Talk:Schizoaffective disorder

Schizoaffective.org

Comment on the link just removed:

• http://www.schizoaffective.org/ Schizoaffective.org - A support group

It seems interesting enough to include. That it is anti-psychiatry doesn't deem it uninteresting, no? Preferable would be to write next to the link: "This page is anti-psychiatry", as they boost this themselves. So can we give people the possibility of making their own opinion instead of censoring for them.

I will reinsert the link as soon as the page starts working, if no one objects.

I think that it is good to hear both sides to this. There are pros and cons to medicating a person with schizoaffective disorder.

--Fred-Chess 05:56, 26 May 2005 (UTC)

I am concerned that this link, with a generic name like schizoaffective.org, might be considered an authority on the disease. This site is strongly and pervasively preaching a message of "don't see your doctor" and even "don't take your meds." This is a very dangerous message for most people suffering from a psychotic disorder since it is the continued use of their medication that allows them to make intelligent decisions. I think if you want to include this strongly POV link in an otherwise NPOV article, you need more than a few words of disclaimer. But I would welcome other opinions. Shoaler 08:39, 26 May 2005 (UTC)

Shoaler, I hope you're not seriously suggesting that the non-medicated mentally ill can't make intelligent decisions. Francesca Allan of MindFreedomBC 04:20, 1 December 2005 (UTC)

Certainly not as a generalization. But some forms and degrees of mental illness can seriously impair a person's ability to accurately evaluate their environment. They read malice where none exists and evaluate average daily situations as threatening. It is very difficult, if not impossible, for persons such as this to make a knowledgeable decision. For many of these people, a specific medication or group of medications can help them be nearly asymptomatic. In such a situation, they are much more capable of evaluating their world accurately and making a knowledgeable decision -- BUT in the absence of symptoms, and if the medication has unpleasant side effects, it is easy to believe that you are no longer sick and to discontinue the medication. Especially when persuasive people tell you that you don't need your doctor or your medication. For people who have worked hard to find the right medication and for whom medication has allowed them the first real chance at living a semi-normal life, telling them not to take their meds or not to work with their doctor, I believe is cruel and abusive. –Shoaler (talk) 19:22, 1 December 2005 (UTC)

Cannabis

Should this growing section be moved to the talk page until a consensus is reached? It appears that there is currently only a single contributer (User:71.241.143.23) who is advocating for cannabis use for this illness, while both Shoaler & I have tried a couple of different tact's so far regarding it's inclusion. The current state of this section of the article seems to be verging on original research, and has the potential to flare-up up into an all out edit war. As a matter of fairness I have invited User:71.241.143.23 on his talk page to weigh in on this. -- 63.226.38.196 14:24, 14 March 2006 (UTC)

I have seen claims on the internet of the efficacy of cannabis in treating schizoaffective disorder. I have seen far more discussions of the problems of trying to sort out the symptoms of a patient with both schizoaffective disorder and cannabis abuse. I think that the use of cannabis in treating SA is currently just a footnote and deserves no greater treatment in the article. –Shoaler (talk) 15:01, 14 March 2006 (UTC)

I am new to wikipedia but quite familair with this disorder from all sides. As this article is to be a NPOV article, any unproven or controversial studies can be cited but should not take up 30-percent of the article (i.e. Cannabis). I agree with Shoaler that if Cannabis is to be included it should be nothing more than a footnote or link to another source. Having it in the article is irresponsible. Both students (young and old) and individuals (caregivers or people with the disorder) will rely on the information in this article. You accept a HUGE responsiblility when editing these articles since your insert of POV or unproven information can have a far-reaching, negative impact on many lives. 24.95.36.22 16:39, 1 April 2006 (UTC)DJG

I have reduced this section to a level more appropriate to the degree to which cannabis plays in treating SA. Much of the details of how cannabis is purported to work should be covered in the article on medicinal cannabis since SA is one of many disorders for which a claim of cannabis efficacy is made. I have also added citations to support the paragraph. –Shoaler (talk) 19:03, 2 April 2006 (UTC)

I actually have schizo-affective disorder and although I am pro-marijuana, it does makes my psychotic features worse.Species2112 04:05, 14 October 2007 (UTC)

I agree with what you did. Thanks for fixing this. -- Argon233 ^T _@ ^C _¶ ^U _∠  23:33, 5 April 2006 (UTC)

I condensed the cannabis section for more encyclopedic wording, npov, the removal of uncited speculation, and consistency with cited sources. I've tried my best to report in a neutral manner what has been proven, what is speculative, and clear distinctions between the two. I think I've been even-handed. 21:06, 15 October 2007 (UTC) —Preceding unsigned comment added by Addisonstrack (talk • contribs)

I think it should be worth noting that specific Subspecies of Cannabis can be used to treat the symptoms of SchizoAffective Disorder, while other strains may aggravate the Psychotic symptoms. It is worth including that there are many claims that Cannabis can be a effective treatment in regulating the mood component of this disorder, especially with users who tend to lean on the BiPolar side. —Preceding unsigned comment added by 70.79.117.231 (talk) 21:59, 22 July 2009 (UTC)

Your claims, user 70.79.117.231, are not supported by current scientific evidence. Cannabis and psychotic disorders do not go together well, as current converging trends of psychiatric research show.76.169.29.127 (talk) 07:29, 25 July 2009 (UTC)

Yes, there is current scientific evidence that suggests Cannabinoids play a role as an effective treatment towards psychotic disorders. Including Schizophrenia specifically a 2007 German study reported improved cognition in patients who used Cannabis, and a 2008 Australian study found that patients diagnosed with schizophrenia report experiencing subjective relief from pot.

Future psychiatric research will prove my claims, as more research is conducted in regards to specific Cannabinoids which can be used as an effective treatment for Psychotic Disorders, including SchizoAffective. —Preceding unsigned comment added by 96.49.25.77 (talk) 21:44, 1 September 2009 (UTC)

Signs and Symptoms

I removed the warning message that 70.49.59.224 added to this section because, basically, I couldn't understand the point that s/he was making, and the reference din't help. Schizoaffective disorder is a diagnosis made by a mental health professional, frequently a physician (psychiatrist). The DSM is just a collection of diagnoses with numbers so the professional can communicate the diagnosis to other professionals (and to insurance companies). The DSM does not diagnose anything itself. –Shoaler (talk) 13:02, 23 October 2006 (UTC)

Clarification

From the article's intro:

Bipolar schizoaffective disorder is more similar to bipolar disorder than schizophrenia.

Does that mean BSD is more similar to bipolar disorder than to schizophrenia, or does it mean BSD ismore similar to biploar disorder than schizophrenia is? AxelBoldt 18:46, 29 January 2007 (UTC)

because it appears in DSM and ICD it must be true?

I have an issue about such an extensive article on this topic. It is simply one diagnostic category of DSM and ICD and probably only deserves a small mention and then a significant section left to the broader concept of Schizotypy. Only the distinct aspects of schizoaffective disorder need to be addressed here.

the continued listing of these (DSM and ICD) categories of mental illness, without balance is not a WP:NPOV - as it unintentionally supports the concept of diagnosis and categories without question - or at least without more balanced acknowledgement that these are a particular world view. Wikipedia should not be a repeat of DSM. I see similar issues with Schizophreniform disorder and schizoaffective disorder - ie they seem like a direct copy of the concept, without alerting the reading to the possible bias.

I will begin to edit as per these comments

the section on diagnosis is misleading. Schizoaffective disorder is a diagnosis. Earlypsychosis (talk) 09:36, 23 February 2009 (UTC)

Look at Schizophrenia#Controversies_and_research_directions for some criticism of Schizoaffective disorder (poor interrater agreement) etc. Follow the sources there. As far language goes, use the wording in the introduction to Schizophrenia; it's been heavily debated over time, and is probably the best the wiki can muster. Sorry I don't have the time to help here for now. Xasodfuih (talk) 10:34, 23 February 2009 (UTC)

or maybe all articles on mental health diagnosis need a WP:Undue if they fail to acknowledge that the concept is based on DSM and that other view points exist Earlypsychosis (talk) 08:56, 25 February 2009 (UTC)

This is perhaps overambitious but it might be a good idea to have a "psychiatric diagnoses" article which would include the various controversies, categories, theories, and so on. Then specific articles would both have a place to link and the beginnings of standards for categorizing diagnoses in individual articles. OldMonkeyPuzzle (talk) 16:36, 10 April 2010 (UTC)

edit of first line illness

first line now reads more accurately that schizopaffective disorder is a diagnosis. the reference to neurobiological illness was removed for several reasons - firstly the reference to illness is not strictly WP:NPOV and secondly the link redirects to mental disorder, a subtle, yet important distinction. Earlypsychosis (talk) 00:42, 28 February 2009 (UTC)

schizoaffective disorder and school

how do i state to my college the problems this illness is having on me? I have gone from the Dean list to appealing for lack of achievement for taking to many electives. I have been having problems and have had to have medicines changed which will mostly take up another semester. I am getting credits for these classes. and have aready brought supplies for these classes. I don't want to stop going to classes but I am in no shape to take harder classes at this time. Help I have to write an appeal. What can I say with out blowing my chance to remain in school?? —Preceding unsigned comment added by 68.0.108.207 (talk) 18:10, 2 January 2010 (UTC)

(I know this is not appropriate for this talk page, but before it is erased, let me say:) Talk to your doctor! The one who prescribes the meds. He/she can help you write an appropriate justification, etc. –Shoaler (talk) 23:48, 2 January 2010 (UTC)

Copyright problems with diagnostic criteria

The American Psychiatric Association has not released its Diagnostic and Statistical Manual of Mental Disorders into public domain, but claims copyright. The Wikimedia Foundation has received a letter of complaint (Ticket:2010030910040817, for those with access) about the use of their diagnostic criteria in this and a number of other articles. Currently, this content is blanked pending investigation, which will last approximately one week. Please feel free to provide input at the copyright problems board listing during that time. Individuals with access to the books would be particularly welcome in helping to conduct the investigation. Assistance developing a plan to prevent misuse of the APA's material on Wikipedia projects would also be welcome. Thank you. Moonriddengirl ^(talk) 14:00, 11 March 2010 (UTC)

Interestingly, the BehaveNet website reprints DSM-IV and DSM-IV-TR diagnostic criteria with permission (and has had this information available since at least 2003). Zach99998 (talk) 08:14, 5 June 2010 (UTC)

I also now realize you're aware of this :) Zach99998 (talk) 10:34, 5 June 2010 (UTC)

Changed section called "Introduction" to "General Features

The second section was called "Introduction" which was causing confusion, so I changed it to "General Features." I have no attachment to the title "General Features" if anyone can think of something better. OldMonkeyPuzzle (talk) 16:40, 10 April 2010 (UTC)

Coatracks, Forks, and Personal Investment

This article has about 3,000 words more than the article on schizotypal disorder, but about 3000 less than the article on schizoid disorder. The schizotypal article seems to focus on diagnostic criteria and the like, while the schizoid article seems to focus on history. Both define the diagnoses simply as disorders rather than diagnoses describing disorders.

The schizoaffective article has an odd tone. There seems to be a great deal of personal investment by the main author. It seems to consist mostly of various ideas and approaches to who is schizoaffective and ideas about treatment. This is necessarily pretty fuzzy.

There is no real model as far as I can see. But this needs some work to be coherent, factual, and inclusive. OldMonkeyPuzzle (talk) 17:32, 10 April 2010 (UTC)

I just made a couple of edits to the intro: I removed a "not to be confused with schizophrenia" warning, a line that began "Schizoaffective disorder is often misunderstood by the general public ...," an obsolete warning box about the intro being too long; and a typo.OldMonkeyPuzzle (talk) 17:53, 10 April 2010 (UTC)

OT

Unable to figure out the references for this text therefore removed.

===Occupational therapy===

The role of occupational therapy in treating a mental health condition like schizoaffective disorder is primarily focused on support, education, advocacy, evaluation through assessment and skills training in a variety of settings. Occupational therapy intervention may take place in rehabilitation programs in in-patient, out-patient, community mental health settings, as well as in group therapy sessions and family meetings. One of the main goals of occupational therapy is to create intervention plans, and provide rehabilitative services that meet the needs of each individual client. As a result, occupational therapists may be involved in many different therapeutic interventions depending on the unique needs of their client. Occupational therapists may be involved in more than one therapeutic process with each client at a given time. For example, an occupational therapist may educate a client’s family about schizoaffective disorder in addition to running a skills based therapy session involving the client. One of the main areas of involvement for occupational therapists working with clients with schizoaffective disorder is improving social functioning. In a 2008 study, Grimm et al. suggest that in order "to improve the occupational or social functioning of individuals with schizophrenic disorders, it is important to [first] assess their specific strengths and problem areas and the overall effect of these on [their daily activities]". (26) Impairments in cognitive and social functioning have a significant affect on a person’s daily activities across many areas. Executive function skills such as planning, attention, reasoning, problem solving, learning and memory yield the strongest relationship with functional performance (27). These same skills are required in social functioning because effective social relationships require appropriate perception and cognitive skills (28). Because areas of cognitive and social functioning are most impacted, the aim of occupational therapy in the treatment of schizoaffective disorder is to "[improve cognitive] and social deficits as well as motor, process, communication and social interaction skills" (28). Therapy may take place in an individual or group context and may include a variety of methods and programs: social skills training, cognitive behavioral therapy, cognitive remediation therapy, assertive community training, life skills training, supported employment, group therapy, and psychoeducation are some examples. A further description of each therapy type can be found at http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=nicecg82&part=ch8#ch8.s125. Group therapy sessions are often lead by occupational therapists and provide opportunities for observational learning and create an environment where clients can practice the skills being learned. "Groups can also provide opportunities to bolster social support" (27). Through group therapy sessions, individuals can also make contact with other individuals with schizoaffective disorder, which can be very therapeutic. Social skills training targets social and living skills and can affect a number of dimensions important to recovery in persons with schizoaffective disorder. Techniques used in social skills training programs by occupational therapists include: behavioral demonstrations, role-playing, coaching, modeling, shaping and generalization training. (27). Cognitive behavioral therapy is an "insight focused therapy that emphasizes recognizing and changing negative thoughts and maladaptive beliefs" (29). Cognitive behavioral therapy has been effective at reducing the severity of positive and negative symptoms in persons with schizophrenic disorders thereby improving community functioning and quality of life (27). Cognitive remediation therapy aims to improve the cognitive functions and executive thinking skills in persons with schizoaffective disorder. Improvements in thinking skills such as planning, attention and reasoning lead to improvements in an individual’s occupational and social functioning. "Life skills training, such as money management, meal preparation and transportation can produce positive results when done in the natural environment where activities occur" (28). In addition to leading different skills based groups, occupational therapists play an important role in providing support for clients with mental illnesses such as schizoaffective disorder. They directly support their client by providing them with education regarding their illness, including common signs and symptoms that are to be expected. Occupational therapists also provide support through advocating on their client’s behalf, searching out possible privileges, and/or entitlements that may be available to individuals with mental illness. These privileges are often obtained in the context of work, school, or employment agencies. Occupational therapists are a fundamental part of the involvement and education of clients’ families in the therapy process. "When families become involved in treatment, relapse, noncompliance, and re-hospitalization rates significantly go down". (28) Education of family members occurs through family meetings, occupational therapists can be the contact person for the family to ask questions and express their concerns. Occupational therapists may also provide families with education on crisis intervention, problem solving training and other tools that will help them support their family members in recovering from schizoaffective disorder. Additionally, occupational therapists use various assessment tools to evaluate a client’s strengths, weaknesses, improvement, and whether occupational therapy would be helpful to the client. Creek & Lougher (2008), describe assessments used by occupational therapists in three categories, including, initial assessments, ongoing assessments, and later assessments. Each category serves a specific purpose in the therapeutic process. For example, initial assessments are used to evaluate the client’s strengths, problem areas, and whether occupational therapy is appropriate (30). Ongoing assessments display change, and whether outcomes have been reached (30). Furthermore, later assessments display ongoing problems, and help to determine whether changes in the intervention are necessary (30). Throughout the evaluation process occupational therapists use many different specific assessments. A list of specific assessments can be found at http://www.qotfc.edu.au/mental-health/documents/links/ot_resources_townsville_mhs.pdf. Occupational therapists help people living with Schizo-affective Disorder by supporting, educating, advocating for them and by providing evaluation through assessments and skills training in a variety of settings. Through these methods occupational therapy improves the clients functioning based on what the individual is having troubles with as well as helps the individual improve in areas that they deem as meaningful to them.

Doc James (talk · contribs · email) 02:01, 28 May 2010 (UTC)

Claims about the causes of the disorder

The article says: "Genetics, early environment, neurobiology, psychological and social processes are important contributory factors." As a professional I have yet to come over sound research showing clear causal relations between any of these factors (especially genetics and neurobiology) and the diagnosis. If you do, please make sure to give references. Otherwise, I suggest a reformulation of "are important contributory factors" to "may be contributory factors". —Preceding unsigned comment added by 91.186.74.5 (talk) 09:30, 28 July 2010 (UTC)

I was about to make the same comment. Declaring in an off-hand way that genetics is one of the causes is a very subtle but ultimately mendacious way to introduce causation without scientific validation.Historian932 (talk) 20:21, 25 March 2011 (UTC)

These are potential causes and should be read as such.--Doc James (talk · contribs · email) 20:23, 25 March 2011 (UTC)

Schizoaffective disorder

Some peolpe think that Schizoaffective disorder is from family members and that if you have it you have to be on meds to "controll" it. But what the doctors don't know anything they beileive that every case is the same and its not take me for exsample i've had Schizoaffective disorder for as long as i can remember, and i'm only 18. i refuse to take my meds because all it dose is make me unable to think strate or walk right. the pills themselfs are worst then delling with my disorter. i say to the docs. if you dont have or if you do try those pills for two weeks and see how they affect you and i bet you'll take them off the shelfs and stop trying to fix us. theres nothing wrong!!!!!!! — Preceding unsigned comment added by 129.71.148.90 (talk) 18:02, 2 June 2011 (UTC)

From section re: cannabis and epidemiology

I'll leave this here in case there's actuallly a decent source to back it up. News articles are not acceptable per WP:MEDRS.

Also, Sweden and Japan--where self-reported marijuana use is very low--have similar rates of psychosis to the U.S. and Canada.

Watermelon mang (talk) 05:26, 29 April 2012 (UTC)

pdd missing from dsm

I think this is note worthy. In the dsm schizophrenia lists pervasive development disorder as a preferable alternative diagnosis if there are symptoms of a pdd and unless delusions are bizzar. This isn't the case for schizoaffective disorder even though along with schizophrenia it's a common missduagnosis esp when comorbid adhd is taken into account. — Preceding unsigned comment added by 92.40.253.206 (talk) 12:49, 24 January 2013 (UTC)

Thank you for your comment! So in what way would you like to change the article? Lova Falk talk 14:13, 26 January 2013 (UTC)

Orphaned references in Schizoaffective disorder

I check pages listed in Category:Pages with incorrect ref formatting to try to fix reference errors. One of the things I do is look for content for orphaned references in wikilinked articles. I have found content for some of Schizoaffective disorder's orphans, the problem is that I found more than one version. I can't determine which (if any) is correct for this article, so I am asking for a sentient editor to look it over and copy the correct ref content into this article.

Reference named "Stahl":

• From Tiagabine: Stahl, S. Stahl's Essential Psychopharmacology: Prescriber's Guide. Cambridge University Press: New York, NY. 2009. pp. 523-526
• From Treatment of bipolar disorder: [[cite book|author= Stahl SM | title=Stahl's Essential Psychopharmacology: Neuroscientific basis and practical applications| publisher=Cambridge University Press | year=2008}}

I apologize if any of the above are effectively identical; I am just a simple computer program, so I can't determine whether minor differences are significant or not. AnomieBOT⚡ 02:54, 17 March 2013 (UTC)

 Fixed Lova Falk talk 14:30, 4 May 2013 (UTC)

Lead too long

The lead is the first part of the article most people read, and many only read the lead. Consideration should be given to creating interest in reading more of the article, but the lead should not "tease" the reader by hinting at content that follows. Instead, the lead should be written in a clear, accessible style with a neutral point of view; it should ideally contain no more than four paragraphs and be carefully sourced as appropriate.

The current article has seven paragraphs in the Lead. Checkingfax (talk) 03:23, 3 December 2013 (UTC)  Fixed

Spell check

I did a spell check of the easy words. Checkingfax (talk) 23:30, 12 December 2013 (UTC)

My 67 year old brother was diagnosed with Schizoaffective disorder at age 17

My 67 year old brother was diagnosed with Schizoaffective disorder at age 17. He is a ward of the State of California and has been living in group homes, however, now he is in a locked facility. He's absolutely miserable at the Green Acres Lodge. The person in charge has decided that my brother can't go on outings or to the program. My brother loves to be outside and is very depressed. His case manager will only listen to the person in charge at Green Acres Lodge. At this point, I feel I should take custody of my brother and help him find some personal happiness. The dilemma is I live in on the East Coast. Getting my brother from the West Coast to the East Coast won't be easy. Also, I am not sure how damaged he is given that he's been on psychiatric drugs for 50 years. I hate to take responsibility for his care and them regret it.

December 24, 2013