Schizoaffective disorder

Schizoaffective disorder is often diagnosed in patients with features of both schizophrenia, and bipolar depression or severe major depression during the majority of their disorder; however, the diagnosis is controversial.

The already very limited evidence base to guide treatment of schizoaffective disorder has been further undermined by changes in the diagnostic criteria. Nevertheless, the principles of treating schizoaffective disorder are the same as the Principles of treating psychoses including schizophrenia and the relevant mood disorder (see Principles of managing bipolar depression in adults and young people or Principles of treating major depression in adults and young people). Drug therapy should be overseen by a psychiatrist. A pragmatic approach often taken by psychiatrists is to combine an antipsychotic (either oral or a long-acting injectable) with a different class of psychotropic as appropriate for the relevant mood disorder (see Bipolar disorder or Major depression).

See also the advice on:

• treating a first episode of psychosis
• recovery and relapse prevention
• managing negative symptoms
• relapse management
• treatment-resistant schizophrenia.