Mixture of symptoms of schizoaffective disorder and its treatment

Signs of illness

Before making such a diagnosis, the doctor must identify the symptoms of schizoaffective disorder. The patient's preclinical condition is often characterized by social detachment and emotional coldness. Patients, as a rule, have few friends and tend to engage in solitary work. Their behavior is often quite eccentric.

Patients can be quite indifferent to both praise and criticism from others. If the disease is not treated, the patient will become more and more alienated from society, his interests will be far from family and friends. As a rule, those suffering from this disorder fail in their careers. The insidiousness of this disease is that it can last for many years, and at the same time progress. These include emotional disturbances that determine the subtype of the disease, as well as immediate signs of schizophrenia:

• Frequent auditory hallucinations.
• Delirium of control, influence from outside.
• Disruption of speech.
• Disorganization of thought and speech processes.
• Depersonalization and also derealization.
• Attention and memory disorders.
• Visual hallucinations.
• Decreased mental activity.

Symptoms of the disease

The general clinical picture of the pathology is characterized by the presence of signs common to affective disorder and schizophrenia. These symptoms include:

• increased excitability, which, against the background of aggressiveness, leads to a nervous breakdown;
• sleep disorders – increased drowsiness or insomnia;
• decreased level of appetite;
• rapid fatigue and physical fatigue, even with minor exertion;
• loss of interest in what is happening around and in previously interested activities;
• development of a guilt complex, inferiority, which over time turns into a feeling of deep hopelessness; thoughts about death;
• fogginess of mental activity, intellect;
• inability to concentrate on any process;
• desire for a certain type of activity, usually of a sexual nature;
• changing the tempo of speech towards acceleration under certain circumstances;
• during periods of exacerbation - dangerous behavior in society;
• a stable tendency towards a decrease in mental work and intelligence, manifested as classical dementia;
• crazy ideas and statements;
• auditory hallucinations, the occurrence of which is associated with increased emotional experiences or fatigue;
• periodic strange, illogical, incorrect behavior, accompanied by monotonous delirium;
• illogical emotions - laughter at a funeral.

The diagnosis of “schizoaffective psychosis” excludes the state of alcohol or drug intoxication. It is also necessary to exclude organic brain damage.

This diagnosis may be indicated by symptoms such as speech insufficiency, the appearance of catatonic signs, a feeling of the ability to telepathy, which manifest themselves against the background of an affective disorder for two or more weeks.

Hallucinations

A hallucination is a sensation that occurs independently of real stimuli. Depending on the analyzer, auditory, visual, tactile, olfactory, and taste hallucinations are distinguished. Sometimes it happens that the patient perceives his own thoughts as coming from outside. In this case, they talk about pseudohallucinations.

The vast majority of hallucinations experienced by patients belong to the auditory modality (about 70% of patients). Only 10% suffer from visual impairment. Tactile hallucinations are also thought to be common, but sufferers do not always report them.

Symptom of delirium

Delusions are one of the main symptoms of schizoaffective personality disorder. Delusions are those beliefs that in no way correspond to the real state of affairs, and that are particularly persistent.

Typically, in schizophrenic disorder, delusions are the first sign that the illness has worsened. It is believed that only 20% of the total number of patients do not suffer from one or another type of delusion and perceive reality correctly. The most common is the so-called delusion of relation - it seems to the patient that everything around him is not happening by chance, and he is in the center of events. Conversations, gestures, actions of other people - all this applies to him. Delusions of grandeur, jealousy, religious experiences, and hypochondria are also common.

Causes

Scientists cannot currently agree on the causes of the disorder. Most scientists adhere to the genetic theory of the development of SAD. It is believed that those people whose relatives were carriers of schizophrenia or affective disorder are “rewarded” with the risk of getting sick.

Another version suggests the presence of a risk gene for schizophrenic conditions. According to the theory, this gene “sleeps” in the body of almost every person, but wakes up under exceptional circumstances. It turns out that everyone has the opportunity to develop recurrent schizophrenia. The theory only assumes the development of this scenario: there is no clear evidence in this regard.

A connection between the disease and epilepsy has been established. The assumption is confirmed by the results of echoencephalography. In patients with SAD, increased excitability of the same brain regions was observed as in schizophrenia.

An interesting fact has been noticed: people born in late winter - early spring suffer more from the disease.

Negative environmental factors play a large role in the formation of the disorder. Firstly, it has been established that the disease more often affects lonely people who lack outside support. Secondly, the cause is negative events in a person’s life. This category includes poverty, forced change of residence, psychological trauma, chronic, acute stress.

The interdependence between drug and alcohol addiction and schizoaffective disorder is established. Both pathological conditions can provoke each other. Psychotropic substances and alcohol are excellent stimulants of the ball. However, the tormenting sensations of the disease subside for some time under the influence of psychotropics. In the future, when the effect of alcohol and drugs lowers the level of dopamine, the condition does not improve - it worsens, turning into a deeper form.

Physiological factors are also considered as a cause: viral infections, head injuries, hormonal surges.

Disorders of mental activity

Another symptom of schizoaffective disorder is thought disturbances. The most common is the complete absence of thoughts. Subjectively, this is perceived by patients as a “failure” in thoughts. Such a stop is associated not only with disturbances in mental activity, but also with memory pathologies. The patient may forget what he started talking about, his thoughts may become confused and suddenly interrupted. The ability to think abstractly is often impaired. The following symptoms also include thinking disorders:

• Repetition of the same phrases (perseveration).
• Meaningless rhymes.
• Violations of figurative thinking.
• Neologisms.
• Merging of concepts.

Derealization and depersonalization

These symptoms of schizoaffective disorder are among the most common. The fact is that with this disease, the boundaries between one’s own “Ego” and the outside world are erased. In this case, they talk about depersonalization. The patient may feel parts of his body foreign or changed; the world may seem unreal to him. He may perceive strangers as close ones, and family members, on the contrary, as strangers. Depersonalization can manifest itself as a reincarnation of the “Ego,” its merging with the world, or complete disappearance.

Derealization is an altered perception of objects in the surrounding reality. For example, some of their properties may seem more significant than others, even if in reality these properties are of little significance. Reality can be perceived as something like a movie, where everyone plays a role.

Side effects of therapy

As symptoms of schizoaffective disorder, experts identify not only the primary signs that indicate the presence of the disease, but also the so-called negative syndromes that develop as a result of treatment with psychotropic medications. This type includes the following symptoms:

• Retardation of movements, impoverishment of thinking and speech.
• Weakening of mental activity, partial or complete lack of spontaneity.
• Autism – unwillingness to cooperate, manifestations of asociality.
• Decreased ability to make decisions, weakened will.
• Difficulties in maintaining a conversation - there is no contact with the interlocutor.

Depressive type

Schizoaffective disorder of the depressive type is a type of disorder in which symptoms of two diseases are expressed - both schizophrenia and depression. The patient fully suffers from all the symptoms of a depressive disorder: he has a depressed mood, he may suffer from insomnia. There is a feeling of hopelessness, thoughts of suicide. Weight fluctuations may occur – both weight gain and weight loss.

However, in addition to these symptoms, patients also complain of classic signs of schizophrenic disorders. For example, the patient may complain that someone recognizes or controls his thoughts. Sometimes he may be haunted by painful ideas that he is being spied on, constantly haunting him. The patient may hear different voices that may not blame him, but discuss his behavior, or say that they want to kill him.

In psychiatric practice, it is believed that the symptoms of this type of schizoaffective disorder are not as severe as those of manic disorder, but they are longer lasting and have a worse prognosis.

Diagnosis of schizoaffective disorder

If symptoms appear, the doctor will look at your medical history and perform a complete examination. Although there are no laboratory tests to reliably identify schizoaffective disorder, a doctor may use other tests, such as X-rays or blood tests, to determine whether the symptoms are actually due to the disease. If the doctor's examination does not reveal a physical cause for the development of symptoms, then the patient should consult a psychiatrist or psychologist - specialists in mental illnesses who have been specifically trained in how to determine the diagnosis of these diseases and how to treat them. Psychiatrists and psychologists specifically design interviews and other tests to determine whether a person is sick or not. A diagnosis of schizoaffective disorder is made when a person has periods of continuous illness, or has had mania, depression, psychosis, or all of these disorders, and only has symptoms of schizophrenia. In addition, to be diagnosed with the disease, a person must have had symptoms for at least two weeks.

Manic type

Manic schizoaffective disorder is characterized by the presence of symptoms of mania and schizophrenia. It is believed that patients in this category recover the fastest. This disorder, in addition to the general symptoms of schizophrenia, is characterized by high spirits and overestimation of one’s achievements. These signs are often combined with increased irritability, anger, and delusions of grandeur.

In all cases, there is increased activity and decreased concentration. The patient may express a variety of fanciful delusional ideas. In order to find out whether a particular symptom is actually experienced by him, the psychiatrist conducts a thorough interview.

Mixed type

Mixed schizoaffective disorder is a disorder in which manic phases alternate with depressive phases. Typically, patients suffer from mild hallucinations and delusions. Increased physical and speech activity is often observed. This type of disorder is considered to have a relatively favorable prognosis.

The depressive phase usually lasts longer than the manic phase. Its main symptoms are motor, speech, and mental retardation; depressed state, immersion in melancholy; isolation. The phrase “stone in the chest” is suitable to describe the condition; patients often use it to convey information about their melancholy. Motor retardation in some cases reaches complete stupor.

The manic phase usually involves excessive activity and foolishness. Passive behavior is replaced by excited behavior. At this time, mental processes proceed at an accelerated rate, and motor and speech excitation is observed. At first, the manic phase is not so pronounced, but as the disease progresses it becomes more and more distinct, which allows us to talk about diagnosing schizoaffective disorders in patients. The patient often becomes very aggressive and irritable. Manic manifestations are accompanied by hallucinations, delusions, and in some cases, delusions of grandeur.

Symptoms of the disease

One of the main symptoms that people with schizoaffective disorder express is frequent mood swings. Moreover, this happens quite abruptly, uncontrollably and unpredictably. Over time, hallucinations are added to this, attention is scattered, and control over one’s own actions and decisions is lost. Schizoaffective psychosis is dangerous because a person ceases to distinguish the differences between reality and his inner fictional world. For him, the framework of reality is erased, and his imagination takes the leading role. This occurs due to serious changes in the patient’s brain, which cannot always return to its previous healthy state.

Symptoms of schizoaffective disorder can be either subtle or pronounced. Minor changes in a person’s behavior can only be noticed by his close and dear people.

Global changes are noticeable to everyone around us. They may appear like this:

• Depressed or depressed state;
• Complete or partial lack of appetite;
• Sudden changes in body weight;
• Alcohol abuse;
• Complete disorder of sleep and rest patterns;
• Weakness and lack of interest in life;
• Blame and self-reproach;
• Distracted attention, loss of control over your thoughts;
• Various manias and groundless experiences;
• Thoughts about suicide or death itself.

A person is also able to see hallucinations, stops monitoring his health and appearance, he develops obsessive ideas, his speech is confused and incomprehensible due to the large flow of thoughts.

Therapy

Treatment of schizoaffective disorder is a rather lengthy and labor-intensive process. Mild forms of the disorder can be treated quite well without affecting the ability to work. As with many other mental disorders, the best option is considered to be a combination of pharmacotherapy and psychotherapeutic methods. Medicines help relieve the symptoms of the disorder itself - hallucinations, delusions. Antipsychotic drugs help well in this case.

Psychotherapy methods help to identify the conditions that provoked an exacerbation of the disease. In addition, separate work is carried out with the patient’s relatives. The following drugs are usually used in therapy:

• Antidepressants - Amitriptyline, Fluoxetine.
• Neuroleptics - Haloperidol, Clozapine, Risperidone.
• Normotimics – “Carbamazepine”.

The drug “Rispolept” is also used in the treatment of schizoaffective personality disorder. The medicine belongs to the category of antipsychotic drugs. With its help, it is possible to achieve improvement in an outpatient setting.

You cannot treat this type of disorder on your own; the treatment regimen and all medications are prescribed only by a psychiatrist. In addition, the entire treatment process must take place under the supervision of a specialist. Disability is not provided for in schizoaffective disorder, because the disease does not cause gross personality disorders and does not affect the intellectual sphere. But if the disease progresses unfavorably, often recurs, the patient becomes dangerous to himself and to society, then in this case he is assigned a disability.

Treatment of the disorder

This syndrome can only be confirmed by a psychiatrist after communicating with the patient and conducting a series of diagnostic tests and studies. Treatment of this disease should be aimed at eliminating severe symptoms and achieving long-term remission. In the future, work is carried out to socialize the patient and return him to normal life. During an exacerbation, antipsychotics are prescribed. Drugs in this group that are often used for this disease include:

1. Solean.
2. Haloperidol.
3. Monithen.
4. Truxal.
5. Solex.
6. Kvetiron.
7. Abixa.
8. Risperidone.
9. Clozapine.
10. Rispaxol.
11. Clopixol, etc.

In addition, antidepressants, sedatives and tranquilizers are introduced into the treatment regimen. In some cases, the use of sleeping pills is required. During the period of exacerbation, physiotherapy can stabilize the patient’s condition. The use of bromide collar and pine baths may be indicated.

After stabilization of the patient's condition, long-term work with a psychotherapist is required. Both group work and individual conversations can be beneficial. In addition, work with the patient’s relatives is required, because family conflicts and emotional tension in relationships can cause increased exacerbations. To reduce the risk of exacerbations, the patient may be recommended to take medications in maintenance doses.

Often the patient needs to change his job to a less stressful one. Periodically, hospital therapy is required.