Bipolar schizophrenia - facts and myths

What is bipolar schizophrenia?

The term ?bipolar schizophrenia? is not an official medical diagnosis and is considered controversial. It is most commonly used informally to describe schizoaffective disorder, which combines psychotic symptoms (delusions, hallucinations) with mood changes (mania or depression). This is why some people colloquially call it ?bipolar schizophrenia.?

What are the symptoms of schizoaffective disorder?

According to DSM?5 and ICD?10/11, symptoms are divided into two groups. The first group includes psychotic symptoms that last for at least two weeks without concurrent mood disturbance. These include delusions such as persecutory, grandiose or referential delusions, auditory hallucinations, disorganized speech and behavior, catatonic behavior, and negative symptoms such as blunted affect or apathy. The second group consists of affective symptoms that occur for most of the illness. In the depressive type, these include low mood, hopelessness, suicidal thoughts, insomnia, loss of appetite, delusional guilt or hallucinations. In the manic type, symptoms include elevated mood, hyperactivity, reduced need for sleep, impulsivity, grandiose or persecutory delusions and inappropriate social behavior. In the mixed type, depressive and manic symptoms appear simultaneously or alternately. It is also necessary to rule out other causes, such as psychoactive substances or metabolic disorders.

What is the prognosis for schizoaffective disorder?

Around 50 percent of patients achieve remission within five years, and approximately 25 percent function well socially for at least two years. Key factors for a better prognosis include early diagnosis, predominant mood-incongruent psychotic symptoms, continuous treatment, a family history of schizophrenia and the course of the illness.

What medications are used for schizoaffective disorder?

The foundation of treatment is a combination of pharmacotherapy, psychotherapy and psychoeducation. Antipsychotics such as risperidone, olanzapine, quetiapine or perazine are most commonly used, some of which are also available as long-acting injections (LAI). Paliperidone is considered the most effective drug for schizoaffective disorder. Additionally, mood stabilizers such as lithium, carbamazepine or valproate are used, particularly for the bipolar type. In the depressive type, antidepressants such as SSRIs may also be prescribed. Cognitive-behavioral therapy, social skills training and support groups have also proven to be highly effective.

Can schizoaffective disorder be cured?

There is no complete cure in the sense of the illness disappearing entirely. Schizoaffective disorder is a chronic condition that often requires long-term treatment. However, with proper therapy and adherence to medical recommendations, many patients achieve symptomatic and functional remission. Regular medication, psychotherapy, psychosocial support and early intervention significantly improve stability and quality of life.