Holistic Management of Depressive-Type Schizoaffective Disorder: A Case Illustration

Authors

  • Muh Azka Aldani Fadhlurahman Universitas Nahdlatul Ulama Surabaya image/svg+xml
  • Hafid Algristian Universitas Nahdlatul Ulama Surabaya image/svg+xml
  • Yekti Mumpuni Rumah Sakit Radjiman Wediodiningrat Lawang

DOI:

https://doi.org/10.61978/psychosocia.v4i2.1359

Keywords:

schizoaffective disorder, holistic management, pharmacotherapy, family support, spiritual coping

Abstract

Schizoaffective disorder is a complex psychiatric condition characterized by the coexistence of psychotic and mood symptoms, often requiring comprehensive and long-term management. Achieving sustained clinical stability in depressive-type schizoaffective disorder remains challenging, particularly when psychosocial stressors and limited support systems are present. This case illustration describes a holistic management approach integrating pharmacological treatment, structured family involvement, and patient-centered spiritual coping within an Indonesian cultural context. We present the case of a 44-year-old female diagnosed with depressive-type schizoaffective disorder based on the Indonesian Guidelines for the Classification and Diagnosis of Mental Disorders, corresponding to international diagnostic principles. Clinical data were obtained through psychiatric interviews, longitudinal clinical observation, and review of medical records. The intervention consisted of combined antipsychotic and antidepressant pharmacotherapy, accompanied by structured family support and ethically integrated spiritual coping strategies aligned with the patient’s preferences. Over the course of follow-up, the patient demonstrated a reduction in psychotic symptoms (notably ideas of reference) and depressive features, alongside improvements in sleep patterns, self-care, treatment adherence, and emotional regulation. Functional gains were observed in daily activities and engagement with meaningful roles, with no acute relapse reported during the observed follow-up period. Family involvement contributed to adherence monitoring and stress reduction, while spiritual coping functioned as an internal resource for meaning-making and resilience rather than as a standalone intervention. This case illustrates that a holistic management strategy addressing biological, psychosocial, and spiritual dimensions may support clinical stabilization and functional recovery in depressive-type schizoaffective disorder. While findings from a single case cannot be generalized, this report highlights the potential clinical value of integrating family support and patient-centered spirituality into routine psychiatric care within culturally relevant settings.

References

Addington, J., Heinssen, R. K., Robinson, D. G., Schooler, N. R., Marcy, P., Brunette, M. F., & Correll, C. U. (2015). Duration of Untreated Psychosis in Community Treatment Settings in the United States. Psychiatric Services, 66(7), 753–756. https://doi.org/10.1176/appi.ps.201400124 DOI: https://doi.org/10.1176/appi.ps.201400124

American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR (5th ed.). American Psychiatric Publishing. https://doi.org/10.1176/appi.books.9780890425787 DOI: https://doi.org/10.1176/appi.books.9780890425787

Barrio, C., Cacciottolo, F., & Alvares, J. (2023). Personality Disorders and the Psychotic Spectrum: A Review of Treatment Implications. Current Psychiatry Reports, 25(3), 167–178. https://doi.org/10.1007/s11920-023-01418-2

Bhugra, D., & Becker, M. A. (2005). Migration, Cultural Bereavement and Cultural Identity. World Psychiatry, 4(1), 18–24. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414713/

Bhugra, D., Watson, C., & Wijesuriya, R. (2021). Cultural Competence in Mental Health Care: A Review. European Psychiatry, 64(1), e54. https://doi.org/10.1192/j.eurpsy.2021.2217 DOI: https://doi.org/10.1192/j.eurpsy.2021.2217

Borsboom, D. (2017). A Network Theory of Mental Disorders. World Psychiatry, 16(1), 5–13. https://doi.org/10.1002/wps.20375 DOI: https://doi.org/10.1002/wps.20375

Citrome, L. (2014). Schizoaffective Disorder: Challenges in Diagnosis and Treatment. Current Medical Research and Opinion, 30(9), 1703–1715. https://doi.org/10.1185/03007995.2014.922091

Correll, C. U., Galling, B., Pawar, A., Krivko, A., Bonetto, C., Ruggeri, M., Craig, T. J. K., Nordentoft, M., Srihari, V. H., & Guloksuz, S. (2017). Comparison of Early Intervention Services vs Treatment as Usual for Early-Phase Psychosis. JAMA Psychiatry, 74(6), 555–565. https://doi.org/10.1001/jamapsychiatry.2018.0623 DOI: https://doi.org/10.1001/jamapsychiatry.2018.0623

Dixon, L. B., Goldman, H. H., Bennett, M. E., Wang, Y., McNamara, K. A., Mendon, S. J., & Essock, S. M. (2016). Implementing Coordinated Specialty Care for Early Psychosis: The RAISE Connection Program. Psychiatric Services, 66(7), 691–698. https://doi.org/10.1176/appi.ps.201400281 DOI: https://doi.org/10.1176/appi.ps.201400281

Drake, R. E., Whitley, R., & Deegan, P. E. (2010). Recovery and Severe Mental Illness. Psychiatric Clinics of North America, 33(3), 711–728. https://doi.org/10.1016/j.psc.2010.04.001 DOI: https://doi.org/10.1016/j.psc.2010.04.001

Jäger, M., Pfennig, A., Schmauss, M., Laux, G., Pfeiffer, H., & Naber, D. (2011). Functional Outcome in Patients with Schizoaffective Disorder. European Psychiatry, 26(5), 297–303. https://doi.org/10.1016/j.eurpsy.2010.07.010 DOI: https://doi.org/10.1016/j.eurpsy.2010.07.010

Kane, J. M., Correll, C. U., & Citrome, L. (2019). Treatment of Schizoaffective Disorder. Journal of Clinical Psychiatry, 80(3). https://doi.org/10.4088/JCP.18ac12573

Kirmayer, L. J., Narasiah, L., Munoz, M., Rashid, M., Ryder, A. G., Guzder, J., Hassan, G., Rousseau, C., & Pottie, K. (2014). Common Mental Health Problems in Immigrants and Refugees. CMAJ, 183(12), E959–E967. https://doi.org/10.1503/cmaj.090292 DOI: https://doi.org/10.1503/cmaj.090292

Koenig, H. G. (2012). Religion, Spirituality, and Health: The Research and Clinical Implications. ISRN Psychiatry, 2012, 278730. https://doi.org/10.5402/2012/278730 DOI: https://doi.org/10.5402/2012/278730

Lacro, J. P., Dunn, L. B., Dolder, C. R., Leckband, S. G., & Jeste, D. V. (2002). Prevalence of and Risk Factors for Medication Nonadherence in Patients with Schizophrenia. Journal of Clinical Psychiatry, 63(10), 892–909. https://doi.org/10.4088/JCP.v63n1007 DOI: https://doi.org/10.4088/JCP.v63n1007

Leamy, M., Bird, V., Le Boutillier, C., Williams, J., & Slade, M. (2011). Conceptual Framework for Personal Recovery in Mental Health. British Journal of Psychiatry, 199(6), 445–452. https://doi.org/10.1192/bjp.bp.110.083733 DOI: https://doi.org/10.1192/bjp.bp.110.083733

Malaspina, D., Owen, M. J., Heckers, S., Tandon, R., Bustillo, J., Schultz, S., Barch, D., Gaebel, W., Gur, R., Tsuang, M., van Os, J., & Carpenter, W. (2013). Schizoaffective Disorder in DSM-5. Schizophrenia Research, 150(1), 21–25. https://doi.org/10.1016/j.schres.2013.04.026 DOI: https://doi.org/10.1016/j.schres.2013.04.026

Millan, M. J., Fone, K., Steckler, T., & Horan, W. P. (2012). Negative Symptoms of Schizophrenia: Clinical Characteristics, Pathophysiological Substrates, and Therapeutic Approaches. Neuroscience & Biobehavioral Reviews, 36(10), 2195–2224. https://doi.org/10.1016/j.neubiorev.2012.06.007 DOI: https://doi.org/10.1016/j.neubiorev.2012.06.007

Pargament, K. I. (2011). Spiritually Integrated Psychotherapy: Understanding and Addressing the Sacred. Guilford Press.

Peralta, V., & Cuesta, M. J. (2018). Schizoaffective Disorder: Clinical and Conceptual Issues. Schizophrenia Bulletin, 44(6), 1173–1179. https://doi.org/10.1093/schbul/sby070 DOI: https://doi.org/10.1093/schbul/sby070

Peteet, J. R. (2019). Approaching Spirituality in the Clinical Encounter. Journal of Religion and Health, 58(6), 2051–2062. https://doi.org/10.1007/s10943-019-00838-2 DOI: https://doi.org/10.1007/s10943-019-00838-2

Pharoah, F., Mari, J. J., Rathbone, J., & Wong, W. (2010). Family Intervention for Schizophrenia. Cochrane Database of Systematic Reviews, (12), CD000088. https://doi.org/10.1002/14651858.CD000088.pub3 DOI: https://doi.org/10.1002/14651858.CD000088.pub3

Slade, M. (2009). Personal Recovery and Mental Illness: A Guide for Mental Health Professionals. Cambridge University Press. https://doi.org/10.1017/CBO9780511581649 DOI: https://doi.org/10.1017/CBO9780511581649

van Os, J., Kenis, G., & Rutten, B. P. F. (2010). The Environment and Schizophrenia. Nature, 468(7321), 203–212. https://doi.org/10.1038/nature09563 DOI: https://doi.org/10.1038/nature09563

World Health Organization. (2022). World Mental Health Report: Transforming Mental Health for All. World Health Organization. https://www.who.int/publications/i/item/9789240049338

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Published

2026-04-30

How to Cite

Fadhlurahman, M. A. A., Algristian, H., & Mumpuni, Y. (2026). Holistic Management of Depressive-Type Schizoaffective Disorder: A Case Illustration. Psychosocia : Journal of Applied Psychology and Social Psychology, 4(2), 65–70. https://doi.org/10.61978/psychosocia.v4i2.1359

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