Which of the following has the highest risk of metabolic syndrome?

A. Depressed type. Schizoaffective disorder, depressive type, involves schizophrenia symptoms (delusions, hallucinations, disorganized thinking) along with major depressive episodes. There is no history of mania or hypomania, distinguishing it from the bipolar type.

B. Unspecified type. Schizoaffective disorder, unspecified type, is used when the clinician determines that the patient meets criteria for schizoaffective disorder but does not clearly fit into the bipolar or depressive subtypes.

C. Anxiety type. There is no "anxiety type" of schizoaffective disorder. While individuals with schizoaffective disorder may experience anxiety, it is not a defining feature. Anxiety disorders are separate conditions and do not define a subtype of schizoaffective disorder.

D. Bipolar type. Schizoaffective disorder, bipolar type, is diagnosed when schizophrenia symptoms occur alongside manic or mixed episodes, with or without depressive episodes. This distinguishes it from the depressive type, which lacks manic symptoms.

A. Lack of motivation. Avolition, not alogia, refers to a severe lack of motivation to initiate and sustain goal-directed activities. It is a common negative symptom of schizophrenia, leading to difficulties in completing tasks such as hygiene, work, or social activities.

B. No empathy. Lack of empathy is more commonly associated with antisocial personality disorder (ASPD) or narcissistic personality disorder (NPD) rather than schizophrenia. Individuals with schizophrenia may struggle with social interactions, but this is due to cognitive deficits rather than a lack of concern for others.

C. Reduction in quantity of words spoken. Alogia refers to poverty of speech, characterized by diminished verbal output and difficulty generating spontaneous speech. It is a negative symptom of schizophrenia, often presenting as brief, empty responses or difficulty engaging in conversation.

D. Inability to experience pleasure. Anhedonia refers to the inability to feel pleasure in activities that were once enjoyable. It is another negative symptom of schizophrenia and is also seen in major depressive disorder and other mood disorders.