Schizoaffective disorder

disease
On this page

Summary

Schizoaffective disorder (MONDO:0005487) is a disease with 5 cohort genes (8 GWAS associations across 4 studies) and 551 clinical trials. Top therapeutic interventions include ziprasidone, olanzapine, and quetiapine.

At a glance

  • Cohort genes: 5
  • GWAS associations: 8
  • Clinical trials: 551

Clinical features

No curated clinical features (Orphanet) for this disease.

Identifiers

Disease identifiers

FieldValue
Canonical nameschizoaffective disorder
Mondo IDMONDO:0005487
EFOEFO:0005411
DOIDDOID:5418
ICD-11106339515
NCITC94378
UMLSC0036337
MedGen11334
Is cancer (heuristic)no

Data availability: 8 GWAS associations (4 studies).

Disease family

An umbrella term covering 2 Mondo subtypes.

Classification path: disease › human disease › disease by developmental or physiological process › psychiatric disordercognitive disorderpsychotic disorderschizoaffective disorder

Related subtypes (7): schizophreniform disorder, alcoholic psychosis, delusional disorder, substance-induced psychosis, schizophrenia, methamphetamine-induced psychosis, postpartum psychosis

Subtypes (2): schizoaffective bipolar disorder, schizoaffective depressive disorder

Genetics & variants

GWAS landscape

8 GWAS associations across 4 studies. Top hits map to 6 distinct genes (as reported by GWAS).

Top associations by p-value

rsIDp-valueGeneRisk alleleOdds ratio
rs47212956e-10MAD1L1?
rs176939632e-09GPR89P - RSL24D1P1?
rs7768773e-09GALNT13?1.39
rs67033354e-09SDCCAG8?
rs27103233e-08ITIH1?
rs20775864e-08EMX1?
rs65588725e-08CSMD1?
rs756084935e-08LINC01741 - SEC16B?

Top studies (by case count)

StudyLead authorYearCasesControlsTitle
GCST009283Bigdeli TB20196,1523,918Contributions of common genetic variants to risk of schizophrenia among individuals of African and Latino ancestry.
GCST90473261UK Biobank Whole-Genome Sequencing Consortium2025316458,124Whole-genome sequencing of 490,640 UK Biobank participants.
GCST90726762Kim HI202613843,888Exome sequencing and analysis of 44,028 British South Asians enriched for high autozygosity.
GCST002254Sleiman P201300GWAS meta analysis identifies TSNARE1 as a novel Schizophrenia / Bipolar susceptibility locus.

Variant details and genetic-evidence tiers

Tier distribution (top 50 variants)

TierVariants
Tier 1: coding0
Tier 2: splice/UTR1
Tier 3: regulatory0
Tier 4: intronic/intergenic7

MAF distribution

BucketVariants
common (>=0.05)8
low_freq (0.01-0.05)0
rare (<0.01)0
unknown0

Functional consequences

ConsequenceCount
intron_variant7
3_prime_UTR_variant1

Top variants

rsIDChrPosAllelesMAFConsequenceGenep-valueTier
rs472129571997034T>G0.378intron_variantMAD1L16e-10Tier 4: intronic/intergenic
rs17693963627742386A>C,G0.096intron_variantGPR89P - RSL24D1P12e-09Tier 4: intronic/intergenic
rs7768772153941017A>C,G0.05intron_variantGALNT133e-09Tier 4: intronic/intergenic
rs67033351243445665A>G0.438intron_variantSDCCAG84e-09Tier 4: intronic/intergenic
rs2710323352781889T>A,C,G0.466intron_variantITIH13e-08Tier 4: intronic/intergenic
rs2077586272934422A>G0.053_prime_UTR_variantEMX14e-08Tier 2: splice/UTR
rs655887284380617G>A,C0.429intron_variantCSMD15e-08Tier 4: intronic/intergenic
rs756084931177796886C>G,T0.05intron_variantLINC01741 - SEC16B5e-08Tier 4: intronic/intergenic

Genes & proteins

Mendelian disease overlap and somatic drivers

GenCC: 0 · Orphanet: 2 · OMIM-shared: 0 · Dual-evidence (GWAS+Mendelian): 0

Orphanet rare-disease linkage (cohort genes)

GeneOrphanet IDRare disease
SDCCAG8Orphanet:110Bardet-Biedl syndrome
SDCCAG8Orphanet:3156Senior-Loken syndrome

Cohort genes → proteins

5 cohort genes, 5 distinct canonical proteins.

Evidence partition

SubsetGenes
gwas_only5

Cohort genes (full)

SymbolHGNCEnsemblUniProtNameEvidence
SDCCAG8HGNC:10671ENSG00000054282Q86SQ7Serologically defined colon cancer antigen 8gwas
CSMD1HGNC:14026ENSG00000183117Q96PZ7CUB and sushi domain-containing protein 1gwas
GALNT13HGNC:23242ENSG00000144278Q8IUC8Polypeptide N-acetylgalactosaminyltransferase 13gwas
ITIH1HGNC:6166ENSG00000055957P19827Inter-alpha-trypsin inhibitor heavy chain H1gwas
MAD1L1HGNC:6762ENSG00000002822Q9Y6D9Mitotic spindle assembly checkpoint protein MAD1gwas

Cohort function summary

Lead sentence per gene, UniProt-curated.

SymbolProtein nameFunction (lead sentence)
SDCCAG8Serologically defined colon cancer antigen 8Plays a role in the establishment of cell polarity and epithelial lumen formation.
CSMD1CUB and sushi domain-containing protein 1Potential suppressor of squamous cell carcinomas.
GALNT13Polypeptide N-acetylgalactosaminyltransferase 13Catalyzes the initial reaction in O-linked oligosaccharide biosynthesis, the transfer of an N-acetyl-D-galactosamine (GalNAc) residue from UDP-GalNAc to a serine or threonine residue on the protein receptor.
ITIH1Inter-alpha-trypsin inhibitor heavy chain H1May act as a carrier of hyaluronan in serum or as a binding protein between hyaluronan and other matrix protein, including those on cell surfaces in tissues to regulate the localization, synthesis and degradation of hyaluronan which are es…
MAD1L1Mitotic spindle assembly checkpoint protein MAD1Component of the spindle-assembly checkpoint that prevents the onset of anaphase until all chromosomes are properly aligned at the metaphase plate.

Protein-family classification

Druggable: 2 · Difficult: 0 · Unknown: 3 · Druggable fraction: 0.4

Family distribution

Cohort families vs a genome-wide background (hypergeometric, BH-FDR; fold = observed/expected). Counts kept; sorted by enrichment, so the catch-all Other/Unknown bucket no longer leads.

FamilyGenesFoldFDR
Complement153.6×0.056
Enzyme (other)12.4×0.530
Other/Unknown31.1×0.608

Per-gene assignment

SymbolFamilyDruggable?ECInterPro (top 3)
SDCCAG8Other/UnknownnoSDCCAG8
CSMD1ComplementyesSushi_SCR_CCP_dom, CUB_dom, Sperma_CUB_dom_sf
GALNT13Enzyme (other)yes2.4.1.41Ricin_B_lectin, Glyco_trans_2-like, Nucleotide-diphossugar_trans
ITIH1Other/UnknownnoVWF_A, ITI_HC_C, VIT
MAD1L1Other/UnknownnoMad1

Expression context

Cohort genes with no expression data: 0.

5 cohort genes are a single-cell marker in ≥1 SCXA experiment.

Breadth distribution (Bgee present_calls)

BucketGenes
narrow (1-5 tissues)0
moderate (6-20)0
broad (>20)5
unknown0

Top tissues across cohort

TissueCohort genes
calcaneal tendon1
corpus callosum1
thyroid gland1
Brodmann (1909) area 231
middle temporal gyrus1
primary visual cortex1
cerebellar cortex1
cerebellar hemisphere1
cerebellum1
liver1
male germ line stem cell (sensu Vertebrata) in testis1
right lobe of liver1
left testis1
right testis1
sural nerve1

Per-gene tissue summary (top 30)

SymbolBgee breadthFANTOM5 breadthSCXATop tissues
SDCCAG8134ubiquitousmarkercorpus callosum, calcaneal tendon, thyroid gland
CSMD1179broadmarkerBrodmann (1909) area 23, middle temporal gyrus, primary visual cortex
GALNT13184broadmarkercerebellar cortex, cerebellar hemisphere, cerebellum
ITIH1154tissue_specificmarkerright lobe of liver, liver, male germ line stem cell (sensu Vertebrata) in testis
MAD1L1137ubiquitousmarkersural nerve, right testis, left testis

Protein interactions among cohort

Intra-cohort edges: 0.

Hub genes (top 10 by interactor count)

SymbolInteractor count
MAD1L12,947
SDCCAG81,837
CSMD11,577
ITIH11,543
GALNT13977

Structural data

PDB: 3 · AlphaFold-only: 2 · No structure: 0

Cohort genes with PDB structures (top 30)

SymbolUniProtPDB entries
MAD1L1Q9Y6D95
ITIH1P198272
CSMD1Q96PZ71

AlphaFold-only cohort genes (top 30 by pLDDT)

SymbolUniProtpLDDT
GALNT13Q8IUC893.06
SDCCAG8Q86SQ778.67

Function

Pathway analysis

Distinct Reactome pathways touched by cohort: 31. Enrichment computed across 5 evidence-associated genes (3 with Reactome annotation).

Pathways by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 3 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

PathwayCohort genesFoldFDRSample cohort genes
Mitotic Prometaphase246.1×0.011SDCCAG8, MAD1L1
M Phase244.0×0.011SDCCAG8, MAD1L1
Cell Cycle, Mitotic232.1×0.013SDCCAG8, MAD1L1
Cell Cycle224.0×0.018SDCCAG8, MAD1L1
Centrosome maturation184.6×0.044SDCCAG8
Amplification of signal from the kinetochores165.6×0.044MAD1L1
O-linked glycosylation of mucins161.4×0.044GALNT13
Loss of Nlp from mitotic centrosomes152.9×0.044SDCCAG8
Loss of proteins required for interphase microtubule organization from the centrosome152.9×0.044SDCCAG8
Mitotic Spindle Checkpoint152.9×0.044MAD1L1
AURKA Activation by TPX2150.8×0.044SDCCAG8
Recruitment of mitotic centrosome proteins and complexes145.3×0.044SDCCAG8
Regulation of PLK1 Activity at G2/M Transition142.3×0.044SDCCAG8
Mitotic G2-G2/M phases142.3×0.044SDCCAG8
G2/M Transition142.3×0.044SDCCAG8
Amplification of signal from unattached kinetochores via a MAD2 inhibitory signal138.8×0.044MAD1L1
Recruitment of NuMA to mitotic centrosomes138.8×0.044SDCCAG8
Anchoring of the basal body to the plasma membrane137.7×0.044SDCCAG8
Cilium Assembly136.2×0.044SDCCAG8
Mitotic Metaphase and Anaphase132.3×0.044MAD1L1
Mitotic Anaphase132.3×0.044MAD1L1
EML4 and NUDC in mitotic spindle formation130.9×0.044MAD1L1
Cell Cycle Checkpoints129.5×0.044MAD1L1
Resolution of Sister Chromatid Cohesion128.8×0.044MAD1L1
RHO GTPases Activate Formins125.9×0.047MAD1L1
RHO GTPase Effectors122.7×0.051MAD1L1
Organelle biogenesis and maintenance122.0×0.051SDCCAG8
Separation of Sister Chromatids120.2×0.054MAD1L1
Signaling by Rho GTPases111.4×0.090MAD1L1
Signaling by Rho GTPases, Miro GTPases and RHOBTB3111.2×0.090MAD1L1

GO biological processes by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 5 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

GO termCohort genesFoldFDRSample cohort genes
oviduct epithelium development11123.5×0.010CSMD1
deactivation of mitotic spindle assembly checkpoint11123.5×0.010MAD1L1
mammary gland branching involved in pregnancy1842.6×0.010CSMD1
regulation of metaphase plate congression1674.1×0.010MAD1L1
hyaluronan metabolic process1421.3×0.011ITIH1
tube formation1421.3×0.011SDCCAG8
conditioned place preference1337.0×0.011CSMD1
positive regulation of mitotic cell cycle spindle assembly checkpoint1306.4×0.011MAD1L1
microtubule organizing center organization1280.9×0.011SDCCAG8
startle response1224.7×0.012CSMD1
attachment of mitotic spindle microtubules to kinetochore1210.7×0.012MAD1L1
female gonad development1160.5×0.014CSMD1
regulation of cilium assembly1120.4×0.017SDCCAG8
mitotic spindle assembly checkpoint signaling1112.3×0.017MAD1L1
protein O-linked glycosylation via N-acetylgalactosamine186.4×0.020GALNT13
establishment of cell polarity176.6×0.020SDCCAG8
cell projection organization174.9×0.020SDCCAG8
centrosome cycle167.4×0.020SDCCAG8
thymus development167.4×0.020MAD1L1
negative regulation of T cell proliferation166.1×0.020MAD1L1
protein O-linked glycosylation144.9×0.028GALNT13
memory136.6×0.033CSMD1
male gonad development131.2×0.037CSMD1
neuron migration126.8×0.041SDCCAG8
glucose homeostasis126.1×0.041CSMD1
gene expression116.0×0.063CSMD1
cell division19.2×0.104MAD1L1

Therapeutics

Drugs indicated for this disease

10 approved, 16 in late-stage (phase 3) trials. Disease-direct ChEMBL indications, not inferred from the associated-gene cohort below.

DrugDevelopment status
AripiprazoleApproved (phase 4)
BrexpiprazoleApproved (phase 4)
ClozapineApproved (phase 4)
HaloperidolApproved (phase 4)
OlanzapineApproved (phase 4)
PaliperidoneApproved (phase 4)
Paliperidone PalmitateApproved (phase 4)
QuetiapineApproved (phase 4)
RisperidoneApproved (phase 4)
ZiprasidoneApproved (phase 4)
(D)-SerinePhase 3 (in late-stage trials)
AmantadinePhase 3 (in late-stage trials)
AspirinPhase 3 (in late-stage trials)
BexarotenePhase 3 (in late-stage trials)
CannabidiolPhase 3 (in late-stage trials)
FenretinidePhase 3 (in late-stage trials)
IcosapentPhase 3 (in late-stage trials)
LorazepamPhase 3 (in late-stage trials)
LurasidonePhase 3 (in late-stage trials)
MetforminPhase 3 (in late-stage trials)
MinocyclinePhase 3 (in late-stage trials)
PipamperonePhase 3 (in late-stage trials)
PramipexolePhase 3 (in late-stage trials)
RaloxifenePhase 3 (in late-stage trials)
SulforaphanePhase 3 (in late-stage trials)
ZonisamidePhase 3 (in late-stage trials)

Earlier-phase candidates (phase 2, investigational — efficacy not yet established): Bifeprunox, Brilaroxazine, Cholecalciferol, Cycloserine, Dextrose, Estradiol, Galantamine, Glycine, Memantine, Pregnenolone Succinate, Serine, Valacyclovir, Varenicline.

Drug target analysis

Approved (phase 4): 0 · Phase ≥3: 0 · Phased (≥1): 0 · Undrugged: 5

Druggability breadth: 1 of 5 evidence-associated genes (20%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).

Top cohort targets by molecule count

SymbolMoleculesMax phase
SDCCAG800
CSMD100
GALNT1300
ITIH100
MAD1L100

Bioactivity and enzyme data

Enzyme cohort genes (≥1 EC): 1.

Cohort genes with ChEMBL bioactivity (full, sorted by assay count)

SymbolAssaysType breakdown
GALNT131Binding:1

Cohort enzymes (BRENDA EC)

SymbolEC numbersNames
GALNT132.4.1.41polypeptide N-acetylgalactosaminyltransferase

Pharmacogenomics

Cohort genes with a PharmGKB record: 5; with CPIC/DPWG dosing guidelines: 0.

No cohort gene has a CPIC/DPWG genotype-guided dosing guideline (PharmGKB).

Chemical tractability of cohort targets

0 approved/phased compounds have measured bioactivity against a cohort gene (and aren’t yet in disease-level trials). This is a research / tractability signal, NOT a therapeutic recommendation — a bioactivity row often reflects off-target or screening binding (e.g. promiscuous kinase inhibitors against a cohort kinase), implying no disease mechanism.

Druggability pyramid

Cohort genes binned by druggability tier (high → low):

TierDefinitionGenesSymbols
AApproved (phase 4 drug)0
BPhased (≥1) drug, not yet approved0
CDruggable family + PDB, no drug1CSMD1
DDruggable family + AlphaFold only, no drug1GALNT13
EDifficult family or no structure, no drug3SDCCAG8, ITIH1, MAD1L1

Undrugged target profiles

5 cohort genes are undrugged. Ranked by ‘starting-point quality’ (assay depth + drugged-partner adjacency).

SymbolChEMBL assaysDrugged partners (top 3)
SDCCAG80
CSMD10
GALNT131
ITIH10
MAD1L10

Clinical trials & evidence

Clinical trials

Clinical trials: 551.

Phase distribution (across all retrieved trials)

PhaseTrials
Not specified284
PHASE4119
PHASE349
PHASE247
PHASE133
PHASE1/PHASE29
PHASE2/PHASE37
EARLY_PHASE13

Top trials by phase / activity

NCTPhaseStatusTitle
NCT02639702PHASE4RECRUITINGSwitching From Twice-Daily to Once-Daily Clozapine Dosing in Schizophrenia
NCT03495024PHASE4RECRUITINGSmoking Cessation With Varenicline in Schizophrenia: Antipsychotic-Induced Neurological Symptoms as Correlates
NCT04580134PHASE4RECRUITINGCLOZAPINE Response in Biotype-1
NCT05208190PHASE4RECRUITINGClozapine for the Prevention of Violence in Schizophrenia: a Randomized Clinical Trial
NCT06562608PHASE4RECRUITINGAnticholinergic Deprescription in Schizophrenia
NCT06740890PHASE4RECRUITINGExercise and Olanzapine-samidorphan
NCT07105111PHASE4RECRUITINGA Study to Evaluate the Effectiveness of Valbenazine in Adult Participants With Tardive Dyskinesia (TD) Who Remain Symptomatic While Receiving or After Stopping a Vesicular Monoamine Transporter 2 (VMAT2) Inhibitor
NCT00007774PHASE4COMPLETEDTo Determine if Olanzapine is More Cost Effective Than Haloperidol for the Treatment of Schizophrenia
NCT00034801PHASE4COMPLETEDOlanzapine Versus Active Comparator in the Treatment of Depression in Patients With Schizophrenia
NCT00061802PHASE4COMPLETEDEfficacy and Safety of Two Atypical Antipsychotics vs. Placebo in Patients With an Acute Exacerbation of Either Schizophrenia or Schizoaffective Disorder
NCT00090012PHASE4COMPLETEDComparison of Continuing Olanzapine to Switching to Quetiapine in Overweight or Obese Patients With Schizophrenia and Schizoaffective Disorder
NCT00100776PHASE4COMPLETEDEfficacy of High Dose Olanzapine for the Treatment of Schizophrenia and Schizoaffective Disorder
NCT00156715PHASE4COMPLETEDEfficacy of Quetiapine in the Treatment of Patients With Schizophrenia and a Comorbid Substance Use Disorder
NCT00169026PHASE4TERMINATEDAlcoholism and Schizophrenia: Effects of Clozapine
NCT00176423PHASE4COMPLETEDEfficacy Study of Galantamine for Cognitive Impairments in Schizophrenia
NCT00177008PHASE4COMPLETEDAripiprazole for the Treatment of Schizophrenia With Co-Morbid Social Anxiety
NCT00177580PHASE4COMPLETEDImproving Symptoms of Schizophrenia and Schizoaffective Disorder by Supplementing Medications With Pravastatin
NCT00190749PHASE4COMPLETEDSafety Study of Olanzapine and a Comparator in Patients With Schizophrenia and Schizoaffective Disorder
NCT00202293PHASE4COMPLETEDComparison of Combination Olanzapine+Lithium or Chlorpromazine+Lithium in Treatment of First Manic Episode With Psychotic Features
NCT00206102PHASE4COMPLETEDA Study of the Cataractogenic Potential of Seroquel and Risperdal in the Treatment of Participants With Schizophrenia or Schizoaffective Disorder
NCT00208143PHASE4COMPLETEDSeroquel Therapy for Substance Use Disorders Comorbid With Schizophrenia
NCT00208169PHASE4COMPLETEDAbilify Therapy for Reducing Comorbid Substance Abuse
NCT00215579PHASE4COMPLETEDDetermining the Effects of Risperdal Consta in Patients With Psychotic Disorders and Incomplete Adherence
NCT00222794PHASE4COMPLETEDA Clinical Trial to Examine Effects of Atomoxetine in the Treatment of Negative Symptoms in Patients With Schizophrenia
NCT00224822PHASE4COMPLETEDThe Effects of Aripiprazole on Patients With Metabolic Syndrome
NCT00231335PHASE4COMPLETEDEfficacy and Safety Study of Escitalopram Augmentation in Treatment Resistant Schizophrenia
NCT00246259PHASE4COMPLETEDA Trial Comparing Risperidone Long-Acting Injection With Oral Antipsychotic in the Treatment of Early Psychosis
NCT00253110PHASE4COMPLETEDA Comparison of Risperidone With Haloperidol in Patients With Schizophrenia and Schizoaffective Disorder
NCT00269919PHASE4COMPLETEDAn Efficacy and Safety Study of Long-Term Risperidone Microspheres in Participants With Schizophrenia
NCT00303602PHASE4COMPLETEDComparing the Effect of Under the Tongue Olanzapine Versus Swallowed Olanzapine on Body Mass Index (A Ratio of Weight to Height)
NCT00304655PHASE4COMPLETEDAcute Psychosis Treatment in the Long Term, Unitary Group Study (APLUS)
NCT00306475PHASE4COMPLETEDDoes The Addition Of Divalproex Sodium ER To An Atypical Antipsychotic Drug (APD) Improve Cognition And Psychopathology In Outpatients With Schizophrenia (SCH) Or Schizoaffective Disorder (SAD)?
NCT00313391PHASE4COMPLETEDRisperdal Consta and Health Care Utilization in Patients With Schizophrenia
NCT00314327PHASE4TERMINATEDOptimizing Response in Psychosis Study
NCT00320697PHASE4COMPLETEDSmoking Relapse Prevention in Schizophrenia
NCT00320723PHASE4COMPLETEDNicotine Replacement Therapy for Smoking Cessation in Schizophrenia
NCT00320736PHASE4COMPLETEDGalantamine for Cognition in People With Schizophrenia
NCT00325689PHASE4COMPLETEDAripiprazole Used as Dual Therapy in the Treatement of Patients With Chronic Stable Schizophrenia or Schizoaffective Disorder.
NCT00330863PHASE4COMPLETEDPreventing Relapse in Schizophrenia: Oral Antipsychotics Compared To Injectables: Evaluating Efficacy
NCT00337662PHASE4COMPLETEDEfficacy Study of Early Onset of Antipsychotic Drug Action in Schizophrenia

Drugs tested across these trials (top 30)

MoleculeMax phaseTrials referencing
ZIPRASIDONE445
OLANZAPINE416
QUETIAPINE411
RISPERIDONE411
ARIPIPRAZOLE410
VARENICLINE410
CLOZAPINE49
RALOXIFENE49
LURASIDONE47
BUPROPION46
HALOPERIDOL44
MODAFINIL44
PALIPERIDONE PALMITATE44
AMANTADINE43
AMISULPRIDE43
ATOMOXETINE43
CHLORPROMAZINE43
GALANTAMINE43
NALTREXONE43
PALIPERIDONE43
ASENAPINE42
BREXPIPRAZOLE42
CANNABIDIOL42
CYCLOSERINE42
GLYCINE42
HALOPERIDOL DECANOATE42
MEMANTINE42
METFORMIN42
MINOCYCLINE42
PERPHENAZINE42