Your Guide to Schizoaffective Disorder

Medically Reviewed By Nicole Washington, DO, MPH
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Schizoaffective disorder is a chronic mental illness that affects the way you think, feel, and act. You may experience symptoms of psychosis, depression, and mania. This means that it has symptoms of both schizophrenia and bipolar disorder. Around 1 in 200 people develop schizoaffective disorder at some point during their life. The onset of the condition is most likely to occur during early adulthood.

If you have schizoaffective disorder, you may have symptoms of schizophrenia and mania or schizophrenia and depression. You may also experience symptoms of schizophrenia, mania, and depression at different times.

Read on to learn more about schizoaffective disorder. This guide includes information about treatments, symptoms, causes, and more.

What are the types of schizoaffective disorder?

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There are two types of schizoaffective disorder: bipolar type and depressive type.

With bipolar-type schizoaffective disorder, you will experience mania, or high moods, alongside psychosis. Some people may also experience depression or low moods.

With depressive-type schizoaffective disorder, depression, or low moods, occurs alongside psychosis.

Psychosis is similar to schizophrenia. This means that you may experience symptoms such as hallucinations, delusions, and disorganized thoughts or speech.

In order for doctors to diagnose either type of schizoaffective disorder, you must experience extended periods of psychosis without any mood episodes.

Are schizoaffective disorder and schizophrenia the same?

Medical professionals previously viewed schizoaffective disorder as a subtype of schizophrenia. However, they now recognize it as a separate diagnosis.

Both conditions share similar symptoms of psychosis. However, for a doctor to diagnose schizoaffective disorder, psychotic episodes need to occur alongside a mood disorder such as depression or bipolar disorder.

Research suggests that schizoaffective disorder occurs around one-third as frequently as schizophrenia. However, it is important to note that medical professionals often misdiagnose schizoaffective disorder, as the condition shares criteria with other prevalent psychiatric disorders.

View our hub to learn more about schizophrenia.

Symptoms of schizoaffective disorder

Symptoms you experience with schizoaffective disorder will depend on whether you have the bipolar or depressive type. With either type, you will have symptoms of schizophrenia.

Symptoms of schizophrenia

It is possible to divide schizophrenia symptoms into two categories: positive symptoms and negative symptoms. Positive symptoms refer specifically to elements of psychosis or events that occur outside of reality. Negative symptoms impact the way you feel about yourself and how the condition affects your functioning.

Positive symptoms of schizophrenia include:

  • hallucinations
  • delusions
  • disorganized thinking
  • disorganized actions
  • catatonic behavior

Negative symptoms of schizophrenia include:

  • loss of interest in hobbies or activities
  • lack of motivation
  • slower movements
  • changes in your sleeping patterns
  • feeling like you do not have much to say
  • lack of eye contact
  • a reduced range of emotions
  • low sex drive
  • difficulties planning or setting goals

Learn more about early and psychotic symptoms of schizophrenia.

Symptoms of bipolar disorder

With schizoaffective disorder, symptoms of bipolar disorder can either include mania or both mania and depression.

Symptoms of mania include:

  • feeling overly energetic or restless
  • talking quickly and struggling to focus on one topic
  • having racing thoughts
  • not needing a lot of sleep
  • being more irritable or argumentative than usual
  • behaving in ways that are not typical for you, such as spending lots of money, taking recreational drugs, or gambling

Learn more about symptoms of bipolar disorder.

Symptoms of depression

Depressive-type schizoaffective disorder combines symptoms of psychosis with depression.

Symptoms of depression include:

  • low mood or feeling negative
  • feeling tired
  • lacking in energy
  • no longer finding interest in things you enjoyed
  • difficulties with sleeping
  • changes in appetite
  • thoughts about death or suicide

Learn more about symptoms of depression.

With bipolar-type schizoaffective disorder, you may experience symptoms of psychosis, mania, and depression. With depressive-type schizoaffective disorder, you will only experience symptoms of psychosis and depression.

How to treat schizoaffective disorder

There are two main approaches to treating schizoaffective disorder: therapy and medication. Electroconvulsive therapy (ECT) may also be an option where no other treatments have worked.

Therapy for schizoaffective disorder

Psychotherapies such as cognitive behavioral therapy (CBT) and family therapy may help you to manage and understand your condition.

During CBT, a therapist will work with you to help you manage the way you respond to symptoms. You may gain a better understanding of your condition, as well as how you act when symptoms emerge.

Family therapy helps to improve the support you receive from loved ones. It can increase their knowledge and understanding of what you feel and experience with schizoaffective disorder. Having a strong support unit around you can be crucial in overcoming an episode of psychosis.

Medication for schizoaffective disorder

Your doctor may prescribe medication to help to alleviate symptoms. Medications for schizoaffective disorder can include:

  • Antipsychotics: Antipsychotic medications target psychosis. They can help to alleviate the severity of hallucinations and delusions.
  • Mood stabilizers: Mood stabilizers are typically prescribed for conditions such as bipolar disorder. They can help with symptoms of mania and depression.
  • Antidepressants: Antidepressants target depressive moods. Your doctor may prescribe these for depressive-type schizoaffective disorder, where symptoms of mania are not present.

Electroconvulsive therapy

ECT is a last resort for people who have not responded to other types of treatment. It is particularly useful for treating catatonia and aggression. It is generally a safe option for most chronically hospitalized patients.

Learn more about ECT.

What causes schizoaffective disorder?

Like schizophrenia and bipolar disorder, there is no one cause of schizoaffective disorder. However, possible causes of schizoaffective disorder include genetics and environmental factors.

Environmental factors

Stress is a key environmental factor that some researchers believe can lead to schizoaffective disorder. A chemical imbalance in the brain may contribute to the likelihood of the condition developing. Stress can trigger the onset of schizoaffective disorder.

Examples of stressful situations include:

  • experiencing abuse or neglect
  • losing a loved one
  • losing a job or being forced to move home
  • financial problems

Genetic factors

It is possible that genes contribute to schizoaffective disorder. There is not one particular gene that causes the condition, but a combination of genes may make you more likely to develop it.

Some of these genes may involve the neurotransmitter chemical gamma-aminobutyric acid (GABA). GABA prevents the brain from receiving too many signals at once, and problems with this chemical can result in symptoms of schizoaffective disorder.

More research can increase understanding of the relationship between schizoaffective disorder and genetics. However, due to strong overlaps between schizoaffective disorder, bipolar disorder, and schizophrenia, it can be challenging to distinguish between conditions and causes.

Diagnosing schizoaffective disorder

It can be difficult to diagnose schizoaffective disorder due to symptoms being similar to other conditions, namely schizophrenia and bipolar disorder.

A doctor will carry out physical and neurological examinations to rule out any other diagnoses. The doctor may then reach a diagnosis of schizoaffective disorder if the patient meets the following criteria:

  • an uninterrupted period of either manic or depressive mood alongside at least one of three symptoms of schizophrenia:
    • delusions
    • hallucinations
    • disorganized speech
    • catatonic behavior
    • negative symptoms, such as a lack of emotion or motivation
  • at least 2 weeks of hallucinations and delusions without a major mood episode
  • symptoms of a major mood episode for most of the duration of the illness
  • no suggestion that symptoms occur as a result of substance use or a different medical condition

To diagnose bipolar-type schizoaffective disorder, episodes of mania, sometimes with depression, must be present.

To diagnose depressive-type schizoaffective disorder, only episodes of depression must be present.

Is it possible to prevent schizoaffective disorder?

It is not possible to prevent schizoaffective disorder.

However, it is possible to take steps to prevent a relapse of symptoms. Medications can help to alleviate negative symptoms of schizophrenia such as depression. Antipsychotics help to prevent a relapse of psychotic episodes such as hallucinations and delusions.

Ongoing therapy can help you to manage thoughts and behavior. This is particularly important to ensure that you are equipped with the tools to handle another episode should it occur following a period of remission.

Risk factors for schizoaffective disorder

There are various risk factors that may make you more likely to develop schizoaffective disorder. These risk factors include:

  • Age: Around 30% of cases occur in adults ages 25–35 years.
  • Sex: The condition occurs more frequently in females than in males (assigned at birth).
  • Family history: You have an increased risk of schizoaffective disorder if you have a first-degree relative, such as a parent or sibling, with bipolar disorder, schizophrenia, or schizoaffective disorder.

Summary

There are two types of schizoaffective disorder: bipolar type and depressive type. With bipolar-type schizoaffective disorder, an individual experiences mania or mania and depression, alongside psychotic symptoms. Depressive-type schizoaffective disorder combines psychosis with depression.

Common symptoms of schizoaffective disorder include hallucinations, delusions, and disorganized thinking. As the condition shares similarities with other conditions, such as schizophrenia and bipolar disorder, it can be difficult to diagnose.

Following diagnosis, schizoaffective disorder can be treated with therapies such as CBT and family therapy, as well as medications including antipsychotics, mood stabilizers, and antidepressants.

Contact your doctor if you experience psychotic symptoms, episodes of mania, or depression. They will be able to carry out tests and refer you to a mental health team as necessary.

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Medical Reviewer: Nicole Washington, DO, MPH
Last Review Date: 2022 Apr 12
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.