Will My Schizoaffective Boyfriend Ever Get Well?

Reader’s Question

I am living with a man who has been diagnosed with Schizoaffective Disorder. I have known for awhile that he was being treated for depression but only recently learned that his actual full diagnosis is Schizoaffective Disorder. I had plans to marry this man. Should I rethink this issue? I’ve been reading about his condition and from what glean it appears he will never “get well.”

Our Clinical Psychologist’s Reply

The diagnosis of Schizoaffective Disorder is given when an individual has had a relatively uninterrupted significant period of illness in which they have not only had at least one manic, depressive, or mixed (features of both mania and depression) episode, but also displayed concurrent delusions or hallucinations that were present for at least 2 weeks when their mood disturbance symptoms were absent.

The criteria for making the diagnosis of Schizoaffective Disorder have changed over the past several years. In addition, the condition is fairly hard to distinguish from a mood disturbance that has some accompanying psychotic features. It’s easier to correctly diagnose a mood disorder when the psychotic features that might accompany it are congruent with the patient’s mood (e.g., a depressed person who hears voices telling them they are no good). But sometimes the psychotic symptoms that accompany a depressive or manic episode do not fit with the person’s mood. If psychotic features persist for at least two weeks even when the person is not in the throes of a mood disturbance or showing any signs of mood disturbance, the schizoaffective diagnosis applies.

The prognosis for individuals who have a mood disturbance that includes some psychotic features is better than for individuals who have Schizoaffective Disorder. Still, the prognosis for individuals with Schizoaffective Disorder is better than for those who have schizophrenia or who are in the early stages of that disease. Also, although the majority of schizophrenics face a lifetime of management of their symptoms as opposed to a “cure,” this is not always the case.

It would be important to get clarification of the complete diagnostic picture and to review all of the supporting history (e.g., family history, history of the patient’s overall ability to function and cope, etc.) and the treating physician’s impressions before coming to any conclusions about what the future might hold as far as the likely course of the illness is concerned.