Monday, August 28, 2017

Into the DSM - Schizoaffective Disorder

Schizoaffective disorder readily lends itself to close-call differential diagnosis questions and is a natural favorite for exam writers. A question may boil down to this: Is it schizophrenia or schizoaffective disorder? Well, here are the criteria for schizoaffective disorder:

A. A major mood episode (MDD or manic) concurrent with Criterion A of schizophrenia*
B. Delusions or hallucinations for two or more weeks in the absence of a major mood episode.
C. Symptoms meet criteria for a major mood episode for the majority of the illness.
D. Not attributable to substance or another medical condition.

Bipolar type (that is, psychotic symptoms alongside--but not exclusively during--a manic episode).
Depressive type (same as a above, but with symptoms of MDD).

Remember that psychotic symptoms can be present within bipolar or depressive illness. They can also be present--with the absence of any major mood episodes--in schizophrenia and other psychotic disorders.

That's a lot to have understood before facing down a question about mood/psychotic symptoms. But now you're that much closer to correctly answering a social work exam question on the topic.

For a lot more about schizoaffective disorder, try this long Wikipedia page:

*Here's Criterion A of schizophrenia, referenced above: Two or more of the following present most of the time for a month or more:
  • Delusions
  • Hallucinations
  • Disorganized speech
  • Grossly disorganized or catatonic behavior
  • Negative symptoms (e.g., blank affect, avolition)

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