What Is Schizoaffective Disorder?

Schizoaffective disorder is a psychiatric illness characterized by a combination of psychotic features and mood symptoms. This disorder can be difficult to cope with. It’s also confusing and distressing for friends and family who care about a person living with the condition.

A person who has this disorder can have an improved quality of life with better symptom control once the condition is diagnosed and treated with medication and therapy. 

Characteristics

Schizoaffective disorder has a combination of traits of schizophrenia and mood disorders. That means that a person has psychosis, with hallucinations and delusions, as well as clinical depression or mania.

Schizoaffective disorder is formally defined by the fifth edition of the Diagnostic and Statistical Manual of Disorder of Mental Disorders (DSM-5), which is the disease classification system used by psychiatrists and other mental health professionals.

A diagnosis of schizoaffective disorder is made if a person has all four of the following criteria (A, B, C, and D):

A: An episode in which a person has a major mood episode along wth two of the below symptoms of schizophrenia:

1. Delusions (false beliefs)
2. Hallucinations (seeing or hearing things that aren’t there)
3. Highly disorganized speech
4. Grossly disorganized or catatonic behavior
5. Negative symptoms such as diminished emotional expression

B: Hallucinations and delusions for two or more weeks without mood symptoms

C. Bipolar symptoms or depressive symptoms are present most of the time over the course of the illness

D. Medical issues and substance use are not responsible for the symptoms

This condition generally develops during late adolescence or early adulthood, and it tends to cause symptoms throughout a person's lifespan.

Types

There are two types of schizoaffective disorder. They differ based on the mood disorder that's associated with the psychosis.

The two types are:

• Depressive type: This applies only if bouts of major depression are present.
• Bipolar type: This applies if manic episodes have been present at some point in the illness. Depressive symptoms may also occur.

Similar Conditions

Certain psychiatric illnesses can cause mood and psychotic symptoms and can be confused with schizoaffective disorder, including:

• Psychotic depression
• Bipolar disorder with psychotic features
• Schizophreniform disorder
• Schizophrenia

The central distinction between schizoaffective and bipolar disorder is that in bipolar disorder the psychotic symptoms are only present during the presence of an active mood episode.

Impact

The condition affects approximately 3 out of 1000 people, and it is less common than schizophrenia, depression, or bipolar disorder.

Schizoaffective disorder can result in episodes of psychosis and mood instability that impair self-care and interactions with others.

Day-to-Day Effects

A person living with schizoaffective disorder may experience episodes of psychosis, depression, and mania. The disorder can make it difficult to get along with others and it often interferes with a person’s ability to maintain a job and take care of everyday responsibilities.

Some consequences of this disease include:

• Detachment from reality: A person with this disease believes things that are different from what everyone else around them believes. While it isn't always the case, the hallucinations and delusions can have a theme of persecution or paranoia.
• Isolation: Schizoaffective disorder can make a person withdraw from others, either due to paranoia or apathy. This may lead to long periods of isolation.
• Rejection: A person who is living with schizoaffective disorder may have episodes of diminished self care, and can have an appearance that others consider frightening or unacceptable during these times. Additionally, people with this disorder may talk in a way that is irrational, either due to the psychosis or the mania. This can lead to rejection from others, and it can also put a person who has this disease in danger. 

This condition increases the risk of self-harm, homelessness, and untreated health problems.

Coping

If you think you or someone you care about might have schizoaffective disorder, it’s important to be kind and compassionate and to seek professional care. 

Many people have heard of schizophrenia, depression, and bipolar disorder—but the term schizoaffective disorder is not as well known and can sometimes lead to confusion for patients and families, potentially delaying diagnosis and treatment.

Getting appropriate psychiatric help is the best way to reduce the effects of the disorder and to improve the lives of everyone involved.

You may start by reaching out to your primary care doctor, who may ask you for details about your symptoms, possible medical issues, and might give you a referral to a psychiatrist. When you speak with a psychiatrist, you will be able to describe the feelings and thoughts that you have been having in more detail.

Treatment

Schizoaffective disorder isn’t curable, but it’s manageable. Treatment includes psychotherapy and prescription medications. Medications can include antipsychotics, antidepressants, and mood stabilizers.

Sometimes, inpatient hospitalization is necessary during severe episodes. While you might continue to have some flare-ups over the years, you can have a happy life with healthy relationships.

Myths

Schizoaffective disorder, like many psychiatric illnesses, is often misunderstood. That can make it perplexing for people who have it and can make it hard to explain the condition to others.

Some common myths about the condition include: 

Schizoaffective disorder is a split personality: The term "schizo" means split and is often misunderstood as a split personality. While schizoaffective disorder can cause changes in personality, it is distinct from dissociative identity disorder (which is sometimes known as "multiple" or "split" personality). 

Schizoaffective disorder is the same as a histrionic personality: Histrionic personality disorder is characterized by highly dramatic emotional and attention-seeking behavior. While people with histrionic personality disorder can say things that sound paranoid or highly emotional, people with this personality disorder do not experience hallucinations or delusions.

Schizoaffective disorder makes people believe conspiracy theories:

Although those suffering from schizoaffective disorder may have a variety of paranoid and delusional beliefs, many people without psychiatric disorders believe in conspiracy theories, and many with schizoaffective disorder do not ascribe to conspiracy theories.

A Word From Verywell

Living with schizoaffective disorder means dealing with many challenges. This condition can be complicated to understand for the person who has the disorder and for others around them. It’s important for a person who has schizoaffective disorder to get support from a multidisciplinary team of healthcare professionals and to have as much social support as possible.