Schizoaffective disorder is a chronic mental health condition characterised by a combination of symptoms of schizophrenia (a psychotic disorder) and a mood disorder (such as bipolar disorder or depression). It's a complex condition where individuals experience both psychotic symptoms and significant mood disturbances, but the pattern of these symptoms is what distinguishes it from schizophrenia or a primary mood disorder with psychotic features.

To be diagnosed with schizoaffective disorder according to the DSM-5 criteria, the following must be met:

• An uninterrupted period of illness during which there is a major mood episode (manic or depressive) concurrent with the active-phase symptoms of schizophrenia.
• Delusions or hallucinations must be present for at least two or more weeks in the absence of a major mood episode (depressive or manic) during the lifetime duration of the illness.

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

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

Key aspects of Schizoaffective Disorder:

• Combination of Symptoms: Individuals experience psychotic symptoms like hallucinations (seeing or hearing things that aren't there) and delusions (false beliefs), as well as mood symptoms such as periods of intense sadness, loss of interest, and changes in sleep, appetite, and energy (depression), or periods of elevated mood, increased energy, racing thoughts, and impulsive behaviour (mania or hypomania).
• Temporal Relationship of Symptoms: The crucial diagnostic factor is the occurrence of psychotic symptoms for at least two weeks without a significant mood episode, even though mood symptoms are also a major part of the illness. This helps differentiate it from a mood disorder where psychotic features only occur during mood episodes.
• Types of Schizoaffective Disorder: There are two main subtypes, based on the mood component:
  • Bipolar Type: Includes episodes of mania (and often depression).
  • Depressive Type: Includes only episodes of major depression.
• Varied Presentation: The specific symptoms, their severity, and their pattern can vary significantly from person to person.
• Chronic Nature: Schizoaffective disorder is typically a chronic illness that requires ongoing management.

Common symptoms can include:

Psychotic Symptoms (similar to Schizophrenia):

• Hallucinations: Experiencing sensory perceptions that are not real (e.g., hearing voices, seeing things).
• Delusions: Holding firmly to false beliefs that are not based in reality.
• Disorganised thinking and speech: Difficulty organising thoughts, leading to rambling or nonsensical speech.
• Abnormal motor behaviour: Can range from childlike silliness to unpredictable agitation.
• Negative symptoms: Reduced emotional expression (flat affect), decreased motivation (avolition), lack of pleasure in everyday life (anhedonia), reduced speech (alogia), and social withdrawal.

Mood Symptoms (similar to Mood Disorders):

• Depressive episodes: Persistent sadness, loss of interest or pleasure, significant changes in weight or appetite, sleep problems, fatigue, feelings of worthlessness, difficulty concentrating, and thoughts of death or suicide.
• Manic episodes (in Bipolar Type): Elevated or irritable mood, inflated self-esteem, decreased need for sleep, racing thoughts, increased talkativeness, distractibility, increase in goal-directed activity or psychomotor agitation, and excessive involvement in activities that have a high potential for painful consequences.
• Hypomanic episodes (in Bipolar Type): A less severe form of mania, with similar but less intense symptoms and a shorter duration.

Diagnosing schizoaffective disorder can be challenging, as it shares features with other mental health conditions like schizophrenia, bipolar disorder with psychotic features, and major depressive disorder with psychotic features. A comprehensive psychiatric evaluation, including a detailed history of symptoms and their pattern over time, is crucial for accurate diagnosis and appropriate treatment. Treatment typically involves a combination of antipsychotic medications, mood stabilisers, antidepressants, and psychotherapy.