Schizophrenia What Is Schizoaffective Disorder? Includes Mood Symptoms and Psychotic Symptoms By Arlin Cuncic Arlin Cuncic Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." Learn about our editorial process Updated on March 08, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Verywell / JR Bee Table of Contents View All Table of Contents Definition Symptoms Complications Diagnosis Causes Treatment When to Get Help What Is Schizoaffective Disorder? Schizoaffective disorder is a chronic mental health condition that combines symptoms of psychosis (e.g., hallucinations and delusions) with symptoms of mood disorders (e.g., mania and/or depression). Depending on what type of mood symptoms are present, schizoaffective disorder is diagnosed as either bipolar type or depressive type. The prevalence of schizoaffective disorder in the population is believed to be around 0.3%, which is less than for schizophrenia or mood disorders. Research suggests that women are slightly more prone to it, but men tend to develop the disorder at a younger age. It is usually first diagnosed between age 16 and 30 and is rare in children. Individuals with schizoaffective disorder tend to have periods of improvement followed by periods of worsening symptoms. Whether you have been diagnosed with schizoaffective disorder or are worried that someone you know may have this disorder or has been recently diagnosed, it is important to understand the common symptoms, how a diagnosis is made, and how treatment can help to reduce symptoms and improve functioning in daily life. Psychosis vs. Schizophrenia: What Are the Differences? Symptoms of Schizoaffective Disorder Symptoms of schizoaffective disorder tend to be severe and vary for each individual. They can be broadly categorized into depressive symptoms, manic symptoms, and schizophrenia symptoms. Those with bipolar type will experience a manic episode and may also have depressive episodes, while those with the depressive type will only experience the depressive symptoms. Depressive Symptoms Depressive symptoms of schizoaffective disorder may be psychological or physical. Psychological symptoms include: Sadness Feeling worthless Hopelessness Restlessness Lack of energy Loss of interest in usual activities Trouble concentrating Guilt Self-blame Thoughts of death or suicide Physical symptoms can include: Poor appetiteWeight loss or gainSleeping too much or too little Manic Symptoms People with bipolar type schizoaffective disorder may experience mania, which also has both psychological and physical symptoms. Psychological symptoms can include: Risky or self-destructive behavior (e.g., spending sprees, reckless driving, risky sexual practices) Euphoria Irritable mood Racing thoughts Grandiosity Distractibility Physical symptoms may include: Increased energy and/or activity (e.g., at work, socially, sexually)Talking more or faster than usualReduced need for sleep Psychotic Symptoms Like the other groups of symptoms, psychotic symptoms may also be divided into psychological and physical effects. Psychological symptoms can include: Paranoia Delusions Hallucinations Disorganized thinking Impaired communication Lack of emotion in facial expressions and speech (negative symptoms) Low motivation (avolition) Physical symptoms include slow movements or no movement (catatonia) and poor personal hygiene. While the psychotic symptoms listed above describe how schizoaffective disorder appears to an outsider, it is also helpful to learn what these symptoms feel like to a person with the disorder. Disorganized Thinking If you are experiencing disorganized thinking, you may feel like your thoughts are fuzzy or everything feels disconnected. When you speak, you may not be able to remember what you were talking about, so it's hard for people to follow what you say. You may also feel like your thoughts are not within your control. Thinking You Are Being Controlled You may think you are being controlled by outside forces like aliens, God, or the devil. You may feel someone is inserting thoughts into your head or that your thoughts are being removed. You might also feel like others can hear your thoughts or access them. Hallucinations You may hear one or more voices that sound real and seem to come from outside you but that nobody else can hear. You might start to talk to them or do things that they tell you to do. In fact, these voices are created by your brain and are not real. Delusions Delusions are things you believe to be true but that are not thought to be real by everyone else. They may begin all of a sudden or form over time. Sometimes they are related to the voices that you hear and seem to explain them in some way. Most often delusions are paranoid, such that you think people are plotting against you or spying on you. You might choose to avoid those people as it can feel very scary. Suicidal Ideation Suicidal ideation and behavior can also be a problem for some people with schizoaffective disorder. If someone you know is in danger of attempting suicide or harming another person, stay with that person while you call 911 or your local emergency number. The other alternative is to take the person to the nearest hospital emergency room if you believe that you can do so safely. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. For more mental health resources, see our National Helpline Database. Complications of Schizoaffective Disorder There are a number of potential complications of having schizoaffective disorder, including: Health problemsHomelessnessImpaired academic and occupational functioningInterpersonal conflictsPovertySocial isolationSubstance useSuicidal thoughts and attemptsTrouble adhering to treatmentUnemployment Diagnosis of Schizoaffective Disorder Schizoaffective disorder overlaps with other conditions so it can be difficult to diagnose. Sometimes, it is incorrectly diagnosed as simply bipolar disorder or schizophrenia, which is why it is important for mental health professionals to have a full history of symptoms prior to making a diagnosis. The first step in diagnosing schizoaffective disorder may be conducting a physical exam to rule out any potential medical contributions to the symptoms. Depending on the suspected diagnosis, this may mean undergoing blood testing and brain imaging. Next, a psychiatrist or psychologist will conduct a clinical interview to determine whether symptoms meet the criteria outlined in the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-5). This includes a period of major mood disorder (depression or mania) and at least two of the following schizophrenia symptoms (at least one of the first three is required): DelusionsHallucinationsDisorganized speechDisorganized or catatonic behaviorNegative psychotic symptoms In addition, delusions or hallucinations most occur for two or more weeks in the absence of a mood episode. The mood symptoms must also be present for most of the duration of the illness. The Difference Between Schizophrenia and Schizoaffective Disorder Causes of Schizoaffective Disorder Researchers do not know precisely what causes schizoaffective disorder. However, some propose that it can result from a combination of risk factors that affect brain development prenatally and throughout childhood and adolescence. These include: Birth defectsBrain chemistry and structureGeneticsLife stressors (death in family, loss of job, end of marriage)Psychoactive or psychotropic drug useViral infections including while in the womb Related Conditions People with schizoaffective disorder may also live with overlapping disorders such as attention-deficit hyperactivity disorder, post-traumatic stress disorder (PTSD), anxiety disorders, and substance and alcohol use. A co-occurring disorder can exacerbate the symptoms of schizoaffective disorder and make a person less likely to follow their treatment plan. This is why proper diagnosis and integrated treatment is essential when it comes to managing and coping with a dual diagnosis. Schizoaffective disorder is often confused with other mental illnesses, including schizophrenia and bipolar disorder. These are two distinct disorders, however, each with their own diagnostic criteria and treatment. While they do share many symptoms, the main difference is that there is a prominent mood component with schizoaffective disorder. Recap Genetics, brain development, brain chemistry, stress, and substance use may play a role in the development of schizoaffective disorder. It is also common for people with this condition to have co-occurring mental illnesses such as ADHD, anxiety disorders, and PTSD. Treatment of Schizoaffective Disorder Treatment can help people with schizoaffective disorder to live a more fulfilling life. Treatment may come in the form of medication, therapy, or hospitalization, depending on the particular symptoms. Medication Medications such as mood stabilizers (e.g., lithium), antipsychotics (e.g., paliperidone), and antidepressants (e.g., fluoxetine) may be prescribed for different aspects of schizoaffective disorder. Taking antipsychotic medication will help reduce hallucinations and delusions, lessen disorganized thinking, and soothe agitation. It's important for people with schizoaffective disorder to continue taking medication even if they feel well, as these medications help to stabilize symptoms and prevent a recurrence of them. Often, people with schizoaffective disorder need to take medication for the rest of their lives. Therapy Therapy such as cognitive-behavioral therapy (CBT), family therapy, group therapy, or skills training may be used to treat schizoaffective disorder. During therapy, a person with schizoaffective disorder may learn about their illness, set goals, determine how to manage daily issues, develop skills to interact with others, look for a job, and practice life skills like managing finances, home maintenance, and personal grooming. Family members can participate in therapy to learn how best to support their loved ones. The Best Online Therapy Programs We've tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain. Hospitalization In the event of an acute psychotic episode, suicidal ideation, or threats to others, treatment in a hospital may be necessary. There is, unfortunately, no cure for schizoaffective disorder and long-term treatment and management is often required. However, medication and therapy can help to reduce symptom relapse and disruption to a person's life and the lives of those around them. This is why it is important for them to keep in contact with a psychiatrist to ensure that their treatment regimen is optimal. Recap Schizoaffective disorder is a serious and lifelong condition. Effective treatments are available that can help manage symptoms, improve functioning, and foster well-being. In the case of an acute psychotic episode, hospitalization may be necessary. How Schizoaffective Disorder Is Treated When to Get Help If someone you know is displaying symptoms of schizoaffective disorder, it can be hard to know how to help. While you can try to talk to your friend or relative, you also can't force them to seek treatment. Instead, try offering encouragement and practical advice such as looking up numbers of doctors to call or investigating avenues to receive treatment in the community. In addition, people with this disorder may be disconnected from reality. In the event that the person is struggling with basic necessities of life such as food and shelter, or there are imminent safety concerns, you can call 911 and ask to have that person evaluated for treatment. A Word From Verywell If you have been diagnosed with schizoaffective disorder, it is important to learn to notice when your symptoms are worsening and that you may be entering another episode. Not being able to sleep or feelings of paranoia may be one signal that this is happening. In the event you notice symptoms increasing, it is important to reach out for help as soon as possible from your doctor or other mental health professional. 9 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Alliance on Mental Health. Schizoaffective disorder. Perälä J, Suvisaari J, Saarni SI, et al. Lifetime prevalence of psychotic and bipolar I disorders in a general population. Arch Gen Psychiatry. 2007;64(1):19-28. doi:10.1001/archpsyc.64.1.19 Cleveland Clinic. Schizoaffective disorder. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Verma D, Srivastava MK, Singh SK, Bhatia T, Deshpande SN. Lifetime suicide intent, executive function and insight in schizophrenia and schizoaffective disorders. Schizophr Res. 2016;178(1-3):12-16. doi:10.1016/j.schres.2016.08.009 Ayano G, Tesfaw G, Shumet S. The prevalence of schizophrenia and other psychotic disorders among homeless people: a systematic review and meta-analysis. BMC Psychiatry. 2019;19(1):370. doi:10.1186/s12888-019-2361-7 Smith LL, Yan F, Charles M, et al. Exploring the link between substance use and mental health status: what can we learn from the self-medication theory?. J Health Care Poor Underserved. 2017;28(2S):113-131. doi:10.1353/hpu.2017.0056 Hartman LI, Heinrichs RW, Mashhadi F. The continuing story of schizophrenia and schizoaffective disorder: One condition or two?. Schizophr Res Cogn. 2019;16:36-42. doi:10.1016/j.scog.2019.01.001 Miller JN, Black DW. Schizoaffective disorder: A review. Ann Clin Psychiatry. 2019;31(1):47-53. By Arlin Cuncic Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." 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