Schizoaffective disorder
| Classification according to ICD-10 | |
|---|---|
| F25 | Schizoaffective Disorders |
| F25.0 | Schizoaffective disorder, currently manic |
| F25.1 | Schizoaffective disorder, currently depressed |
| F25.2 | Mixed schizoaffective disorder |
| ICD-10 online (WHO version 2019) | |
The schizoaffective disorder is a mental disorder that both symptoms of schizophrenia and the bipolar affective disorder combines. In addition to the mood problems caused by an affective disorder (such as depression or mania ), symptoms such as delusion or hallucinations from the schizophrenic group of forms occur here .
A distinction can be made between schizomaniac, schizodepressive and mixed forms. The course can be phased (i.e. in alternating episodes) or chronifying with residual symptoms (i.e. with a lasting impairment). Schizomaniac episodes are said to have a slightly more favorable prognosis than the schizodepressive form, which apparently tends to become more chronic .
There is still no clear agreement as to whether this disease syndrome should really form a separate category in terms of its biological origin and treatment options. As with most mental illnesses, no changes in the brain of those affected have so far been detected by imaging methods .
Demarcation
A severe affective disorder can also include psychotic symptoms, but the delusional content that occurs is usually appropriate ( synthym ) to the depressive or manic mood. In the case of depression, for example, the person affected can suffer from delusions of guilt ("I have put some guilt on myself that I can never fix"), delusional poverty ("I will have no more money and will starve") or nihilistic delusions (" I don't exist ”).
Also delusions, delusions of jealousy and paranoia are still in severe depressive episode with psychotic symptoms (see ICD-10 F32.3x, criterion D). In mania often occurs megalomania on. The following table classifies the psychotic symptoms that occur in the context of an affective disorder as synthymic ( corresponding to the mood) or parathymal (inappropriate to the mood or without reference to it):
| F32.30 synthyme psychotic symptoms | F32.31 parathymal psychotic symptoms |
|---|---|
| z. B. delusions of guilt , delusions of worthlessness, physical illness, impending disasters, mocking or damning acoustic hallucinations | z. B. Persecution and relationship delusions without affective content, affective neutral hallucinations |
Diagnostic criteria
In order to be able to speak of a schizoaffective disorder according to ICD-10 , one of the following criteria must be met during the same disorder episode in addition to the presence of an affective disorder and must not be caused by an organic disease or psychoactive substances (drugs or medication):
- Ego disorders such as B. Thought sounding, thought inspiration , thought withdrawal , thought spreading
- Mania for control, mania for influence, feeling of what has been done
- commenting or dialogue voices
- persistent, culturally inappropriate, bizarre and completely unrealistic delusion (not just delusions of grandeur or paranoia)
- Alongside talking, muddled language, neologisms
- catatonic symptoms ( postural stereotypes , waxy flexibility, or negativism )
Differentiating it from schizophrenia is often difficult, since schizophrenia is almost always associated with affective symptoms. Both the course of the disease and the type and severity of the negative symptoms are decisive for the diagnosis .
treatment
The therapy of a schizoaffective disorder depends on the symptoms. The prevention of new phases of the disease mainly consists in the combination of a phase prophylactic with an (atypical) neuroleptic . A modern neuroleptic is rarely used prophylactically alone. If antidepressants are used, they must be administered carefully because of the risk of increasing psychotic and manic symptoms.
literature
- Andreas Marneros : Schizoaffective psychoses. Diagnosis, therapy and prophylaxis. Springer, Berlin 1989, ISBN 3-540-51243-8
- Andreas Marneros: Schizoaffective Diseases. A guide for clinic and practice. Thieme, Stuttgart 1995, ISBN 3-13-104031-9
- Josef Bäuml : Psychoses from the schizophrenic circle of forms. A guide for patients and relatives. 2nd edition, Springer, Heidelberg 2008, ISBN 978-3-540-43646-1
Web links
- Volker Faust (psychosoziale-gesundheit.net): Schizofaffective disorders
Individual evidence
- ↑ a b Codes in ICD-10 (according to DIMDI ): Severe depressive episode with psychotic symptoms (F32.3) ( Memento from January 26, 2018 in the Internet Archive ) and schizoaffective disorders (F25)
- ↑ Josef Schöpf: Psychiatry for Practice: With ICD-10 diagnostics. 2nd edition, Springer-Verlag, Berlin / Heidelberg / New York, 2003, ISBN 3-540-43177-2 , p. 135
