Schizoaffective is a mental health disorder which is characterized as the combination of Schizophrenia (including delusions and hallucinations) and mood disorder symptoms such as depression and mania episodes. There are two types of schizoaffective disorder that are bipolar type (including episodes of mania and sometimes major depressive episode) and depressive type ( only major depressive episode). The course of symptoms of schizoaffective disorder may vary from person to person. They experience psychotic symptom as well as symptoms of either bipolar type or depressive type. Sign and symptoms of Schizophrenia include delusions, hallucinations, impaired communication and speech, bizarre and unusual behavior, symptoms of depression, period of manic mood with an increase in energy and decrease need for sleep over a period of several days, behavior that are out of character, impaired occupational, academic and social functioning, problems with managing personal care including cleanliness and physical appearance. Risk factors in developing schizoaffective disorder include genetic factors (where close blood relative such as parent or sibling having schizoaffective disorder or bipolar disorder) stressful events trigger symptoms or mind-altering drugs.
Seasonal pattern was found in the case of mood disorder, where seasonal changes bring variation in the severity level of mood episodes. Mixed results are found in the literature regarding seasonality in Schizophrenia. Since the end of 18th century, seasonal pattern in the level of severity as well as in the course of hospitalization of patients affecting from Schizophrenia have been observed (Pinel, 1806; Esquirol, 1845). It was found that the number of cases of Schizophrenia registered at hospital are high in spring and summer (Tian, Lee, Liu, & Chen, 2006). Researches suggested that changes in photoperiod maybe the cause of triggering symptoms and lead to onset of Schizophrenia. But still controversy exists regarding seasonal effect of Schizophrenia. Researches indicate strong association between rate of hospitalizations and duration of photoperiod. While examining the effect of sunlight exposure, it is found that vitamin D and melatonin are main factors contributing inhibitory effects on each other (Bogers, Bostoen, & Broekman, 2016; Davies et al, 2003). Increase of melatonin causes increase in psychotic symptoms but, still it is not well-supported with researches. Vitamin D is suggested for patients with Schizophrenia in order to reduce the severity level of psychotic disorder (Sayer, Marshall, & Mellsop, 1991). Lower temperature and shorter photoperiod might be the cause of increase in the rate of hospitalizations (Wang et al, 2018). But research is still needed to identify the effect of seasonality on the etiology and course of Schizophrenia. Theories related to changes in light levels and day lengths have been given considerable importance. Patients with affective disorder have shown sensitivity to environmental changes. Such patients show response to bright light therapy. Research shows that melatonin is supposed to cause disturbance in circadian rhythm because it is the main regulator of intense biological rhythm (Hallam, Olver, & Norman, 2005).
It is advised to health care professionals and care takers working with Schizophrenia or schizoaffective patients to be more vigilant for symptoms around late winters and spring months. Clinicians should provide affective treatment plan to such patients addressing both social and biological rhythm regularity. It is also advised to give phototherapy to them if possible. Besides that, it is also suggested to give knowledge to caretakers regarding onset of symptoms in early spring and summer so that they can be able to treat such patients. Schizophrenia disorder is included in the list of those disorders about which researchers can't be certain of the actual cause behind the onset of its symptoms. But with the help of medication and psychotherapy, condition of such patients can be normalized.
References
Bogers, P.M., Bostoen, T., & Broekman, T.J.(2016) Low levels of vitamin D poorly responsive to daylight exposure in patients with therapy-resistant schizophrenia, Nordic Journal of Psychiatry, 70(4), 262-66. DOI: 10.3109/08039 488.2015.1086023
Davies, G., Davies, G., Ahmad, F., Chant, D., Welham, J. & McGrath, J. (2000). Seasonality of first admissions for schizophrenia in the Southern Hemisphere. Schizophr Res, 41(3), 457–462.
Esquirol, E. (1845). Mental maladies. A treatise on insanity. Philadelphia, PA: Lea and Blanchard.
Hallam, K. T., Olver, J. S., & Norman, T. R. (2005). Effect of Sodium Valproate on Nocturnal Melatonin Sensitivity to Light in HealthyVolunteers. Neuropsychopharmacology, 30(7), 1400–1404.
Pinel, P.(1806). A treatise on insanity: In which are contained the principles of a new and more practical nosology of maniacal disorders than has yet been offered to the public. New York, NY: Hafner.
Sayer, H.K., Marshall. S, & Mellsop, G.W. (1991). Mania and seasonality in the southern hemisphere. J Affect Disord, 23(3),151-6. doi: 10.1016/0165- 0327(91)90027-p. PMID: 1774430.
Tian, W.H., Lee, H.C., Liu, T.C., Chen, C.S. & Lin, H.C. (2006). Seasonal variation in schizophrenia admissions in a Chinese population. Schizophr Res, 86(1–3), 7333–334.
Wang, S., Zhang, X., Xie, M., Zhao, D., Zhang, H., & Zhang, Y. et al (2018). Effect of increasing temperature on daily hospital admissions for sc
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