What causes of schizoaffective disorder? How is it Treated?

by Rethink

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What causes of schizoaffective disorder?

The causes of schizoaffective disorder are unknown but it is thought that both genetic and environmental factors are involved. It is clear that there is a chemical imbalance in neurotransmitters, the chemical messengers of the brain of people with schizoaffective disorder. However it is unclear as yet whether that is caused by the environment or whether it is as a result of a genetic predisposition.

genetic causes

Schizoaffective disorder occurs more often in families where other members have been diagnosed with schizophrenia, schizoaffective disorder or bipolar disorder. This suggests that genetics has a role to play in the development of schizoaffective disorder.

environmental causes

Stress seems to play a key role in triggering schizoaffective disorder and subsequent relapses. It is important for people with schizoaffective disorder to live in an environment with a low degree of stress and to monitor the types of stress that cause relapses.

How is Schizoaffective Disorder Treated?

Both drug and psychosocial therapies are necessary to successfully treat schizoaffective disorder. Schizoaffective disorder is often accompanied by unemployment, poverty and homelessness and as such drug therapy alone usually is insufficient. Drug therapy usually can stop the patient's psychosis, but often only social and occupational rehabilitation therapies can overcome the associated unemployment , poverty and homelessness.

medication

Schizoaffective disorder appears to be a combination of a thought disorder, mood disorder and anxiety disorder. Thus the medical management of schizoaffective disorder often requires a combination of antipsychotic, antidepressant and antianxiety medication. Unfortunately, after the first year of treatment, only a minority of schizoaffective outpatients remain on their oral medications. Thus, long-acting, depot antipsychotic medications are usually required to overcome this non-compliance.

The older (tricyclic) antidepressants often worsen schizoaffective disorder. However, the newer (serotonergic) antidepressants have dramatically benefited many apathetic or depressed schizoaffective patients. Antidepressant use needs to be carefully monitored because it can trigger manic episodes.

Benzodiazepines often can dramatically reduce agitation and anxiety of schizoaffective disorder. this is often especially true for those suffering from catatonic excitement or stupor.

Mood stabilizers are often added on a trial basis if the patient has net responded to antipsychotic treatment alone.

psychosocial treatments

Traditional insight psychotherapy is not recommended for people with schizoaffective disorder. Supportive therapy, which may include advice, reassurance, education, modeling, limit setting, and reality testing, is generally the therapy of choice.

Group therapy, combined with drugs produces somewhat better results than drug treatment alone. It has been found to be most successful when undertaken in an inpatient setting. Positive results are more likely to be obtained when group therapy focuses on real-life plans, problems and relationships; on social and work roles and interaction; on cooperations with drug therapy and discussion of its side effects; on some practical recreational or work activity. This supportive group therapy can be especially helpful in decreasing social isolation and increasing reality testing.

Family intervention can significantly decrease relapse rates for a person with schizoaffective disorder. In high-stress families, a person with schizophrenia may have a aftercare relapse rate of 50-60% of the time in the first year out of hospital. Supportive family intervention can reduce this relapse rate to below 10%. Self help groups in which family members of schizoaffective patients discuss and share issues, have also been particularly helpful.

When a schizoaffective patient is no longer psychotic or distractible, behaviour therapy can successfully teach much needed social and occupational skills. Cognitive behaviour therapy has been found to be particularly effective.

mortality rates

Between 30 and 40 percent of people with schizoaffective disorder will attempt suicide during their lifetime and 10 percent of them will succeed. Should it be appropriate, treatment with lithium and/or clozapine can reduce the chance of suicide in people with schizoaffective disorder.

About the Author

www.rethink.org
Rethink is the largest severe mental illness charity in the UK. We are dedicated to improving the lives of everyone affected by severe mental illness, whether they have a condition themselves, care for others who do, or are professionals or volunteers working in the mental health field.