This disorder emphasizes the temporal relationship of schizophrenic and mood symptoms and is used for conditions that meet the criteria for both schizophrenia and a mood disorder with psychotic symptoms lasting a minimum of 1 month. The clinical features must occur within a single uninterrupted period of illness (for some, this may be years or even decades) that is judged to last until the individual is completely recovered for a significant period of time, free of any significant symptoms of the disorder. In comparison with schizophrenia, schizoaffective disorder occurs more commonly in women than in men.
ETIOLOGICAL THEORIES
Psychodynamics
Refer to CPs: Schizophrenia, Major Depression, and Bipolar Disorder.
Biological
Refer to CPs: Schizophrenia, Major Depression, and Bipolar Disorder.
Recent studies suggest that schizoaffective disorder is a distinct syndrome resulting from a high genetic liability to both mood disorders and schizophrenia.
Family Dynamics
Refer to CPs: Schizophrenia, Major Depression, and Bipolar Disorder.
CLIENT ASSESSMENT DATA BASE
Neurosensory
Depressed mood (at least 2 wks); manic or mixed mood (at least 1 wk)
Pronounced manic and depressive features intermingled with schizophrenic features
Delusions and hallucinations for at least 2 wks (in absence of prominent mood symptoms)
Difficulty following a moving object with the eyes
Teaching/Learning
May report previous episode(s) and remission free of significant symptoms; usually begins in early adulthood (generally earlier than mood disorders)
Absence of substance use or general medical conditions that could account for symptoms
DIAGNOSTIC STUDIES
Refer to CPs: Schizophrenia, Major Depression, and Bipolar Disorder.
NURSING PRIORITIES
1. Provide protective environment; prevent injury.
2. Assist with self-care.
3. Promote interaction with others.
4. Identify resources available for assistance.
5. Support family involvement in therapy.
DISCHARGE GOALS
1. Signs of physical agitation are abating and no physical injury occurs.
2. Improved sense of self-esteem, lessened depression, and elevated mood are noted.
3. Approaches and socializes appropriately with others, individually and in group activities.
4. Adequate nutritional intake is achieved/maintained.
5. Client/family displays effective coping skills and appropriate use of resources.
6. Plan in place to meet needs after discharge.
(Refer to CPs: Schizophrenia, Major Depression, and Bipolar Disorder for other NDs that apply, in addition to the following.)
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