Posted by SLS on October 11, 2005, at 10:42:40
In reply to Schizoaffective disorder, posted by med_empowered on October 10, 2005, at 9:31:16
Schizoaffective disorder is considered by many to be biologically distinct from either bipolar disorder or schizophrenia. I'm not sure what to think, but I lean in the direction that it is a separate illness rather than a comorbid presentation of bipolar disorder and schizophrenia.
I have seen someone with this disorder enter a hypomanic state that then led into a schizoid psychosis. In the hypomanic state, there was a reduced need for sleep (3 hours), racing thoughts, and a tendency towards religiosity. This state could last for days, weeks, or months without the appearance of any schizoid thinking. When it did appear subsequently, the psychosis was pronounced and included both auditory and visual hallucinations. I have not been able to follow her beyond this point because she, by this time, would have received treatment with antipsycotics. I never saw her at the point of incoherency, spewing out word-salads with totally disorganized thinking. She responded very well to a combination of Risperdal, Neurontin, and Xanax. I don't know if the Neurontin played any therapeutic roll. It seemed incapable of preventing affective instability. Key in this regimen was the Xanax. It would prevent the build up of anxiety and attendent insomnia that triggered the hypomania. Without the mania, there was no schizoid episode nor subsequent depression.
I think the DSM might have been a little lazy in its description of schizoaffective disorder. In its description, defines the three disease states by referring to other disorders and reciting the diagnostic criteria it uses for them. This is misleading in that it gives one the impression that schizoaffective disorder is somehow a comorbid presentation or an amalgam of two different disorders.
- Scott
poster:SLS
thread:564018
URL: http://www.dr-bob.org/babble/20051010/msgs/565639.html