Schizoaffective Disorder Workup

  • Author: Guy E Brannon, MD; Chief Editor: David Bienenfeld, MD   more...
 
Updated: Feb 16, 2012
 

Other Tests

If the patient’s neurologic findings are abnormal, performing CT or MRI to rule out any suspected intracranial pathology may be appropriate.

Perform psychological testing to assist with diagnosis (eg, Structured Clinical Interview for Axis I DSM-IV Disorders [SCID-1]).

Perform EEG if indications are present.[33]

Histologic findings include decreased amounts of cortical gray matter and increased fluid-filled spaces.

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Approach Considerations

Workup may include selected laboratory tests, psychological testing, diagnostic imaging (eg, computed tomography [CT] or magnetic resonance imaging [MRI]), or electroencephalography (EEG).

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Laboratory Studies

Laboratory studies that may be performed include the following:

  • Sequential multiple analysis
  • Complete blood count (CBC)
  • Rapid plasma reagent
  • Test of thyroid-stimulating hormone (TSH) or thyroid function tests
  • Urine drug screen
  • Urine pregnancy test
  • Urinalysis
  • Lipid panel[32]
  • HIV test
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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 Grant/research funds Other; Janssen Grant/research funds Other; Pfizer Honoraria Speaking and teaching; Sunovion Honoraria Speaking and teaching; Eli Lilly Grant/research funds Other; Forrest Grant/research funds Other

Chief Editor

David Bienenfeld, MD  Professor of Psychiatry, Vice-Chair and Director of Residency Training, Department of Psychiatry, Wright State University, Boonshoft 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.

Additional Contributors

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. Kan JM. Performance improvement CME: Schizoaffective disorder. J Clin Psychitry. Jul 2011;72(7):e23.

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

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

  4. 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.

  5. 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. Jan 2011;35 Suppl 1:249-52. [Medline].

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

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

  8. 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. Jan 2007;64(1):19-28. [Medline].

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

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

  11. 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. Nov 2000;177:421-6. [Medline].

  12. 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. Jul 2004;185:18-24. [Medline].

  13. 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. Jun 1 2002;55(3):229-37. [Medline].

  14. 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. Sep 2006;86(1-3):208-14. [Medline].

  15. 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. Oct 2001;158(10):1652-8. [Medline].

  16. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Text Revision. Washington, DC: American Psychiatric Association; 2000:319-23.

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

  18. 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].

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

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

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

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

  23. 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].

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

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

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

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

  28. 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. Aug 2004;6(4):314-8. [Medline].

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

  30. 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. Sep-Oct 2010;51(5):504-9. [Medline].

  31. 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. Jun 2010;38(4):384-93. [Medline]. [Full Text].

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

  33. 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. Dec 2003;160(12):2238-40. [Medline].

  34. 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].

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

  36. 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. Jul 2009;70(7):990-6. [Medline].

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

  38. 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].

  39. 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. Dec 2004;65(12):1624-33. [Medline].

  40. 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. Apr 2004;79(1-3):43-50. [Medline].

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

  42. 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. Jul 2003;160(7):1348-50. [Medline].

  43. 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. Apr 2003;64(4):451-8. [Medline].

  44. 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. May 2000;61(5):329-34. [Medline].

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

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

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

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

  49. 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. Sep 2002;63(9):763-71. [Medline].

  50. 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. Sep 2004;19(9):898-905. [Medline].

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

  52. 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. Jul 2003;60(7):681-90. [Medline].

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

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

  55. 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. Jan 1999;174:15-22. [Medline].

  56. 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. Oct 2001;62(10):818-25. [Medline].

  57. 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. Feb 2002;159(2):255-62. [Medline].

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

  59. 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. Dec 2009;115(2-3):115-20. [Medline].

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

  61. 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. Aug 2009;17(4):265-72. [Medline].

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

  63. 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. Jan 2012;73(1):13-20. [Medline].

  64. 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. Nov 2010;35(12):2367-77. [Medline]. [Full Text].

  65. 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. Mar 2011;37(2):352-61. [Medline]. [Full Text].

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

  67. 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. Mar 11 2011;5:125-46. [Medline]. [Full Text].

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

  69. 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. Oct 2010;30(5):487-95. [Medline].

  70. 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. May 2010;71(5):587-98. [Medline].

  71. 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. Jun 2010;43(4):138-46. [Medline].

  72. Correll CU. Understanding schizoaffective disorder: from psychobiology to psychosocial functioning. J Clin Psychiatry. 2010;71 Suppl 2:8-13. [Medline].

 
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