Some Info On Schizo Effective Disorder

[Lauren]

ive only put whats relevent to myself as a few of you have expressed an interest over the last few months

Basic Principles

Both drug and psychosocial therapies are necessary to successfully treat schizoaffective disorder. Because of the unemployment, poverty, and homelessness that often complicates schizoaffective disorder, drug therapy alone usually is insufficient. Drug therapy usually can stop the patient's psychosis, but often only social and occupational rehabilitation therapies can overcome the associated unemployment, poverty and homelessness. Recovering from schizoaffective disorder is an extremely lonely experience, and these patients require all the support that their families, friends, and communities can provide.

Schizoaffective disorder appears to be a combination of a thought disorder, mood disorder, and anxiety disorder. Thus the medical management of schizoaffective disorder oftens requires a combination of antipsychotic, antidepressant, and antianxiety medication. Unfortunately, after the first year of treatment, only a minority of schizoaffective outpatients remain on their oral medications. Thus long-acting, depot antipsychotic medications that last 2-4 weeks between injections (e.g., depot haloperidol, pipotiazine, or fluphenazine) usually are required to overcome this noncompliance problem.

Hospitalization

Treatment of an acutely psychotic patient often requires psychiatric hospitalization. The presence of adequate family or social supports will often shorten the length of this hospitalization, or permit the psychotic patient to be treated solely on an outpatient basis.

Antipsychotic Drugs

Antipsychotic medications are the treatment of choice. Evidence to date suggests that all of the antipsychotic drugs (except clozapine) are similarly effective in treating psychoses, with the differences being in milligram potency and side effects. Clozapine (Clozaril) has been proven to be more effective than all other antipsychotic drugs, but its serious side-effects limit its use.

Individual patients may respond to one drug better than another, and a history of a favorable response to treatment with a given drug in either the patient or a family member should lead to use of that particular drug as the drug of first choice. If the initial choice is not effective in 2-4 weeks, it is reasonable to try another antipsychotic drug with a different chemical structure.

Often an agitated, psychotic patient can be calmed in 1-2 days on antipsychotic drugs. Usually the psychosis gradually resolves only after 2-6 weeks of a high-dose antipsychotic drug regimen. A common error is to dramatically reduce antipsychotic drug dosage just as the patient improves or leaves hospital. This error almost guarantees a relapse. Major reduction in antipsychotic drug dosage should be avoided for at least 3-6 months after hospital discharge. Decreases in antipsychotic drug dosage should be done gradually. It takes at least 2 weeks for the body to reach a new equilibrium in antipsychotic drug level after a dose reduction.

Sometimes patients view the side-effects of the antipsychotic drugs as being worse than their original psychosis. Thus clinicians must be skillful in preventing these side-effects. Sometimes these side-effects can be removed by simply reducing the patient's antipsychotic drug dosage. Unfortunately, such reduction in drug dosage often causes patients to relapse back into psychosis.

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2. Akathisia:

Akathisia is experienced as an inability to sit or stand still, with a subjective feeling of anxiety. Beta-adrenergic antagonists (e.g., atenolol, propranolol) are the most effective treatment for akathisia. These beta-blockers usually can be safely stopped in 1-3 months. Akathisia may also respond benzodiazepines (e.g., clonazepam, lorazepam), or to anti-parkinson drugs (e.g., benztropine, procyclidine).

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Basic Principles

Untreated schizoaffective disorder will often leave a patient friendless, penniless, and homeless. Thus circumstances often force schizophenic patients to rely heavily on their family or psychiatric group homes. There is frequently an inverse relationship between the stability of their living situation and the amount of antipsychotic drugs they require.

Supportive Psychotherapy

Traditional insight-oriented psychotherapy is not recommended in treating schizoaffective patients, whose egos are too fragile. Supportive therapy, which may include advice, reassurance, education, modeling, limit setting, and reality testing, is generally the therapy of choice.

Psychotherapy can have toxic effects, especially when there is a negative transference. One of the toxic effects of psychotherapy is dependency. A pushing, intrusive approach may make withdrawn patients worse.

Group Therapy

Group therapy, combined with drugs, produces somewhat better results than drug treatment alone, particularly with schizoaffective outpatients. Positive results are more likely to be obtained when group therapy focuses on real-life plans, problems, and relationships; on social and work roles and interaction; on cooperation with drug therapy and discussion of its side effects; or on some practical recreational or work activity. This supportive group therapy can be especially helpful in decreasing social isolation and increasing reality testing.

Family Therapy

Family therapy can significantly decrease relapse rates for the schizoaffective family member. In high-stress families, schizophenic patients given standard aftercare relapse 50-60% of the time in the first year out of hospital. Supportive family therapy can reduce this relapse rate to below 10 percent. This therapy encourages the family to convene a family meeting whenever an issue arises, in order to discuss and specify the exact nature of the problem, to list and consider alternative solutions, and to select and implement the consensual best solution. Self-Help groups in which family members of schizoaffective patients discuss and share issues, have been particularly helpful in this regard.

Behavior Therapy

Behavior therapy in hospital often involves rewarding desired behaviors with specific privileges, such as ground privileges or weekend passes.

When the schizoaffective patient is no longer floridly psychotic or distractible, behavior therapy usually can successfully teach much needed social and occupational skills.

The last bits are kinda funny, cause idontget any of it. still, good for a smile i guess.

[pinklady66]

I once knew a person who has the disorder. She was very delusional and thougth that everyone were witches and devils. She came up to me once and told me that I better talk to a minister or a priest because I would be attacked next. What she said did scare me, but I knew that she wasn't quite with it. She was treated on a med called Serequil. She also had talk therapy too.

When I saw her a few weeks later, she was normal it seemed. I had asked her what she meant by what she had said to me. She meant that I get a priest for her and not for me. She had mentioned that she was kidnapped by a bunch of guys and they all wanted to marry her and when she was with them, they made her watch horror flicks all the time. I knew that at the time she was not on meds. I did feel really sorry for her. She was a nice person. I haven't seen her since the last time I was in the hospital with her. I could only hope for the best for her.

I do feel really sorry for the people out there with the disorder and how painful it seems that they are so out of touch with reality. Now that I have seen and been made to understand the disorder, I can sympathize with people who have it and not be scared of them anymore.

You're right when you say that too many people are homeless because of it. They cannot get a job because of their disabilty. Many that I have encountered can't get a disablity cheque here in Canaday because they don't have an address to send a cheque to. It's a sad state of affairs.

[flora]

Wow thanks extinct. I was diagnosed with schizoaffective disorder a couple of years ago and haven't been able to find much info on it outside of the diagnostic criteria.

Thanks for this love flora xox