What is schizoaffective disorder?

Schizoaffective disorder is a psychiatric condition. People with this condition experience both psychosis and mood disorders: Psychosis is a loss of contact with reality, and mood disorders may include episodes of mania or depression. Schizoaffective disorder is divided into two subtypes based on the type of mood disorder involved:

  • depressive: involves major depressive episodes only
  • bipolar: involves manic episodes (high energy with extreme elevated, expansive, or irritable mood) with or without depressive episodes

If you have this condition, you may experience symptoms of psychosis and mood disorders together or separately, often in cycles. That means you’ll have periods of improvement followed by symptomatic periods.

Schizoaffective disorder is less common than schizophrenia and mood disorders. Not many studies have been done on the disorder. Estimates suggest that it’s fairly rare and affects less than 1 percent of the population.

Symptoms of schizoaffective disorder can vary greatly. Many people also experience improvements in their symptoms from time to time. Symptoms include:

  • paranoid thoughts
  • delusions
  • hallucinations
  • confusion
  • disorganized thoughts or behaviors
  • catatonia, which is an inability to move normally
  • speaking too quickly
  • depression or irritability
  • hyperactive or manic mood
  • difficulty concentrating
  • changes in appetite
  • thoughts of suicide
  • poor personal hygiene
  • trouble sleeping
  • social isolation

Scientists don’t fully understand what causes schizoaffective disorder. It may be caused by an abnormality in the chemicals in your brain, such as an imbalance in serotonin and dopamine. There also appears to be a genetic link. Other contributing factors may include:

  • environmental factors
  • exposure to viruses or toxins while in the womb
  • birth defects

Some experts believe that schizoaffective disorder is a form of schizophrenia rather than a separate disorder.

To determine if you have schizoaffective disorder, your doctor will give you a physical exam. This may be followed by a psychiatric evaluation.

Physical exam

Your doctor will start by doing a physical exam. That will help them determine if your symptoms are caused by a physical condition. Seizure disorders, for example, can cause symptoms similar to schizoaffective disorder.

Your doctor will also ask you about any drugs you’re taking. Some drugs can cause symptoms that resemble those associated with schizoaffective disorder. These drugs include:

  • steroid medications
  • cocaine
  • amphetamines
  • phencyclidine, or PCP

After a physical cause has been ruled out, your primary care provider may send you to a mental health professional.

Psychiatric evaluation

A mental health professional will interview you to learn more about your symptoms. They’ll ask you about your symptoms and the thoughts that you’re having. You’ll also be asked about your childhood and any history you have with psychiatric disorders. They’ll then use your responses to come up with a diagnosis and treatment plan for you.

Schizoaffective disorder can cause symptoms similar to other psychiatric disorders. That’s why it’s important to receive a diagnosis. Be honest with your mental health professional. Let them know about everything you’re experiencing, even if you think a symptom may be unrelated. They may change a diagnosis of schizophrenia or mood disorder to schizoaffective disorder and vice versa as they gather additional information about your condition.

Your mental health professional will use diagnostic criteria from the 5th edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5). According to the criteria, people with schizoaffective disorder must have an uninterrupted period of illness during which there’s a major mood episode. The mood episode can be either depressive or manic. During this time, you must also have at least two of the following symptoms:

  • delusions
  • hallucinations
  • disorganized speech

Other behaviors during this episode may include grossly disorganized or catatonic behavior, or negative symptoms. Negative symptoms include decreased or absent emotional expression or avolition. Avolition is a severe lack of motivation.

You must also have delusions or hallucinations for two or more weeks during a time when you aren’t experiencing a major mood episode (depressive or manic).

Additionally, symptoms that meet criteria for a major mood episode must be present for the majority of the total duration of the “active” and “residual” phases of the illness. Symptoms also must not be due to the effects of drug abuse, medication, or a general medical condition.

The complications for people with schizoaffective disorder are similar to those for schizophrenia and major mood disorders. They may include:

  • drug abuse
  • difficulty staying on a treatment regimen
  • suicidal behavior
  • manic behaviors such as spending sprees and promiscuity

Treatment can vary. Medications that may be prescribed include:

  • antipsychotics
  • antidepressants
  • mood stabilizers

Therapy may be used to help you manage the symptoms of your disorder. Through therapy, you’ll learn skills to solve problems and improve relationships. All of your sessions will apply to real-life situations. You may also learn:

  • skills to help you find a job and be successful in the workplace
  • how to manage your finances and living situation

Group therapy is another option for people with schizoaffective disorder. A group therapy setting can help increase your social interaction as you learn how to communicate more effectively with others. Group therapy can also help you to more effectively manage symptoms that can’t be completely resolved with medication alone.

If you have schizoaffective disorder, your outlook may be better than the outlook for people with most other psychotic disorders. There’s no cure for schizoaffective disorder, so long-term treatment is required. Many people being treated for schizoaffective disorder are able to live fulfilling lives.

If you think someone is at immediate risk of self-harm or hurting another person:

  • Call 911 or your local emergency number.
  • Stay with the person until help arrives.
  • Remove any guns, knives, medications, or other things that may cause harm.
  • Listen, but don’t judge, argue, threaten, or yell.

If you think someone is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

Sources: National Suicide Prevention Lifeline and Substance Abuse and Mental Health Services Administration