Primary prevention

The period of time leading up to the first episode of psychosis in schizoaffective disorder has not been well studied. However, pre-schizophrenia is characterised by non-specific symptoms described as schizotaxia, the pre-prodromal period, and the prodrome.[18][19] These changes in thoughts, mood, and behaviour prior to the start of psychotic symptoms constitute an ‘at-risk mental state’. People with an at-risk mental state are at much higher risk of developing psychosis than the general population with up to one third going on to develop psychosis.[20]

Research has shown that it may be possible to identify people with an at-risk mental state:[20]

  • They may present with distress and/or a decline in their social functioning in conjunction with transient or attenuated psychotic symptoms

  • They should be referred to an early intervention in psychosis service for assessment

  • Treatment with cognitive behavioural therapy can reduce the risk of transition to psychosis, but treatment with antipsychotic medication is not effective.

Data on schizophrenia and early-phase psychosis indicate that early detection and intervention is beneficial for most patients.[21][22][23][24][25][26]

Secondary prevention

In general there are insufficient data about preventive measures for schizoaffective disorder. However, including trusted family or friends who can alert the patient and clinician to warning signs of relapse can be helpful. The patient should work with their doctor to identify individual patterns of relapse and recurrence. Encourage patients to speak openly about their experience of their illness, feelings of stigma, and any adverse effects of medications that may threaten adherence and sustained mood stability.

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