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Schizoaffective Disorder

  • Author: Guy E Brannon, MD; Chief Editor: David Bienenfeld, MD  more...
 
Updated: Jan 12, 2016
 

Practice Essentials

Schizoaffective disorder is a perplexing mental illness that has both features of schizophrenia and features of a mood disorder. The coupling of symptoms from these divergent conditions makes diagnosing and treating schizoaffective patients difficult.

Signs and symptoms

The first step in evaluation is to obtain a complete medical history, keeping in mind the diagnostic criteria for schizoaffective disorder.

Several scales are available for rating the severity of disease (eg, PANSS). The Questionnaire is useful for investigating alcohol consumption in patients with schizoaffective disorder.

The next step is to perform a complete mental status examination (MSE), physical examination, and neurologic examination to assist with the evaluation and rule out other disease processes. The MSE typically includes assessment of the following:

  • Appearance
  • Eye contact
  • Facial expression
  • Motor
  • Cooperativeness
  • Mood
  • Affect
  • Speech
  • Suicidal ideation (should be inquired about at every visit)
  • Homicidal ideation
  • Orientation
  • Consciousness
  • Concentration and attention
  • Reading and writing
  • Memory
  • Delusions
  • Hallucinations
  • Insight
  • Judgment

See Presentation for more detail.

Diagnosis

The diagnosis of schizoaffective disorder is made when the patient has features of both schizophrenia and a mood disorder but does not strictly meet diagnostic criteria for either alone. Ongoing reevaluation over the course of the illness is important for confirming the diagnosis.

Laboratory studies that may be performed include the following:

  • Sequential multiple analysis
  • Complete blood count (CBC)
  • Rapid plasma reagent
  • Thyroid-stimulating hormone (TSH) level or thyroid function tests
  • Urine drug screen
  • Urine pregnancy test
  • Urinalysis
  • Lipid panel
  • HIV test

Psychological testing (eg, The Structured Clinical Interview for DSM-5 [SCID-5]) is warranted to assist with diagnosis.

Additional studies that may be helpful include the following:

  • Computed tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Electroencephalography (EEG)

See Workup for more detail.

Management

Management principles include the following:

  • Treatment approaches include both pharmacotherapy and psychotherapy (as well as psychoeducational programs)
  • The treatment plan must be individualized for each patient
  • Inpatient treatment is mandatory for patients who are dangerous to themselves or others and for patients who cannot take care of themselves
  • Transfer to a medical surgical hospital or to a residential or group home should be considered if appropriate
  • Smoking cessation and noncompliance with medications are special concerns

Selection of medications to treat schizoaffective disorder depends on whether the depressive or manic subtype is present. In the depressive subtype, combinations of antidepressants plus an antipsychotic are used. In the manic subtype, combinations of mood stabilizers plus an antipsychotic are used.

Antipsychotics used to treat schizoaffective disorder include the following:

  • Haloperidol
  • Risperidone
  • Olanzapine
  • Aripiprazole
  • Ziprasidone
  • Quetiapine
  • Clozapine
  • Iloperidone
  • Paliperidone
  • Asenapine

Selective serotonin reuptake inhibitors (SSRIs) are greatly preferred to the other classes of antidepressants in this setting. They include the following:

  • Sertraline
  • Fluoxetine
  • Paroxetine
  • Fluvoxamine
  • Citalopram
  • Escitalopram

Mood stabilizers used in this setting are as follows:

  • Lithium
  • Valproic acid
  • Carbamazepine
  • Oxcarbazepine

See Treatment and Medication for more detail.

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Background

Schizoaffective disorder can be defined according to either Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) , criteria (see below) or International Classification of Diseases, Tenth Revision (ICD-10) coding. It is a perplexing mental illness that has both features of schizophrenia (eg, hallucinations, delusions, and distorted thinking) and features of a mood disorder (eg, depression or mania). The coupling of symptoms from these divergent spectrums makes diagnosing and treating schizoaffective patients difficult.

The diagnosis is made when the patient has features of both schizophrenia and a mood disorder but does not strictly meet diagnostic criteria for either illness alone. Unfortunately, it is often difficult to determine whether a patient has 1 of the 2 distinct illnesses (schizophrenia or a mood disorder), a combination of the 2 illnesses (schizophrenia with a mood disorder), or perhaps even a different illness entirely.

An accurate diagnosis is made when the patient meets criteria for major depressive disorder or mania while also meeting the criteria for schizophrenia. Moreover, the patient must have psychosis for at least 2 weeks without a mood disorder.

To diagnosis schizoaffective disorder, one must complete the patient’s history, review medical and psychiatric records, and, if possible, obtain information from family members.[2, 3]

Men with schizoaffective disorder tend to exhibit antisocial personality traits.[4] The age of onset is later for women than for men, and because of limited research in this area, the exact etiology and epidemiology are unclear. Patients with schizoaffective disorder are thought to have a better prognosis than patients with schizophrenia do. Treatment consists of both pharmacotherapy and psychotherapy.

Diagnostic criteria (DSM-5)

The specific DSM-5 criteria for schizoaffective disorder are as follows[5] :

  • An uninterrupted period of illness during which there is a major mood episode (major depressive or manic) concurrent with criterion A for schizophrenia; the major depressive episode must include depressed mood
  • Delusions or hallucinations for 2 or more weeks in the absence of a major mood episode (depressive or manic) during the lifetime duration of the illness
  • Symptoms that meet criteria for a major mood episode are present for the majority of the total duration of the active and residual portions of the illness
  • The disturbance is not attributable to the effects of a substance (eg, a drug of abuse or a medication) or to another medical condition

Subtypes are defined as bipolar type (if a manic episode is part of the presentation, though major depressive episodes may also occur) and depressive type (if only major depressive episodes are part of the presentation). The presence or absence of catatonia is specified.

Various course specifiers are used, though only if the disorder has been present for at least 1 year and if they do not contradict diagnostic course criteria. These specifiers include the following:

  • First episode, currently in acute episode
  • First episode, currently in partial remission
  • First episode, currently in full remission
  • Multiple episodes, currently in acute episode
  • Multiple episodes, currently in partial remission
  • Multiple episodes, currently in full remission
  • Continuous
  • Unspecified

Finally, the current severity of the disorder is specified by evaluating the primary symptoms of psychosis and rating their severity on a 5-point scale ranging from 0 (not present) to 4 (present and severe).

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Pathophysiology and Etiology

The exact pathophysiology of schizoaffective disorder is unknown but may involve neurotransmitter imbalances in the brain.[6] Abnormalities of the neurotransmitters serotonin, norepinephrine, and dopamine could play a role in this disorder. Reduced hippocampal volumes, thalamic abnormalities, and white-matter abnormalities have been noted in patients with schizoaffective disorder.[7, 8, 9]

Although the cause of schizoaffective disorder is unknown, it may be similar to that of schizophrenia. To date, no specific genetic markers have been identified. In utero exposure to viruses, malnutrition, or even birth complications may play a role. More research is needed to fully elucidate the causes of schizoaffective disorder.

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Epidemiology

The frequency of schizoaffective disorder worldwide is difficult to determine, because the diagnostic criteria have changed over the past few years. A Finnish study estimated the lifetime prevalence of schizoaffective disorder to be about 0.32%.[10] A French review cited a range of 0.5-0.8%.[11] These numbers are only estimates; no studies have been performed.

Young people with schizoaffective disorder tend to have the bipolar subtype, whereas older people tend to have the depressive subtype. Overall, the disorder affects more women than men, probably in part because more women have the depressive subtype as opposed to the bipolar subtype. Men with schizoaffective disorder tend to exhibit antisocial traits and behavior in contrast to other personality traits. In addition, the age of onset is later for women than for men. No race-based differences in frequency have been observed.

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Prognosis

The prognosis for patients with schizoaffective disorder is thought to lie between that of patients with schizophrenia and that of patients with a mood disorder. That is, the prognosis is better than that of schizophrenia alone but worse than that of a mood disorder alone.

Individuals with the bipolar subtype are thought to have a prognosis similar to those with bipolar type I, whereas the prognosis of people with the depressive subtype is thought to be similar to that of people with schizophrenia. Overall, determination of the prognosis is difficult.[12, 13, 14, 15]

The overall incidence of suicide is estimated to be about 10%. The incidence of suicide attempts varies among different ethnic and social groups.[16, 17] White individuals have a higher rate of suicide than do African Americans. People who immigrated to a country have higher suicide rates than people born in that country do. Women attempt suicide more than men do, but men complete suicide more often.[6]

A poor prognosis in patients with schizoaffective disorder is generally associated with a poor premorbid history, an insidious onset, an absence of precipitating factors, a predominant psychosis, negative symptoms, an early onset, an unremitting course, or having a family member with schizophrenia.

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Patient Education

Patients should be educated about the following:

  • Social skills training
  • Medication compliance
  • Reducing expressed emotions
  • Cognitive rehabilitation
  • Family therapy

Family education should involve reduction of expressed emotions, criticism, hostility, or overprotection of the patient; such reduction may lead to decreases in relapse rates.

Useful online patient information is available from the following sites:

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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

Disclosure: Received income in an amount equal to or greater than $250 from: Sunovion; Forest.

Chief Editor

David Bienenfeld, MD Professor, Departments of Psychiatry and Geriatric Medicine, Wright State University, Boonshoft School of Medicine

David Bienenfeld, MD is a member of the following medical societies: American Medical Association, American Psychiatric Association, Association for Academic Psychiatry

Disclosure: Nothing to disclose.

Acknowledgements

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

References
  1. Cassels C. FDA Okays Antipsychotic for Schizoaffective Disorder. Medscape Medical News. Nov 14 2014. [Full Text].

  2. Kane JM. Performance improvement CME: Schizoaffective disorder. J Clin Psychiatry. 2011 Jul. 72(7):e23.

  3. Kane JM. Strategies for making an accurate differential diagnosis of schizoaffective disorder. J Clin Psychiatry. 2010. 71 Suppl 2:4-7. [Medline].

  4. Bottlender R, Strauss A, Möller HJ. Social disability in schizophrenic, schizoaffective and affective disorders 15 years after first admission. Schizophr Res. 2010 Jan. 116(1):9-15. [Medline].

  5. American Psychiatric Association. Schizophrenia Spectrum and Other Psychotic Disorders. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Washington, DC: American Psychiatric Association; 2013. 105-10.

  6. Kaplan HI, Sadock BJ, eds. Kaplan and Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. 9th ed. New York, NY: Lippincott Williams & Wilkins; 2003. 508-11.

  7. Radonic E, Rados M, Kalember P, Bajs-Janovic M, Folnegovic-Smalc V, Henigsberg N. Comparison of hippocampal volumes in schizophrenia, schizoaffective and bipolar disorder. Coll Antropol. 2011 Jan. 35 Suppl 1:249-52. [Medline].

  8. Antonius D, Prudent V, Rebani Y, et al. White matter integrity and lack of insight in schizophrenia and schizoaffective disorder. Schizophr Res. 2011 May. 128(1-3):76-82. [Medline]. [Full Text].

  9. Smith MJ, Wang L, Cronenwett W, Mamah D, Barch DM, Csernansky JG. Thalamic morphology in schizophrenia and schizoaffective disorder. J Psychiatr Res. 2011 Mar. 45(3):378-85. [Medline]. [Full Text].

  10. Perälä J, Suvisaari J, Saarni SI, Kuoppasalmi K, Isometsä E, Pirkola S, et al. Lifetime prevalence of psychotic and bipolar I disorders in a general population. Arch Gen Psychiatry. 2007 Jan. 64(1):19-28. [Medline].

  11. Azorin JM, Kaladjian A, Fakra E. [Current issues on schizoaffective disorder]. Encephale. 2005 May-Jun. 31(3):359-65. [Medline].

  12. Baethge C. Long-term treatment of schizoaffective disorder: review and recommendations. Pharmacopsychiatry. 2003 Mar-Apr. 36(2):45-56. [Medline].

  13. Harrow M, Grossman LS, Herbener ES, Davies EW. Ten-year outcome: patients with schizoaffective disorders, schizophrenia, affective disorders and mood-incongruent psychotic symptoms. Br J Psychiatry. 2000 Nov. 177:421-6. [Medline].

  14. Perkins D, Lieberman J, Gu H, Tohen M, McEvoy J, Green A, et al. Predictors of antipsychotic treatment response in patients with first-episode schizophrenia, schizoaffective and schizophreniform disorders. Br J Psychiatry. 2004 Jul. 185:18-24. [Medline].

  15. Smith TE, Hull JW, Huppert JD, Silverstein SM. Recovery from psychosis in schizophrenia and schizoaffective disorder: symptoms and neurocognitive rate-limiters for the development of social behavior skills. Schizophr Res. 2002 Jun 1. 55(3):229-37. [Medline].

  16. Bhatia T, Thomas P, Semwal P, Thelma BK, Nimgaonkar VL, Deshpande SN. Differing correlates for suicide attempts among patients with schizophrenia or schizoaffective disorder in India and USA. Schizophr Res. 2006 Sep. 86(1-3):208-14. [Medline].

  17. Oquendo MA, Ellis SP, Greenwald S, Malone KM, Weissman MM, Mann JJ. Ethnic and sex differences in suicide rates relative to major depression in the United States. Am J Psychiatry. 2001 Oct. 158(10):1652-8. [Medline].

  18. Emsley R, Rabinowitz J, Torreman M. The factor structure for the Positive and Negative Syndrome Scale (PANSS) in recent-onset psychosis. Schizophr Res. 2003 May 1. 61(1):47-57. [Medline].

  19. Etter M, Etter JF. Alcohol consumption and the CAGE test in outpatients with schizophrenia or schizoaffective disorder and in the general population. Schizophr Bull. 2004. 30(4):947-56. [Medline].

  20. Evans JD, Heaton RK, Paulsen JS, McAdams LA, Heaton SC, Jeste DV. Schizoaffective disorder: a form of schizophrenia or affective disorder?. J Clin Psychiatry. 1999 Dec. 60(12):874-82. [Medline].

  21. Lake CR, Hurwitz N. Schizoaffective disorders are psychotic mood disorders; there are no schizoaffective disorders. Psychiatry Res. 2006 Aug 30. 143(2-3):255-87. [Medline].

  22. Levinson DF, Umapathy C, Musthaq M. Treatment of schizoaffective disorder and schizophrenia with mood symptoms. Am J Psychiatry. 1999 Aug. 156(8):1138-48. [Medline].

  23. Marneros A. Schizoaffective disorder: clinical aspects, differential diagnosis, and treatment. Curr Psychiatry Rep. 2003 Jul. 5(3):202-5. [Medline].

  24. Hirsch D, Orr G, Kantarovich V, Hermesh H, Stern E, Blum I. Cushing's syndrome presenting as a schizophrenia-like psychotic state. Isr J Psychiatry Relat Sci. 2000. 37(1):46-50. [Medline].

  25. McKinnon K, Rosner J. Severe mental illness and HIV-AIDS. New Dir Ment Health Serv. 2000 Fall. 69-76. [Medline].

  26. Kane JM. The differential diagnosis of schizoaffective disorder. J Clin Psychiatry. 2010 Dec. 71(12):e33. [Medline].

  27. Brewerton TD. The phenomenology of psychosis associated with complex partial seizure disorder. Ann Clin Psychiatry. 1997 Mar. 9(1):31-51. [Medline].

  28. Kohler CG, Pickholtz J, Ballas C. Neurosyphilis presenting as schizophrenialike psychosis. Neuropsychiatry Neuropsychol Behav Neurol. 2000 Oct. 13(4):297-302. [Medline].

  29. Basu R, Brar JS, Chengappa KN, John V, Parepally H, Gershon S, et al. The prevalence of the metabolic syndrome in patients with schizoaffective disorder--bipolar subtype. Bipolar Disord. 2004 Aug. 6(4):314-8. [Medline].

  30. Douglass AB. Narcolepsy: differential diagnosis or etiology in some cases of bipolar disorder and schizophrenia?. CNS Spectr. 2003 Feb. 8(2):120-6. [Medline].

  31. Dodd S, Brnabic AJ, Berk L, et al. A prospective study of the impact of smoking on outcomes in bipolar and schizoaffective disorder. Compr Psychiatry. 2010 Sep-Oct. 51(5):504-9. [Medline].

  32. Williams JM, Steinberg ML, Zimmermann MH, et al. Comparison of two intensities of tobacco dependence counseling in schizophrenia and schizoaffective disorder. J Subst Abuse Treat. 2010 Jun. 38(4):384-93. [Medline]. [Full Text].

  33. Meyer JM, Koro CE. The effects of antipsychotic therapy on serum lipids: a comprehensive review. Schizophr Res. 2004 Sep 1. 70(1):1-17. [Medline].

  34. Brenner CA, Sporns O, Lysaker PH, O'Donnell BF. EEG synchronization to modulated auditory tones in schizophrenia, schizoaffective disorder, and schizotypal personality disorder. Am J Psychiatry. 2003 Dec. 160(12):2238-40. [Medline].

  35. Vieta E. Developing an individualized treatment plan for patients with schizoaffective disorder: from pharmacotherapy to psychoeducation. J Clin Psychiatry. 2010. 71 Suppl 2:14-9. [Medline].

  36. Tidey JW, Rohsenow DJ. Smoking expectancies and intention to quit in smokers with schizophrenia, schizoaffective disorder and non-psychiatric controls. Schizophr Res. 2009 Dec. 115(2-3):310-6. [Medline]. [Full Text].

  37. Lindenmayer JP, Liu-Seifert H, Kulkarni PM, Kinon BJ, Stauffer V, Edwards SE, et al. Medication nonadherence and treatment outcome in patients with schizophrenia or schizoaffective disorder with suboptimal prior response. J Clin Psychiatry. 2009 Jul. 70(7):990-6. [Medline].

  38. Goff DC, Hill M, Freudenreich O. Treatment adherence in schizophrenia and schizoaffective disorder. J Clin Psychiatry. 2011 Apr. 72(4):e13. [Medline].

  39. Goff DC, Hill M, Freudenreich O. Strategies for improving treatment adherence in schizophrenia and schizoaffective disorder. J Clin Psychiatry. 2010. 71 Suppl 2:20-6. [Medline].

  40. Addington DE, Pantelis C, Dineen M, Benattia I, Romano SJ. Efficacy and tolerability of ziprasidone versus risperidone in patients with acute exacerbation of schizophrenia or schizoaffective disorder: an 8-week, double-blind, multicenter trial. J Clin Psychiatry. 2004 Dec. 65(12):1624-33. [Medline].

  41. Baethge C, Gruschka P, Berghöfer A, Bauer M, Müller-Oerlinghausen B, Bschor T, et al. Prophylaxis of schizoaffective disorder with lithium or carbamazepine: outcome after long-term follow-up. J Affect Disord. 2004 Apr. 79(1-3):43-50. [Medline].

  42. Bogan AM, Brown ES, Suppes T. Efficacy of divalproex therapy for schizoaffective disorder. J Clin Psychopharmacol. 2000 Oct. 20(5):520-2. [Medline].

  43. Centorrino F, Kelleher JP, Berry JM, Salvatore P, Eakin M, Fogarty KV, et al. Pilot comparison of extended-release and standard preparations of divalproex sodium in patients with bipolar and schizoaffective disorders. Am J Psychiatry. 2003 Jul. 160(7):1348-50. [Medline].

  44. Ciapparelli A, Dell'Osso L, Bandettini di Poggio A, Carmassi C, Cecconi D, Fenzi M, et al. Clozapine in treatment-resistant patients with schizophrenia, schizoaffective disorder, or psychotic bipolar disorder: a naturalistic 48-month follow-up study. J Clin Psychiatry. 2003 Apr. 64(4):451-8. [Medline].

  45. Ciapparelli A, Dell'Osso L, Pini S, Chiavacci MC, Fenzi M, Cassano GB. Clozapine for treatment-refractory schizophrenia, schizoaffective disorder, and psychotic bipolar disorder: a 24-month naturalistic study. J Clin Psychiatry. 2000 May. 61(5):329-34. [Medline].

  46. Dietrich DE, Kropp S, Emrich HM. Oxcarbazepine in affective and schizoaffective disorders. Pharmacopsychiatry. 2001 Nov. 34(6):242-50. [Medline].

  47. Ghaemi SN, Goodwin FK. Use of atypical antipsychotic agents in bipolar and schizoaffective disorders: review of the empirical literature. J Clin Psychopharmacol. 1999 Aug. 19(4):354-61. [Medline].

  48. Gunasekara NS, Spencer CM, Keating GM. Spotlight on ziprasidone in schizophrenia and schizoaffective disorder. CNS Drugs. 2002. 16(9):645-52. [Medline].

  49. Gunasekara NS, Spencer CM, Keating GM. Ziprasidone: a review of its use in schizophrenia and schizoaffective disorder. Drugs. 2002. 62(8):1217-51. [Medline].

  50. Kane JM, Carson WH, Saha AR, McQuade RD, Ingenito GG, Zimbroff DL, et al. Efficacy and safety of aripiprazole and haloperidol versus placebo in patients with schizophrenia and schizoaffective disorder. J Clin Psychiatry. 2002 Sep. 63(9):763-71. [Medline].

  51. Lasser RA, Bossie CA, Zhu Y, Gharabawi G, Eerdekens M, Davidson M. Efficacy and safety of long-acting risperidone in elderly patients with schizophrenia and schizoaffective disorder. Int J Geriatr Psychiatry. 2004 Sep. 19(9):898-905. [Medline].

  52. Leucht S, McGrath J, White P, Kissling W. Carbamazepine for schizophrenia and schizoaffective psychoses. Cochrane Database Syst Rev. 2002. CD001258. [Medline].

  53. Potkin SG, Saha AR, Kujawa MJ, Carson WH, Ali M, Stock E, et al. Aripiprazole, an antipsychotic with a novel mechanism of action, and risperidone vs placebo in patients with schizophrenia and schizoaffective disorder. Arch Gen Psychiatry. 2003 Jul. 60(7):681-90. [Medline].

  54. Raja M, Azzoni A. Oxcarbazepine vs. valproate in the treatment of mood and schizoaffective disorders. Int J Neuropsychopharmacol. 2003 Dec. 6(4):409-14. [Medline].

  55. Swainston Harrison T, Perry CM. Aripiprazole: a review of its use in schizophrenia and schizoaffective disorder. Drugs. 2004. 64(15):1715-36. [Medline].

  56. Tran PV, Tollefson GD, Sanger TM, Lu Y, Berg PH, Beasley CM Jr. Olanzapine versus haloperidol in the treatment of schizoaffective disorder. Acute and long-term therapy. Br J Psychiatry. 1999 Jan. 174:15-22. [Medline].

  57. Vieta E, Goikolea JM, Corbella B, Benabarre A, Reinares M, Martínez G, et al. Risperidone safety and efficacy in the treatment of bipolar and schizoaffective disorders: results from a 6-month, multicenter, open study. J Clin Psychiatry. 2001 Oct. 62(10):818-25. [Medline].

  58. Volavka J, Czobor P, Sheitman B, Lindenmayer JP, Citrome L, McEvoy JP, et al. Clozapine, olanzapine, risperidone, and haloperidol in the treatment of patients with chronic schizophrenia and schizoaffective disorder. Am J Psychiatry. 2002 Feb. 159(2):255-62. [Medline].

  59. Gaebel W, Schreiner A, Bergmans P, et al. Relapse prevention in schizophrenia and schizoaffective disorder with risperidone long-acting injectable vs quetiapine: results of a long-term, open-label, randomized clinical trial. Neuropsychopharmacology. 2010 Nov. 35(12):2367-77. [Medline]. [Full Text].

  60. Grootens KP, van Veelen NM, Peuskens J, et a;. Ziprasidone vs olanzapine in recent-onset schizophrenia and schizoaffective disorder: results of an 8-week double-blind randomized controlled trial. Schizophr Bull. 2011 Mar. 37(2):352-61. [Medline]. [Full Text].

  61. Stip E, Tourjman V. Aripiprazole in schizophrenia and schizoaffective disorder: A review. Clin Ther. 2010. 32 Suppl 1:S3-20. [Medline].

  62. Citrome L, Reist C, Palmer L, Montejano LB, Lenhart G, Cuffel B, et al. Impact of real-world ziprasidone dosing on treatment discontinuation rates in patients with schizophrenia or bipolar disorder. Schizophr Res. 2009 Dec. 115(2-3):115-20. [Medline].

  63. Reid WH, Mason M, Hogan T. Suicide prevention effects associated with clozapine therapy in schizophrenia and schizoaffective disorder. Psychiatr Serv. 1998 Aug. 49(8):1029-33. [Medline].

  64. Gahr M, Kölle MA, Schönfeldt-Lecuona C, Lepping P, Freudenmann RW. Paliperidone extended-release: does it have a place in antipsychotic therapy?. Drug Des Devel Ther. 2011 Mar 11. 5:125-46. [Medline]. [Full Text].

  65. Canuso CM, Battisti WP. Paliperidone extended-release: a review of efficacy and tolerability in schizophrenia, schizoaffective disorder and bipolar mania. Expert Opin Pharmacother. 2010 Oct. 11(15):2557-67. [Medline].

  66. Canuso CM, Schooler N, Carothers J, et al. Paliperidone extended-release in schizoaffective disorder: a randomized, controlled study comparing a flexible dose with placebo in patients treated with and without antidepressants and/or mood stabilizers. J Clin Psychopharmacol. 2010 Oct. 30(5):487-95. [Medline].

  67. Canuso CM, Lindenmayer JP, Kosik-Gonzalez C, Turkoz I, Carothers J, Bossie CA, et al. A randomized, double-blind, placebo-controlled study of 2 dose ranges of paliperidone extended-release in the treatment of subjects with schizoaffective disorder. J Clin Psychiatry. 2010 May. 71(5):587-98. [Medline].

  68. Schoemaker J, Naber D, Vrijland P, Panagides J, Emsley R. Long-term assessment of Asenapine vs. Olanzapine in patients with schizophrenia or schizoaffective disorder. Pharmacopsychiatry. 2010 Jun. 43(4):138-46. [Medline].

  69. Honer WG, Macewan GW, Gendron A, et al. A randomized, double-blind, placebo-controlled study of the safety and tolerability of high-dose quetiapine in patients with persistent symptoms of schizophrenia or schizoaffective disorder. J Clin Psychiatry. 2012 Jan. 73(1):13-20. [Medline].

  70. Goff DC, McEvoy JP, Citrome L, Mech AW, Bustillo JR, Gil R, et al. High-Dose Oral Ziprasidone Versus Conventional Dosing in Schizophrenia Patients With Residual Symptoms: The ZEBRAS Study. J Clin Psychopharmacol. 2013 Aug. 33(4):485-490. [Medline].

  71. Fitzgerald P, de Castella A, Arya D, Simons WR, Eggleston A, Meere S, et al. The cost of relapse in schizophrenia and schizoaffective disorder. Australas Psychiatry. 2009 Aug. 17(4):265-72. [Medline].

  72. Pharoah FM, Mari JJ, Streiner D. Family intervention for schizophrenia. Cochrane Database Syst rev. 2003. 4:CD000088.

 
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