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F25.0 Schizoaffective Disorder, Manic Type A disorder in which schizophrenic and manic symptoms are both prominent in the same episode of illness. The abnormality of mood usually takes the form of elation, accompanied by increased self-esteem and grandiose ideas, but sometimes excitement or irritability are more obvious and accompanied by aggressive behaviour and persecutory ideas. In both cases there is increased energy, overactivity, impaired concentration, and a loss of normal social inhibition. Delusions of reference, grandeur, or persecution may be present, but other more typically schizophrenic symptoms are required to establish the diagnosis. People may insist, for example, that their thoughts are being broadcast or interfered with, or that alien forces are trying to control them, or they may report hearing voices of varied kinds or express bizarre delusional ideas that are not merely grandiose or persecutory. Careful questioning is often required to establish that an individual really is experiencing these morbid phenomena, and not merely joking or talking in metaphors. Schizoaffective disorders, manic type, are usually florid psychoses with an acute onset; although behaviour is often grossly disturbed, full recovery generally occurs within a few weeks. Diagnostic Guidelines There must be a prominent elevation of mood, or a less obvious elevation
of mood combined with increased irritability or excitement. Within the same episode, at least one and preferably two typically schizophrenic symptoms (as specified for schizophrenia [F20], diagnostic guidelines (a) -
(d)) should be clearly present. This category should be used both for a single schizoaffective episode of the manic type and for a recurrent disorder in which the majority of episodes are schizoaffective, manic type.
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