User:Madihuddleston/sandbox


 * See most updated draft under the heading "Week 6 exercise"

Week 4 exercise: Start Drafting your contribution.

'''It looks like you have thought a bit about everything you would like to do! I would encourage you to copy and paste part of the article here for "practice" editing.'''

I have formed the start of my draft as a summary of a few sources I plan to use, and I have also updated how I plan to contribute as well. As I continued to review the talk page throughout the week, I noticed that there has been a large decrease in comments/changes since 2015; actually, only TWO comments have been made on the talk page since the year 2015. Because of this, I have decided it would be better to update small pieces of information instead of restructuring the whole page (one user wrote on the talk page that she believed the entire page should deleted and restarted; I believe completely restructuring would take much more work and time than one student could complete in a semester). I would like to make small updates to these areas: signs and symptoms (mainly using the DSM-V and including the range of days/weeks a person must experience symptoms to be diagnosed), causes (I would remove the majority of the information on substance abuse; I would delete it because I have reviewed the majority of the links and they do NOT state a major link between substance abuse and psychotic diagnoses, they only state that small percentages of patients with the disorder also had substance-induced psychosis; the sources do not state if the patient was diagnosed prior to the substance ingestion. However, I would include that substance-induced psychosis can be misread as a symptom or cause of the disorder), and I would like to update the lead. The lead is the first (and possibly the only) part of an article that most viewers read. I would like to make it a bit more concise and word the information more clearly. Under the "Research" heading, I would also remove the quote in parenthesis "likely many," as it is original research (the author drew conclusions about the number of causes; since they are unknown, we can't say that there are "likely many."

Sources to update the signs and symptoms section:

https://www.sciencedirect.com/science/article/pii/S0920996413002260

Summary: DSM-5 states that if a patient only experiences psychotic symptoms during a mood episode, their diagnosis is Mood Disorder with Psychotic Features and not Schizophrenia or Schizoaffective Disorder. If the patient experiences psychotic symptoms without mood symptoms for longer than a two-week period, their diagnosis is either Schizophrenia or Schizoaffective Disorder. If mood disorder episodes are present for the majority and residual course of the illness and up until the diagnosis, the patient can be diagnosed with Schizoaffective Disorder

Sources to update the causes section:

https://onlinelibrary.wiley.com/doi/full/10.1002/ajmg.b.32177

Summary: The authors explain that certain drugs can imitate symptoms of schizophrenia (which we know has similar symptoms to schizoaffective disorder). This is important to note when including that substance-induced psychosis should be ruled out when diagnosing patients so that patients are not misdiagnosed.

Plans for the lead:

I think the first sentence of the first paragraph is very strong, I would not change it. I would reword the latter part of the paragraph so that it is easier for readers to understand that patients need to be diagnosed correctly because other diagnoses with similar symptoms have very different treatment (there is a link later down the page that states they have differing treatments; I would reuse that link). The second sentence in the second paragraph seems a little out of place; I would restructure this so that the paragraph reflects more about symptoms of the disorder. I would use most of the sources if they applied to the symptoms. The third paragraph also seems unorganized, so I would start it off by stating the facts about the unknown cause(s); then I might shift to how people with schizoaffective disorder might be affected by other diagnoses at the end. The DSM-IV is mentioned in the fourth paragraph, which is outdated. I would correct the statements here but still keep most of the structuring, because I think the current wording does a good job of explaining treatment options. I will probably delete the last paragraph because leads should be condensed to about four paragraphs and because the wording seems unclear. I would state at the end of the fourth paragraph that the DSM-V had been updated because the DSM-IV resulted in overuse of the diagnosis.

Week 6 Exercise for Peer Review
For my draft, I have copied certain sections of the published page that I plan to edit here under this heading, and I have added the edits discussed above. What I have added is in bold.

The lead:

paragraph 1

Schizoaffective disorder (SZA, SZD or SAD) is a mental disorder characterized by abnormal thought processes and an unstable mood. The diagnosis of Schizoaffective disorder is made when the person has symptoms of both schizophrenia (usually psychosis) and a mood disorder, but does not meet the diagnostic criteria for schizophrenia or a mood disorder individually. The main criterion for the schizoaffective disorder diagnosis is the presence of psychotic symptoms for at least two weeks without any mood symptoms present. Schizoaffective disorder can often be misdiagnosed when the correct diagnosis may be psychotic depression, psychotic bipolar disorder, schizophreniform disorder or schizophrenia; it is important for providers to accurately diagnose patients, as treatment differs greatly for each of these diagnoses (use the same links here; I did not change information towards the bottom part of the paragraph, just reworded slightly).

I will remove the next sentence; it is not important enough to include in the lead section and a lot of readers may not understand without background information that is discussed later in the article.

The DSM-5 criteria revision for schizoaffective disorder is mainly an attempt to reduce the significant problems with misdiagnosis; but whether this has been achieved awaits outcome studies which have not been completed yet.

paragraph 2

There are two types of schizoaffective disorder: the bipolar type, which is distinguished by symptoms of mania, hypomania, or mixed episode; and the depressive type, which is distinguished by symptoms of depression only. Common symptoms of the disorder include hallucinations, delusions, and disorganized speech and thinking. Auditory hallucinations, or "hearing voices," are most common [same citation, 14]. The onset of symptoms usually begins in young adulthood [citation needed].

(There was previously a sentence here about population prevalence, but I have moved it to the end of the 5th paragraph because it was more about diagnosis than symptoms, which is what this paragraph discusses. It reads as follows: diagnostic criteria has recently been redefined, but former criteria estimated that the prevalence of the disease affects less than one percent of the population, in the range of 0.5-0.8 percent [same citation, just reworded, 9].)

paragraph 3

Genetics, neurobiology, early and current environment, behavioral, social, and experiential components appear to be important contributory factors; some recreational and prescription drugs may cause or worsen symptoms (this sentence is in the current published article; I will remove it because it is original research and has no citation). No single isolated organic cause has been found, but extensive evidence exists for abnormalities in the metabolism of tetrahydrobiopterin (BH4), dopamine, and glutamic acid in people with schizophrenia, psychotic mood disorders, and schizoaffective disorder. People with schizoaffective disorder are likely to have co-occurring conditions, including anxiety disorders and substance use disorders. Social problems such as long-term unemployment, poverty and homelessness are common (citation needed). The average life expectancy of people with the disorder is shorter than those without it, due to increased physical health problems from an absence of health promoting behaviors such as a sedentary lifestyle,[citation needed] and a higher suicide rate.

for paragraph 4 - The DSM-IV is mentioned, which is outdated, but it discusses outcomes based on that criteria. I will reword the statements here so that it is easier to read without a lot of background information, but still keep most of the structuring, because I think the current wording does a good job of explaining treatment options. I will add:

'''As a group, people with schizoaffective disorder that were diagnosed with the DSM-IV (which has since been updated) have a better outcome than people with schizophrenia [use same citations, 5,6]. Outcomes for people diagnosed with SAD using the DSM-V depend on data from prospective cohort studies, which have not been completed yet [same citation, 6]. The DSM-V diagnosis has been updated because criteria from the DSM-IV resulted in overuse of the diagnosis [citation 6, used in last paragraph of the lead]. Former criteria estimated that the prevalence of the disease affects less than one percent of the population, in the range of 0.5-0.8 percent [same citation, just reworded, 9].'''

for paragraph 5:

'''I will delete the last paragraph because leads should be condensed to about four paragraphs and because the wording is unclear and not concise. I would state at the end of the fourth paragraph that the DSM-V had been updated because the DSM-IV resulted in overuse of the diagnosis (which I've included above, including citations).'''

Signs and Symptoms section:

I will leave the first two paragraphs of this section the same and add the following as a last paragraph:

'''DSM-5 states that if a patient only experiences psychotic symptoms during a mood episode, their diagnosis is Mood Disorder with Psychotic Features and not Schizophrenia or Schizoaffective Disorder. If the patient experiences psychotic symptoms without mood symptoms for longer than a two-week period, their diagnosis is either Schizophrenia or Schizoaffective Disorder. If mood disorder episodes are present for the majority and residual course of the illness and up until the diagnosis, the patient can be diagnosed with Schizoaffective Disorder.''' Causes section:I will remove the majority of the information on substance abuse in this section; I plan to delete it because I have reviewed the majority of the links and they do NOT state a major link between substance abuse and psychotic diagnoses, they only state that small percentages of patients with the disorder also had substance-induced psychosis; the sources do not state if the patient was diagnosed prior to the substance ingestion. Plainly, the big takeaway is substance abuse has not been proven as a CAUSE of SAD. I will include that substance-induced psychosis can be misread as a symptom or cause of the disorder:

'''Certain drugs can imitate symptoms of schizophrenia (which we know has similar symptoms to schizoaffective disorder). This is important to note when including that substance-induced psychosis should be ruled out when diagnosing patients so that patients are not misdiagnosed.'''

Under the "Research" heading, I will also remove the quote in parenthesis "likely many," as it is original research (the author drew conclusions about the number of causes; since they are unknown, we can't say that there are "likely many."