Schizoaffective disorder has an age range of origin between 19 and 21 months, with more paranoia at 19 months and more depression at 21 months. Clinically, we can determine age of origin, usually to the month – because infant development is very rapid. The origin, mechanism, treatment, and prevention is the same with all of these disorders. Once the onset has occurred, it is vital that there is a separation between patient and original nuclear family, because contact with original family fosters the parent-to-infant relationship and keeps the patient locked into the infant mind and brain. Separate for a period of time, and the entire process disappears. Reintegration must wait until there have been no psychotic symptoms for a number of months, or even years, and then there can be a very careful means of beginning the reintegration process.
This patient had been hospitalized 12 times, and it was not clear what caused the recurrences of his schizoaffective paranoia. He lived alone with his widowed sister who had reared two children and suffered from major depression herself. Finally, his sister’s son – who moved back home with her – made it clear that he wanted him to leave. Ultimately, he moved out on his own.
Over the course of the next three years, there were no more psychotic episodes. Then he was hospitalized for a surgical procedure. After returning from the hospital, his sister moved in with him for a few days to help him, “just to make him a sandwich and pour him a glass of milk.” Within a week, he became acutely paranoid, was convinced he really had cancer and everyone was lying to him, and he left the country. Two months later, a postcard arrived from Canada saying, “Checking things out up here.”
Relationships with siblings were scrutinized more carefully after this clinical experience, and it became apparent that other close relatives had an effect similar to that of a parent, and precipitated recurrent illnesses.