Schizophrenia Versus Schizoaffective Disorder

Similarities and Differences

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Differentiating between schizophrenia and schizoaffective disorder can be somewhat confusing as on the surface there are many similarities between them, including core psychotic symptoms, such as hallucinations, delusions, or disorganized thinking.

However, from both a medical and scientific research perspective, schizoaffective disorder is seen as a diagnosis different from schizophrenia.

Defining Schizophrenia and Schizoaffective Disorder


Schizophrenia is a mental illness that causes severe psychotic symptoms that interfere with your ability to relate to others, think clearly, take care of yourself, hold down a job, or even be in touch with reality. It's usually difficult to interact with others and the psychotic symptoms tend to cause a lot of confusion. 

Besides psychotic symptoms, such as hallucinations or delusions, people with schizophrenia exhibit a flat affect (not showing much emotion), a paucity of speech, and problems with attention, memory, processing new information, and solving problems. 

Schizoaffective Disorder

Put simply, schizoaffective disorder is a mental health condition in which a person experiences psychotic symptoms of schizophrenia, such as delusions or hallucinations, along with symptoms of a mood disorder, such as depression and/or mania.

There are two types of schizoaffective disorder:

  • Bipolar type: characterized by episodes of mania and sometimes major depression
  • Depressive type: characterized by only episodes of major depression

Core Differences Between Schizophrenia and Schizoaffective Disorder

There are important differences between schizophrenia and schizoaffective disorder, including:

Duration of Mood Episodes

In addition to the psychotic symptoms listed above, people with schizoaffective disorder frequently experience mood episodes of either depression or mania. Moreover, in schizoaffective disorder, the time that a person experiences severe mood symptoms accounts for more than half of the total duration of illness.

On the other hand, with schizophrenia, a person may also experience mood episodes, but the total duration of the mood symptoms is brief compared to the duration of the psychotic symptoms.

Course of the  Psychotic Symptoms

Another key difference is that the psychotic symptoms of schizophrenia tend to be persistent, while in schizoaffective disorder, they tend to come and go.

Furthermore, in terms of the course of the disease, most people who are diagnosed with schizophrenia have a more chronic and persistent course in their illness.

On the other hand, most people diagnosed with schizoaffective disorder experience their illness in episodes. However, this is not a hard and fast rule; in some people, the opposite is true.

Relationship Between Mood Symptoms and Psychotic Symptoms

In schizophrenia, mood symptoms overlap with psychotic symptoms. In other words, the psychotic symptoms are almost always present, but the mood symptoms come and go, whether or not a person is having psychotic symptoms.

In schizoaffective disorder, the psychotic symptoms may be present during the times when a person is also experiencing depression or mania. That said, the diagnosis of schizoaffective disorder requires that the psychotic symptoms be present for a long enough time (at least a couple of weeks) when a person is not experiencing any serious mood symptoms.

Differences in Treatments

The treatment in schizophrenia relies mostly on a special group of medications called antipsychotics. These include older medications such as haloperidol, chlorpromazine, as well as newer medications such as risperidone, olanzapine, ziprasidone, quetiapine, asenapine, or lurasidone.

Maintenance treatment for schizophrenia is almost always an antipsychotic medication.

The treatment for the "affective disorder" part of schizoaffective disorder also includes antipsychotics, mostly during the times when a person is experiencing severe psychotic symptoms. Paliperidone (invega), an antipsychotic, is the only FDA-approved medication to treat schizoaffective disorder.

For their mood symptoms, people with schizoaffective disorder are prescribed antidepressants if they have the depressive type and mood stabilizers, such as valproate or lithium, for the bipolar type.

A Word From Verywell

Keep in mind that schizoaffective disorder is just like schizophrenia except there is a prominent mood component. In other words, schizoaffective disorder is basically schizophrenia with episodes of mania or major depression. 

If you are worried that you or a loved one is experiencing symptoms of schizophrenia or schizoaffective disorder, please seek out help from a healthcare professional. While these disorders are debilitating, with proper treatment, they can be managed. 


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Fischer Ba, Buchanan RW. (2017). Clinical manifestations, course, assessment, and diagnosis. Marder S, ed. UpToDate. Waltham, MA: UpToDate Inc. 

National Alliance on Mental Illness (NAMI).(2017).  Schizoaffective Disorder

National Alliance on Mental Illness (NAMI). (2017). Schizophrenia