What Is Schizoaffective Disorder? Symptoms, Causes, Diagnosis, Treatment, and Prevention

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Schizoaffective disorder is a rare mental illness that can have different effects on different people.Thais Ramos Varela/Stocksy

Schizoaffective disorder is a rare but serious mental health condition. It acts like a combination of related conditions: schizophrenia and either depression or bipolar disorder, according to the National Alliance on Mental Illness (NAMI).

People with schizoaffective disorder experience symptoms that resemble both schizophrenia (such as hallucinations or delusions) and mood episodes (such as a manic or depressive episode).

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, per NAMI.

Signs and Symptoms of Schizoaffective Disorder

Schizoaffective disorder affects each person differently. Some people experience cycles of severe symptoms followed by periods of improvement.

The condition has two types, per Mayo Clinic:

  • Bipolar Type This type of schizoaffective disorder involves episodes of mania and sometimes major depression.
  • Depressive Type This type of schizoaffective disorder involves only episodes of major depression.

Symptoms may include the following, according to NAMI:

  • 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, and jumbled speech
  • 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 behaviors

Common Questions & Answers

What are the key features of schizoaffective disorder?
Schizoaffective disorder acts like a combination of schizophrenia and either depression or bipolar disorder. People with this condition experience hallucinations and delusions, as well as mood episodes such as mania or depression.
What are the warning signs of schizoaffective disorder?
Hallucinations (seeing or hearing things that aren’t there), delusions (false beliefs), illogical thinking, mania, depression, and suicidal thoughts or behaviors can all be signs of schizoaffective disorder.
How treatable is schizoaffective disorder?
Although there’s no cure for schizoaffective disorder, treatments including psychotherapy and medication can help people manage their symptoms and live well with the condition.

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, per NAMI:

  • Genetics If you have a parent or sibling with schizoaffective disorder, you are more likely to develop the condition.
  • Brain Structure and Chemistry People with schizoaffective disorder may have certain differences in brain function.
  • Mind-Altering Drug Use Some drugs, including cannabis and psychoactive drugs such as LSD, have been linked to the development of schizoaffective disorder.
  • Stress Distressing events such as the end of a marriage, job loss, or a death in the family can trigger this condition.

How Is Schizoaffective Disorder Diagnosed?

Your healthcare provider will perform a health exam if they suspect you have schizoaffective disorder, according to MedlinePlus. You’ll also be referred to a psychiatrist for an evaluation.

Your provider may run some tests to rule out medical or drug-related conditions that could cause similar symptoms, such as seizure disorders or use of cocaine, amphetamines, phencyclidine, or steroid medicines, per MedlinePlus.

In the past, diagnosing schizoaffective disorder may have been a less precise process than it is today. In 2013, the American Psychiatric Association revised its guidelines — now known as the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) — to give mental health professionals 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 health providers 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, according to research published in March 2023 in StatPearls.

To be diagnosed with 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, according to StatPearls. In addition, mood episodes must be present during most of your illness.

Duration of Schizoaffective Disorder

Schizoaffective disorder is considered a lifelong condition with no cure, but it can be well-managed with proper treatment, according to Cleveland Clinic. Getting the right treatment can help you keep your symptoms at bay and live a productive, fulfilling life with the disorder.

Treatments and Medication Options for Schizoaffective Disorder

There is no cure for schizoaffective disorder, but people with the condition can manage and minimize their symptoms with proper treatment. People with schizoaffective disorder have better odds of returning to their previous level of function than people with other types of psychotic disorders, per MedlinePlus.

Schizoaffective disorder is treated with a combination of medication and psychotherapy (talking with a professional therapist), according to NAMI.

Medication for schizoaffective disorder depends on the symptoms someone is experiencing (depressive or bipolar) and severity, NAMI states. 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, according to Mayo Clinic:

  • Antipsychotic Drugs These medicines are prescribed to help reduce symptoms such as hallucinations or delusions.
  • Antidepressants These drugs can help lessen feelings of sadness or emptiness, as well as issues with concentration or sleep.
  • Mood Stabilizers These drugs help even out the “highs” and “lows” that are characteristic of bipolar disorder.

Common types of psychotherapy for schizoaffective disorder, per Mayo Clinic, include:

  • Individual Therapy This involves seeing a professional therapist one on one to develop coping strategies for certain symptoms.
  • Group Therapy These are therapy sessions led by professional therapists that happen in safe environments where you can interact with people who are going through the same things as you.
  • 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 develop problem-solving skills and coping strategies.

Life skills training is another intervention that can help people manage schizoaffective disorder. Types of life skills training, per Mayo Clinic, include:

  • Social Skills Training This form of training helps people develop and practice communication skills and new behaviors that allow them to feel comfortable in workplace and social situations.
  • Vocational Rehabilitation and Supported Employment These programs can include job training and counseling, and teach strategies that help people with schizoaffective disorder find and keep jobs and function better in their communities.

If someone with schizoaffective disorder is in crisis or experiencing severe symptoms, they may need to be temporarily hospitalized to ensure their safety and help them care for themselves, according to the Mayo Clinic.

Coordinated specialty care can also be helpful for schizoaffective disorder. This team-based approach to treatment involves meetings with a coordinated care team including clinicians, therapists, and case workers, as well as low doses of antipsychotics and other medication, according to research.

Prevention of Schizoaffective Disorder

Schizoaffective disorder isn’t preventable, but early diagnosis and treatment can improve your odds of living well with the condition and lower your risk of frequent relapses or hospitalizations, according to Cleveland Clinic.

Complications of Schizoaffective Disorder

If it's not properly treated, schizoaffective disorder can lead to the following complications, according to Mayo Clinic:

  • Anxiety disorders
  • Alcohol or substance use issues
  • Social withdrawal
  • Family and relationship conflicts
  • Unemployment, poverty, or homelessness
  • Suicidal thoughts or behaviors

Research and Statistics: Who Has Schizoaffective Disorder

Schizoaffective disorder is a rare condition, affecting an estimated 0.32 percent to 1.1 percent of people, according to research pubilshed in BMJ Best Practice. That’s about 3 in every 1,000 people, per Cleveland Clinic. This number may not be totally accurate because schizoaffective disorder is challenging to diagnose and is sometimes misdiagnosed as other conditions, such as schizophrenia or depression.

People typically develop the disorder in early adulthood, but it can begin as early as one’s teen years or even late in life, according to the American Psychiatric Association. Schizoaffective disorder happens at the same rate in both men and women, but men often develop the disorder at an earlier age than women, NAMI states.

Conditions Related to Schizoaffective Disorder

The symptoms of schizoaffective disorder can overlap with those of other conditions, including:

  • Schizophrenia As mentioned earlier, schizophrenia is very similar to schizoaffective disorder because the two conditions share symptoms like hallucinations and delusions.
  • Bipolar Disorder or Depression With Psychotic Features Some people only experience psychotic symptoms during a disturbance in mood. In these instances, doctors diagnose bipolar disorder or depression with psychotic features, according to the DSM-5. The difference is slight, but it can affect the type of medication used during treatment.
  • Post-Traumatic Stress Disorder (PTSD) With Psychosis People with 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. It can be difficult to distinguish between these flashbacks and true hallucinations, according to a review published in May 2015 in Current Opinion in Psychiatry.

Resources We Love

American Psychiatric Association (APA)

APA is a national group of psychiatrists considered to be the premier psychiatric organization in the United States. It provides reliable information about the diagnosis and treatment of conditions like schizoaffective disorder. If you need to find a psychiatrist, APA offers a “Find a Psychiatrist” directory to help you find one near you.

American Psychological Association (APA)

APA is a scientific group representing psychologists in the United States. If you need to find a psychologist or licensed therapist near you, consider using the APA’s “Psychologist Locator” tool.

Mayo Clinic

Mayo Clinic is a top U.S. hospital offers helpful educational information about the prevalence, symptoms, and treatment of many health conditions, including schizoaffective disorder. You can request an appointment on the Mayo website if you’d like to be seen by a provider at Mayo Clinic.

National Alliance on Mental Illness (NAMI)

NAMI provides trustworthy information about the diagnosis and treatment of schizoaffective disorder, as well as support groups for people with the condition and their loved ones.

Additional reporting by Christina Vogt.

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