Schizoaffective Disorder: Symptoms, Diagnosis, Treatment Everyday Health MenuNewslettersSearch Schizophrenia

What Is Schizoaffective Disorder

By Lindsey KonkelMedically Reviewed by Allison Young, MDReviewed: July 12, 2022Medically ReviewedSchizoaffective disorder is a rare mental illness; its effects on the people who have it are extremely varied.Depositphotos.comSchizoaffective disorder is a mental illness that acts like a combination of related conditions: schizophrenia and either depression or bipolar disorder. (1) People with schizoaffective disorder experience symptoms that resemble both schizophrenia (such as hallucinations or delusions) and mood episodes (such as mania episode or depression). Schizoaffective disorder hasn’t been as well studied as schizophrenia or bipolar disorder, so the treatments for schizoaffective disorder have been borrowed from these related conditions and major depressive disorder, according to the National Alliance on Mental Illness (NAMI). (1)

Prevalence of Schizoaffective Disorder

Schizoaffective disorder is a rare condition. It affects an estimated 0.3 percent to 1.1 percent of people. (2) Women may be slightly more likely to develop the condition than men. The disease typically develops in early adulthood. (2)

Causes and Risk Factors for Schizoaffective Disorder

The exact cause of schizoaffective disorder isn’t known. Schizoaffective disorder may be caused by a combination of factors: (1) Genetics If you have a parent or sibling with schizoaffective disorder, you are more likely to develop the condition. Brain chemistry and structure People with schizoaffective disorder may have certain differences in brain function. Drug use Some drugs, including cannabis and psychoactive drugs such as LSD, have been linked to the development of schizoaffective disorder.

Signs and Symptoms of Schizoaffective Disorder

Schizoaffective disorder affects each person differently. Some people experience cycles of severe symptoms followed by periods of improvement. Symptoms may include the following: (1)Hallucinations (seeing or hearing things that no one else can see or hear)Delusions (false, sometimes paranoid beliefs)Disorganized or illogical thinking (switching very quickly between unrelated topics; speech may seem jumbled)Depressed mood (feelings of sadness, emptiness, or worthlessness that won’t go away)Mania (feelings of euphoria, excess energy, irritability, racing thoughts, or risky behavior)Suicidal thoughts or behavior

Testing and Diagnosis of Schizoaffective Disorder

Your healthcare provider will complete a mental health assessment if he or she suspects schizoaffective disorder. You will also be referred to a psychiatrist. Your doctor will rule out medical or drug-related conditions that could cause similar symptoms. These conditions could include stroke, brain injury, certain hormonal diseases, some autoimmune conditions, seizure disorders, vitamin deficiencies, untreated syphilis, or withdrawal from alcohol or benzodiazepines. (3,4)

Disorders and Conditions Related to Schizoaffective Disorder

In the past, the process of diagnosing schizoaffective disorder may have been less precise than it is today. In 2013, the American Psychiatric Association revised its guidelines to give doctors more guidance on identifying schizoaffective disorders. As a result, today there is more of a distinction between having schizophrenia and mood episodes and having schizoaffective disorder. The criteria encourages clinicians to consider the whole disease course and see if mood episodes have been present for most of it. Despite these improvements, schizoaffective disorder remains one of the most misdiagnosed psychiatric disorders. (5) To receive a diagnosis of schizoaffective disorder, you must experience certain psychotic symptoms during a period of two weeks or longer when you do not experience mood episodes, such as manic or depressive episodes. In addition, mood episodes must be present during most of your illness. Some people only experience psychotic symptoms during a disturbance in mood. In these instances, doctors diagnose bipolar disorder or depression with psychotic features. (4) The difference is slight, but it can affect the type of medication used during treatment. People with post-traumatic stress disorder (PTSD) and other stressor-related disorders sometimes experience psychotic symptoms, such as hearing voices or seeing things that aren’t real. These people can also have intrusive thoughts or flashbacks of past traumatic events. (6) It can be difficult to distinguish between these flashbacks and true hallucinations. (7) Because the symptoms can overlap, it is not always clear whether a person has PTSD or a schizophrenia-like illness, such as schizophrenia or schizoaffective disorder. (7,8)

Treatments and Therapies for Schizoaffective Disorder

Schizoaffective disorder is treated with a combination of medication and psychotherapy (talking with a professional therapist). There is no cure for schizoaffective disorder, but symptoms can be managed and minimized with proper treatment. Medication for schizoaffective disorder depends on the type (depressive or bipolar) and severity. The exact mechanisms by which these medications work is still unknown, but here’s what researchers know about what they help with and the brain chemicals they affect: (9) Antipsychotic drugs These medicines are prescribed to help reduce or eliminate such symptoms as hallucinations or delusions. Antidepressants These drugs alter levels of chemicals in the brain that play a role in mood and emotional regulation. Antidepressants can lessen feelings of sadness or emptiness. Mood stabilizers These drugs help even out the “highs” and “lows” that are characteristic of bipolar disorder. Nondrug treatments for schizoaffective disorder include these options: (1) Cognitive behavioral therapy You’ll talk with a therapist to develop coping strategies for certain symptoms. Peer support groups These are meetings that occur in safe environments where you can interact with people who are going through the same things as you. Professional therapists may or may not be involved. Family therapy This involves seeing a therapist along with some or all of your family members. It’s helpful when your family knows as much about your medical condition as possible. Therapists can also help your family find problem-solving skills and coping strategies. Rehabilitation These programs can include job training and counseling, financial management, and the development of communication skills. Rehabilitation programs teach strategies that help people with schizoaffective disorder function better in their communities. Coordinated specialty care This team-based approach to treatment involves meetings with a coordinated care team including clinicians, therapists, and case workers combined with low doses of antipsychotics and other medication. (10) NEWSLETTERS

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Editorial Sources and Fact-Checking

Schizoaffective Disorder. National Alliance on Mental Illness.Schizoaffective Disorder. BMJ Best Practice. June 11, 2022.Schizoaffective Disorder. MedlinePlus. October 2, 2019.Abrams DJ, Rojas DC, Arciniegas DB. Is Schizoaffective Disorder a Distinct Categorical Diagnosis? A Critical Review of the Literature. Neuropsychiatric Disease and Treatment. December 2008.Wy TJP, Saadabadi A. Schizoaffective Disorder. National Center for Biotechnology Information. May 2, 2022.Malaspina D, Owen MJ, Heckers S, et al. Schizoaffective Disorder in the DSM-5. Schizophrenia Research. October 2013.OConghaile A, DeLisi LE. Distinguishing Schizophrenia From Posttraumatic Stress Disorder With Psychosis. Current Opinions in Psychiatry. May 2015.Hartman LI, Heinrichs RW, Mashhadi F. The Continuing Story of Schizophrenia and Schizoaffective Disorder: One Condition or Two? Schizophrenia Research: Cognition. June 2019.Mental Health Medications. National Alliance on Mental Illness.Dixon LB, Goldman HH, Srihari VH, Kane JM, et al. Transforming the Treatment of Schizophrenia in the United States: The RAISE Initiative. Annual Review of Clinical Psychology. May 7, 2018.Additional SourcesWhat is Schizophrenia? American Psychiatric Association.Learn about Schizophrenia. Brain and Behavior Research Foundation.Schizophrenia. National Institute of Mental Health.Show Less

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