April 2019 By PsychDB.com

Schizoaffective Disorder

Criterion A

An uninterrupted period of illness during which there is a major mood episode (depressive or manic) concurrent with Criterion A of schizophrenia.

Note: The major depressive episode must include Criterion A1: Depressed mood.
Criterion B

Delusions or hallucinations for 2 or more weeks in the absence of a major mood episode (depressive or manic) during the lifetime duration of the illness.

Criterion C

Symptoms that meet criteria for a major mood episode are present for the majority of the total duration of the active and residual portions of the illness.

Criterion D

The disturbance is not attributable to the effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.

Specifiers

Subtype Specifier

Specify whether:

  • Bipolar type: This subtype applies if a manic episode is part of the presentation. Major depressive episodes may also occur.
  • Depressive type: This subtype applies if only major depressive episodes are part of the presentation.

Episode Specifier

Specify if: The following course specifiers are only to be used after a 1-year duration of the disorder and if they are not in contradiction to the diagnostic course criteria.

  • First episode, currently in acute episode: First manifestation of the disorder meeting the defining diagnostic symptom and time criteria. An acute episode is a time period in which the symptom criteria are fulfilled.
  • First episode, currently in partial remission: Partial remission is a time period during which an improvement after a previous episode is maintained and in which the defining criteria of the disorder are only partially fulfilled.
  • First episode, currently in full remission: Full remission is a period of time after a previous episode during which no disorder-specific symptoms are present.
  • Multiple episodes, currently in acute episode: Multiple episodes may be determined after a minimum of two episodes (i.e., after a first episode, a remission and a minimum of one relapse).
  • Multiple episodes, currently in partial remission
  • Multiple episodes, currently in full remission
  • Continuous: Symptoms fulfilling the diagnostic symptom criteria of the disorder are remaining for the majority of the illness course, with subthreshold symptom periods being very brief relative to the overall course.
  • Unspecified
What is psychosis?

The term psychosis has been defined in various ways in the medical literature over time. The narrowest and current definition of psychosis is hallucinations and delusions, with the lack of reality testing or insight. A broader definition of psychosis would also include disorganized thought, emotions, and behaviour. This loose definition was more common in the past, and schizophrenia was often overdiagnosed as a result.

Comparison

Brief psychotic disorder
Onset Sudden
Length 1 day to 1 month
Psychotic Symptoms At least 1 of:
  • Delusions
  • Hallucinations
  • Disorganized speech
  • Grossly disorganized or catatonic behaviour
    Mood Symptoms No
    Functional Decline? Full resolution of symptoms
    Schizophreniform disorder
    Onset Can be prodromal
    Length 1 month to 6 months
    Psychotic Symptoms At least 2 of:
    • Delusions
    • Hallucinations
    • Disorganized speech
    • Grossly disorganized or catatonic behaviour
    • Negative symptoms
      Mood Symptoms No
      Functional Decline? Not required
      Schizophrenia
      Onset Can be prodromal
      Length > 6 months
      Psychotic Symptoms
      Mood Symptoms No
      Functional Decline? Required
      Schizoaffective disorder
      Onset Can be prodromal
      Length Major mood episode
      + 2 weeks of isolated psychotic symptoms
      Psychotic Symptoms
      • Delusions or hallucinations for 2 or more weeks
      • Must be in absence of a major mood episode (depressive or manic) during the lifetime duration of the illness
        Mood Symptoms Required
        Functional Decline? Not required
        Delusional disorder
        Onset Can be prodromal
        Length > 1 month
        Psychotic Symptoms One or more delusions, with no other psychotic symptoms.
        Mood Symptoms No
        Functional Decline? Normal function aside from impact of delusions
        Type Onset Length Psychotic Symptoms Mood Symptoms Functional Decline?
        Brief psychotic disorder Sudden 1 day to 1 month At least 1 of:
        • Delusions
        • Hallucinations
        • Disorganized speech
        • Grossly disorganized or catatonic behaviour
          No Full resolution of symptoms
          Schizophreniform disorder Can be prodromal 1 month to 6 months At least 2 of:
          • Delusions
          • Hallucinations
          • Disorganized speech
          • Grossly disorganized or catatonic behaviour
          • Negative symptoms
            No Not required
            Schizophrenia Can be prodromal > 6 months No Required
            Schizoaffective disorder Can be prodromal Major mood episode
            + 2 weeks of isolated psychotic symptoms
            • Delusions or hallucinations for 2 or more weeks
            • Must be in absence of a major mood episode (depressive or manic) during the lifetime duration of the illness
              Required Not required
              Delusional disorder Can be prodromal > 1 month One or more delusions, with no other psychotic symptoms. No Normal function aside from impact of delusions

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