eMedicine Specialties > Psychiatry > Adult

Schizoaffective Disorder: Follow-up

Author: Guy E Brannon, MD, Associate Clinical Professor of Psychiatry, Louisiana State University Health Sciences Center; Director, Adult Psychiatry Unit, Chemical Dependency Unit, Clinical Research, Brentwood Behavior Health Company
Contributor Information and Disclosures

Updated: Jun 3, 2009

Follow-up

Further Inpatient Care

  • Patients may require further inpatient care if they represent a danger to themselves or to others or if they are gravely disabled.

Further Outpatient Care

  • For best results, patients require medication and therapy.

Inpatient & Outpatient Medications

  • When an inpatient who has schizoaffective disorder makes the transition to being an outpatient, stressing the importance of medication compliance is crucial.
  • Patients with schizoaffective disorder often lack judgment and insight into their illness. They commonly refuse to continue the medications started in the hospital after they are discharged. Noncompliance can also be due to adverse effects of the medication, such as sedation and weight gain.
  • Patients with schizoaffective disorder begin to feel better as a result of their medications and believe that they no longer need to take them. This thinking leads to the discontinuation of medication and results in the patient returning to the hospital within the next several weeks or so.
  • If possible, select once-daily or long-acting medications, such as decanoate injections, to help with patient compliance.
  • Also discuss compliance with a family member. Always discuss all the risks, benefits, adverse effects, and alternatives of each medication with the patient and family.
  • Obtain written informed consent before starting medication therapy.

Transfer

  • Medical surgical hospital, if needed
  • Residential or group home, if needed

Complications

  • Noncompliance with medications is a complication of therapy.
  • Expressed emotions must be reduced in all areas of a patient's life, including stress-reduction techniques employed to prevent relapse and possible rehospitalization.

Prognosis

  • The prognosis lies somewhere between that associated with schizophrenia and that associated with a mood disorder.

Patient Education

  • Patients should be educated about the following:
    • Social skills training
    • Medication compliance
    • Reducing expressed emotions
    • Cognitive rehabilitation
    • Family therapy
  • For excellent patient education resources, visit eMedicine's Mental Health and Behavior Center. Also, see eMedicine's patient education article Schizophrenia.
  • Family education should involve reduction of expressed emotions, criticism, hostility, or over protection of the patient, which may led to decreases in relapse of this illness.

Miscellaneous

Medicolegal Pitfalls

  • Be familiar with local mental health laws.
  • If patients with schizoaffective disorder represent a danger to self or others or are gravely disabled and are unwilling to seek help on a formal voluntary basis, they may need to be committed for further evaluation and treatment.
  • If noncompliance with medications is an issue, one may seek a court order to force the patient to take medications (eg, in lieu of rehospitalization), which may help increase medication compliance.
 


More on Schizoaffective Disorder

Overview: Schizoaffective Disorder
Differential Diagnoses & Workup: Schizoaffective Disorder
Treatment & Medication: Schizoaffective Disorder
Follow-up: Schizoaffective Disorder
References
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Further Reading

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Keywords

mental illness, psychosis, mental disorder, hallucinations, delusions, schizophrenia, depression, mania, manic depressive, manic subtype, major depressive disorder, viral infection, malnutrition, birth complications, mood disorder, distorted thinking, bipolar disorder, antisocial personality traits, psychotherapy

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Contributor Information and Disclosures

Author

Guy E Brannon, MD, Associate Clinical Professor of Psychiatry, Louisiana State University Health Sciences Center; Director, Adult Psychiatry Unit, Chemical Dependency Unit, Clinical Research, Brentwood Behavior Health Company
Guy E Brannon, MD is a member of the following medical societies: American Medical Association, American Medical Writers Association, American Psychiatric Association, American Society of Addiction Medicine, Association of Clinical Research Professionals, Louisiana State Medical Society, and Southern Medical Association
Disclosure: AstraZeneca Honoraria Speaking and teaching; Takeda Honoraria Speaking and teaching; Wyeth Honoraria Speaking and teaching; Janssen Honoraria Speaking and teaching; Pfizer Honoraria Speaking and teaching

Medical Editor

Ronald C Albucher, MD, Chief Medical Officer, Westside Community Services; Consulting Staff, California Pacific Medical Center
Ronald C Albucher, MD is a member of the following medical societies: American Psychiatric Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

David Bienenfeld, MD, Vice-Chair, Program Director, Professor, Department of Psychiatry, Wright State University School of Medicine
David Bienenfeld, MD is a member of the following medical societies: American Medical Association, American Psychiatric Association, and Association for Academic Psychiatry
Disclosure: Nothing to disclose.

CME Editor

Harold H Harsch, MD, Program Director of Geropsychiatry, Department of Geriatrics/Gerontology, Associate Professor, Department of Psychiatry and Department of Medicine, Froedtert Hospital, Medical College of Wisconsin
Harold H Harsch, MD is a member of the following medical societies: American Psychiatric Association
Disclosure: lilly Honoraria Speaking and teaching; Forest Labs Honoraria Speaking and teaching; AstraZeneca Honoraria Speaking and teaching; Pfizer Grant/research funds Speaking and teaching; Northstar Grant/research funds Research; Novartis Grant/research funds research; Pfizer  Speaking and teaching; Sanofi-avetis Grant/research funds research; Otsuke Grant/research funds reseach; GlaxoSmithKline Grant/research funds research

Chief Editor

Stephen Soreff, MD, President of Education Initiatives, Nottingham, NH; Faculty, Metropolitan College of Boston University, Boston, MA
Stephen Soreff, MD is a member of the following medical societies: American College of Mental Health Administration and American Psychosomatic Society
Disclosure: Nothing to disclose.

 
 
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