Schizoaffective Disorder in Children and Adolescents

ICD-10 code: F25.9

Schizoaffective disorder is part of a cluster of diagnoses called the schizophrenia spectrum and other psychotic disorders. Schizophrenia spectrum and other psychotic disorders are a group of psychiatric conditions that include:

  • Schizotypal (personality) disorders
  • Brief Psychotic Disorder
  • Schizophreniform Disorder
  • Schizophrenia
  • Schizoaffective Disorder
  • Substance/Medication-Induced Psychotic Disorder
  • Psychotic Disorder Due to Another Medical Condition
  • Catatonia

These disorders are characterized by symptoms that can be divided into two groups: positive and negative.

Positive symptoms are those which are in addition to normal experiences and which youth without schizophrenia will rarely experience. Positive symptoms include delusions, hallucinations, disorganized thinking (speech), and grossly disorganized or abnormal motor behavior (including catatonia). Delusions are fixed beliefs that are not amenable to change in light of conflicting evidence. Hallucinations are perception-like experiences that occur without external stimulus. Disorganized thinking/speech is characterized by a derailment or loose associations in an individual’s speech pattern. Grossly disorganized or abnormal motor behavior is a difficulty in sustaining goal-oriented behavior. This may manifest itself in a variety of ways, ranging from childlike “silliness” to unpredictable agitation.

Negative symptoms include diminished emotional expression, avolition, alogia and anhedonia. Negative symptoms are those that involve a loss of normal function or experience. Diminished emotional expression is the reductions in the expression of emotions in the face, eye contact, intonation of speech, and movement of hand, head, and face that normally give an emotional emphasis to speech. Avolition is a decrease in motivated self-initiated purposeful movement. Alogia is manifested by diminished speech output. Anhedoia is the decreased ability to experience pleasure from positive stimuli.

What is Schizoaffective Disorder?

Schizoaffective disorder is a neuropsychiatric disorder that encompasses clinical features found in both mood disorders and schizophrenia. This is characterized by delusions, hallucinations, formal thought disorder, or negative symptoms that co-occur with depressive and/or manic symptoms.

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Understanding Schizoaffective Disorder

Schizoaffective disorder in children and adolescents is very difficult to accurately diagnose in children and adolescents. The stability of early-onset schizoaffective disorder as a diagnosis appears to vary over time and can be difficult to distinguish from schizophrenia, bipolar disorder, and other mood disorders.

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How is Schizoaffective Disorder treated?

Schizoaffective Disorder in children and adolescents is treated using generalized results from adult population studies or from studies that utilize childhood or adolescent “schizophrenia-spectrum” inclusion criteria. There are currently no published guidelines for schizoaffective disorder in the youth population.

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