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Outlook for schizoaffective disorder and schizophrenia

Outlook for schizoaffective disorder and schizophrenia
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How Schizoatwo facesffective Disorder compares to other disorders

There is little information about schizoaffective disorder in children, which usually starts around puberty.  As a parent, you know how seriously it affects your child, but how does it compare to depression and bipolar (manic and depressive states) and schizophrenia?  What is the course of schizoaffective disorder, and how can you help your child’s future?

Schizoaffective disorder is not as serious as schizophrenia,
but more serious than bipolar/depression.

Research conducted in Britain* studied young people who received typical treatment for schizoaffective disorder, schizophrenia, and bipolar/depression who were between the ages of 17 and 30 (average age was 22).  Over a 10 year period, those with schizoaffective disorder improved slightly, better than those with schizophrenia.

Outlook for schizoaffective disorderBehavioral functioning over time for schizoaffective disorder, schizophrenia and affective disorders (depression, bipolar) at four consecutive follow-ups.  (This scale goes from 2 (good) to 6 (poor). A “1” would be the level of a person with no symptoms and who is considered normal.)
*M. Harrow, L. Grossman, Herbener, E. Davies; The British Journal of PsychiatryNov 2000, 177 (5) 421-426

Behavioral functioning is measured by how well a person does in five areas:Russian brain diagram

  1. Work and social functioning
  2. Adjustment to typical life situations
  3. Capacity for self-care
  4. Appearance of major symptoms
  5. Number of relapses and rehospitalizations.

Your child will struggle with these, but there’s good news according to a recent landmark study:
Family support improves a patient’s outcome.

A new treatment program was developed that altered some well-established practices.  A set of schizophrenia patients received the following support and were later compared with those who had the usual medication approach.

  1. Dosages of antipsychotic medication were kept as low as possible
  2. Help with work or school such as assistance in deciding which classes or opportunities are most appropriate, given a person’s symptoms;
  3. Education for family members to increase their understanding of the disorder;
    (“Efforts to engage and collaborate with family members are often successful during an acute psychotic episode, whether it is the first episode or a relapse, and are strongly recommended.”
    Family Involvement Strongly Recommended by the American Psychiatric Association)
  4. One-on-one talk therapy in which the person with the diagnosis learns tools to build social relationships, reduce substance use and help manage the symptoms.”

Patients who went through this for of treatment made greater strides in recovery over the first two years of treatment than patients who got the usual drug-focused care.  More here.
New Approach Advised to Treat Schizophrenia, Benedict Carey, New York Times, Oct. 20, 2015

“..if you look at the people who did the best—those we caught earliest after their first break with reality—their improvement by the end was easily noticeable by friends and family.”

beautifulbrainThe longer psychotic symptoms stay in an extreme phase,” in which patients become afraid and deeply suspicious,” the more likely the person will be vulnerable to recurring psychosis, and the more difficulty they will have coming out of it and adjusting to normal life.

How to help your child

Be very realistic about what your child can handle in school.  They may be extremely intelligent–but maybe can’t handle too much homework; or class disruptions; or lack of empathy from the teacher.  A parent or school counselor should help your child find low-stress classes or activities, and consider limiting the number of classes per day.  They can only hold it together for so long!  I found it helped my schizoaffective child to take later classes, starting at 10 or 11 am.

Get the whole family on board to make his or her life easier.  Your child might be stressful and a source of irritation for everyone, but family members can help reduce this by taking on the chores your troubled child would ordinarily do; avoid pressuring them about something, or anything; and allow your child to say oddball things without confronting them about how irrational they are or arguing with them.

DIY talk therapy – Here are some ways to guide your child out of their troubled states.

Anxiety

  •  psychosisSchizoaffective kids may express anxiety in a tangled web of seemingly unrelated things, and spike them with paranoia about what they mean. Listen carefully, and conduct a gentle interview to explore what truly is bothering them.  It may be as simple as the room being too cold.
  • Give them plenty of time (if you can). A venting session is sometimes all they need.
  • Diplomatically redirect a negative monologue with a comment about something pleasant. This is where it’s useful to hand them a cat or call over a dog, offer tea or juice, or briefly check email.  The point is to break the spell.

Run-on obsessive thoughts

  • Voicehelping hands and thoughts can be angry, mean, and relentless. Your child may not tell you this is happening, or may simply assume you already know what’s in their head.  Ask him or her if thoughts or voices are pestering them.  If so, show indignation at how wrong it is for them to mistreat your child, “that’s not right that this is happening to you; this is so unfair to you; you deserve better; I want to help if I can…”
  • Encourage your child to ignore the voices/thoughts and they may go away, or encourage them to tell the voices/thoughts to leave them alone. “I refuse to listen to you anymore!  Quit pestering me!  Obsessive thoughts and voices are just bullies.

Help your child stand up to thought/voice bullies the same as
as you would help any child dealing with a bully.  This works.

Take care and have hope.  You can do this.

Margaret

 

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