○ Closer examination showed it carried great
○ Expressed Emotion (EE): attitude towards a risk of serious illness and death
person with a mental disorder as reflected by ● Psychosurgery
comments about the patient made to an ● Electroconvulsive Therapy (ECT)
interviewer ● Transcranial Magnetic Stimulation
■ Formulated by George Brown ○ Treatment for hallucinations
■ Indicated that if the levels of criticism ○ Uses wire coils to repeatedly generate
(disapproval), hostility (animosity), and magnetic fields-up to 50 times per
emotional overinvolvement second-that pass through the skull to the
(intrusiveness) expressed by the families brain
were high, patients tended to relapse
Antipsychotic Medications
● Neuroleptics
LEVELS OF EXPRESSED EMOTION
○ Meaning “taking hold of the nerves”
High View the symptoms of schizophrenia as ○ Provided the first real hope
controllable and that the hostility arises ○ Help people think more clearly and reduce
when family members think that
hallucinations and delusions
patients just do not want to help
themselves ○ Dopamine antagonists
○ Haldol and Thorazine: earliest neuroleptics
“Why don’t you pick up a book, do a drugs; called conventional or first-generation
crossword or something like that to keep
your mind off it.” antipsychotics
○ Risperidone and Olanzapine: newer
I’ve tried to jolly him out of it and medications; called atypical or second
pestered him into doing things. Maybe
I’ve overdone it, I don’t know.
generation antipsychotics

Low I know it’s better for her to be on her Psychosocial Interventions

own, to get away from me and try to do ● Clinicians attempt to reattach social skills
things on her own.
● such as basic conversation, assertiveness,
Whatever she does suits me. ● and relationship building
● Therapists divide complex social skills into their
I just tend to let it go because I know
component parts, which clients model
that when she wants to speak she will
speak. ● Clients do role-playing and ultimately practice
their new skills in the “real world”
● Programs teach a range of ways people can adapt
TREATMENT
to their disorder yet live in the community
● Virtual Assessments and Treatments
Cultural Treatments
○ Provide clinicians with controllable and safer
● Kenya
environments in which to study and treat
○ Kisii tribal doctors listen to their patients to
persons with schizophrenia
find the location of the noises in their heads
● Behavioral Family Therapy
(hallucinations), then get them drunk, cut out
○ Resembles classroom education
a piece of scalp, and scrape the skull in the
○ Family members are informed about
area of the voices
schizophrenia and its treatment, relieved of
○ Xhosa people of South Africa report using
the myth that they caused the disorder
traditional healers who sometimes
○ Family members are taught practical facts
recommend the use of oral treatments to
about antipsychotic medications and their
induce vomiting, enemas, and the slaughter
side effects
of cattle to appease the spirits
○ Family members are helped with
● Hispanics
communication skills so that they can
○ Family support
become more empathic listeners
● British
○ Help them learn constructive ways of
○ Use more biological, psychological, and
expressing negative feelings to replace the
community treatments

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 harsh criticism that characterizes some family ● Bipolar type: applies if a manic episode is part of
interactions the presentation; major depressive episodes may
○ Help them learn problem-solving skills to help also occur
them resolve conflicts that arise ● Depressive type: applies if only major depressive
● Vocational Rehabilitation episodes are part of the presentation
○ Supportive Employment: involves providing
coaches who give on-the-job training Genetic and Psychological Risks
● Assertive Community Treatment (ACT) Program ● Among individuals with schizophrenia, there may
○ Involves using a multidisciplinary team of be an increased risk for schizoaffective disorder in
professionals to provide broad-ranging first-degree relatives
treatment
Suicide Risks
Preventions ● Lifetime risk of suicide for schizophrenia and
● Identify and treat children who may be at risk of schizoaffective disorder is 5%
getting the disorder later in life ● Presence of depressive symptoms is correlated
● Treatment of persons in the prodromal stages with a higher risk for suicide

Common Comorbidities
REFERENCES
● Substance-Related Disorders American Psychiatric Association. (2013). Diagnostic and
○ Tobacco Use statistical manual of mental disorders (5th ed.).
○ Smoke cigarettes regularly [Link]
● Anxiety Disorders Barlow, D., Durand, V., Lalumiere, M., & Hofmann, S. (2018).
● Obsessive-Compulsive Disorder and Panic Abnormal psychology: An integrative approach
(8th ed.). Cengage Learning.
Disorder
Hooley, J., Nock, M., & Butcher, J. (2021). Abnormal
● Schizotypal or Paranoid Personality Disorder may
psychology (18th ed.). Pearson.
sometimes precede the onset of schizophrenia

SCHIZOAFFECTIVE DISORDER

DEFINING SCHIZOAFFECTIVE DISORDER

Schizoaffective Disorder – presence of both

prominent mood episode (major depressive or manic)
and active-phase symptoms preceded or followed by
at least 2 weeks of delusions or hallucinations without
prominent mood symptoms; decline in functioning
not required
● Occupational functioning is frequently impaired,
but this is not a defining criterion compared to
schizophrenia
● Negative symptoms may be less severe and less
persistent
● may be at
● Individuals may be at increased risk for later
developing episodes of major depressive disorder
or bipolar disorder if mood symptoms continue
following the remission of symptoms
● Typical age at onset of schizoaffective disorder is
early adulthood

DIAGNOSTIC CRITERIA

Key Features
● Presence of major mood episode and psychotic
symptoms
● Duration: 2+ weeks without mood symptoms

Specifiers

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