Understanding Schizophrenia vs. Schizoaffective Disorder

Schizophrenia and schizoaffective disorder are two different mental disorders. They share many common psychotic symptoms but there are subtle differences. The treatment and outlook for schizophrenia vs schizoaffective disorder varies, so it is important to distinguish between them. Please continue reading to learn more about these mental health conditions.

Are schizophrenia and schizoaffective the same?

No, as mentioned above, schizophrenia and schizoaffective disorder are two different psychotic disorders as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Schizophrenia is a chronic mental health condition that affects less than 1% of people in the United States. It is characterized by a range of psychotic symptoms such as delusions and hallucinations. While there is no cure for schizophrenia, most symptoms can be significantly improved with treatment.

Schizoaffective disorder is also a chronic mental health condition with a prevalence rate of around 0.3%. In this disorder, there are schizophrenia symptoms and also mood symptoms. Indeed, many people with schizoaffective disorder are initially incorrectly diagnosed with schizophrenia or bipolar disorder. Like schizophrenia, schizoaffective disorder can be effectively managed with proper treatment including therapy and medications.

Both conditions occur due to chemical imbalances in the brain. The symptoms typically start when a person is in their early 20s. Men and women are equally affected but the symptoms tend to start earlier in men. There is often a family history of mental health conditions in affected individuals.

What are the psychotic symptoms in schizophrenia?

The most common psychotic symptoms seen in people with schizophrenia include delusions (beliefs that are clearly false) and hallucinations (seeing, hearing, or feeling things that are not there). Other symptoms of schizophrenia can include incoherent speech, disorganized thinking, disorganized behavior, and lack of motivation. Schizophrenia symptoms may also include a flat affect (not showing any emotion), speaking less, and having problems with memory, attention, processing new information, and problem-solving.

How does a schizoaffective person act?

A person with schizoaffective disorder can experience a wide variety of negative symptoms that affect all aspects of their life, including daily living, self-care including grooming and hygiene, social relationships, and work. The following symptoms of schizoaffective disorder are similar to symptoms of schizophrenia:

Delusions (false beliefs, difficulty telling the difference between reality and fantasy)
Hallucinations (unusual sensory experiences)
Disorganized thinking
Disorganized speech
Low motivation
Poor attention
Problems with memory, problem-solving, and processing new information
Inability to experience pleasure

Additionally, people with schizoaffective disorder generally exhibit mood disorder symptoms, most commonly major depression or mania. Some people can have mood swings, alternating between major depressive episodes and manic episodes, similar to what is seen in bipolar disorder.

What are the major differences between schizophrenia and

schizoaffective disorder?

The main difference between the two disorders--schizoaffective disorder and schizophrenia--is that people with schizoaffective disorder have symptoms of both schizophrenia and mood disorders. Based on the type of mood symptoms, schizoaffective disorder is classified as:

Depressive type: This is characterized by a depressed mood without mania.
Bipolar type: This is characterized by mood episodes alternating between major depression and mania.

Another difference between the two disorders is that the psychotic symptoms of schizophrenia tend to be chronic and persistent, whereas the symptoms of schizoaffective disorder are episodic (the symptoms come and go with some symptom-free intervals in between).

Keep in mind that these are not hard and fast rules. There are many similarities between schizophrenia and schizoaffective disorder. For instance, a person with schizophrenia may experience a major mood episode. However, it is only called schizoaffective disorder when there’s a major mood disorder diagnosed and mood symptoms are present most of the time. A person with schizoaffective disorder may not have psychotic symptoms while they’re experiencing a major mood episode. However, psychotic symptoms are almost always present in people with schizophrenia, even as mood symptoms come and go.

How do doctors arrive at a schizophrenia diagnosis or

schizoaffective disorder diagnosis?

Mental health professionals diagnose schizoaffective disorder or schizophrenia based on interviews with the patient and family members. The interview helps determine whether a person is experiencing the specific symptoms of these two disorders and whether the symptoms have been present long enough to meet the diagnostic criteria.

The presence and duration of mood symptoms differentiate between schizoaffective disorder vs. schizophrenia.

Psychiatrists and other mental health professionals also rule out other causes that can lead to similar symptoms, such as a brain tumor or illicit drug use.

Treatment for schizophrenia or schizoaffective disorder

There are several effective treatment options for both schizophrenia and schizoaffective disorder.

The treatment for schizophrenia mainly consists of antipsychotic medications such as haloperidol (Haldol), chlorpromazine (Thorazine), risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), ziprasidone (Geodon), lurasidone (Latuda), and asenapine (Saphris).

The treatment for schizoaffective disorder consists of these same antipsychotic medications. The FDA has also approved an antipsychotic medication called paliperidone (Invega) to treat schizoaffective disorder along with mood stabilizers and antidepressants.

While people with schizophrenia and schizoaffective disorder may require lifelong treatment, it is possible to manage these two disorders with treatment regimens that include medications and therapy, including family therapy.

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