Ettina wrote:
The dividing line between schizoaffective and bipolar is said to be 'mood-incongruent' hallucinations/delusions.
Someone who's just bipolar, they may hallucinate/have delusions when they're in the middle of a severe mood episode, but the hallucinations/delusions match their mood. So if they're manic, they'll be grandiose or paranoid or both (paranoia often involves grandiosity - you'd have to be important for so many people to be out to get you, right?). If they're depressed, they'll have insulting voices or think they're dead or blame themselves to a delusional level ('I caused the Holocaust' sort of thing).
A schizoaffective person has clear manic/hypomanic and depressive episodes, but also has hallucinations/delusions that don't fit this pattern. Either they have some hallucinations/delusions when they aren't manic or depressed, or have hallucinations/delusions that don't match their mood (eg grandiose delusions when depressed). One guy I heard of had three distinct types of episodes - manic, depressed, and paranoid. The paranoid episodes were what got him the schizoaffective diagnosis.
Where I live you get one or the other diagnosis. You don't get both. Actually, the shrinks are just calling it a subtype of Schizophrenia, which I believe the DSM V was trying to do.
Bipolar can have hallucinations and delusions especially during a mania. The difference between the two diagnosis, is a bipolar who is not actively depressed or manic do not have the hallucinations/delusions. Schizoaffective people do. If you pull the antipsychotics, those problems start coming back.
So with Schizoaffective Disorder you get the mood swings which can go away, but the hallucinations/delusions still hang around even when the mood swings leave.
17 Feb 2014, 5:48 am
