Schizophrenia and schizoaffective disorder are closely related but separate mental health conditions. They both feature psychotic symptoms, which can include hallucinations and delusions. They can also impact a person’s daily functioning. These conditions are highly stigmatized and misunderstood. However, this is no reflection on the people who have them. Receiving a diagnosis is a critical step on the way to finding effective treatment. 

People who have these conditions may need support from care teams to overcome treatment barriers. Psychotic symptoms and mood episodes can make it difficult to attend regular sessions. Recognizing symptoms and documenting them is an important part of the process.

In this blog post, we’ll outline the key differences between schizophrenia and schizoaffective disorder.

Key differences between schizoaffective disorder and schizophrenia

Both schizophrenia and schizoaffective disorder involve periods of psychosis. This is defined as a break from reality. People with either condition may experience delusions or strongly held beliefs that aren’t true. Or they might see, hear or feel things that aren’t there. The presence of psychotic symptoms is only one factor in the big picture of a person’s condition. A clinician may need to have an ongoing relationship with a person to know they’re making the right diagnosis.

The following are the biggest differences between schizophrenia and schizoaffective disorder:

• Mood component — Schizoaffective disorder includes significant mood episodes while schizophrenia does not. However, the negative symptoms included in the criteria for schizophrenia can resemble depression. These are “negative” in the sense that a behavior or effect is missing, for instance, emotional blunting and social withdrawal. Depression and schizophrenia also have a high rate of co-occurrence. If a person has mood symptoms most of the time, including episodes of mania or depression, they’re more likely to have schizoaffective disorder. 
• Differences in onset — Symptoms of schizophrenia are usually mild at first and build up over time. However, it can have a faster onset. People often develop these conditions as teens and young adults. Schizophrenia in childhood is rare, but it happens from time to time. There have been very few cases of schizoaffective disorder in children. Most people start showing symptoms between 25 and 35 years of age.
• Differences in duration of symptoms — To have schizoaffective disorder, a person must show mood symptoms during periods of psychosis and at other times. However, they also need to have a two-week period of psychosis with no mood symptoms. When psychotic symptoms and disorganized behavior are more dominant, schizophrenia is more likely. It also requires at least six months of symptoms that are milder than full mood or psychotic episodes. 
• Subtypes — If a person has significant manic or depressive episodes or both, they may have a subtype of schizoaffective disorder. These include bipolar type and depressive type. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) doesn’t include any subtypes of schizophrenia.

Diagnosis and treatment

There are subtle differences in presentations between these two conditions and others. Clinicians must rule out major depressive disorder with psychotic features and other similar conditions. There are established criteria for each, but they have changed over the years. It’s often up to a clinician’s judgment based on their experience. 

These differences are important when considering what types of medications to prescribe. Broadly speaking, the best treatment approaches usually combine psychotherapy and medication. However, people who have certain mood disorders will respond differently to certain medications. For instance, a person who has bipolar disorder may not be able to take some types of antidepressants. Talk with your provider about the risks associated with different medications based on your diagnosis.

Find clinical excellence and compassionate care at Lightfully

Knowing the differences between schizoaffective disorder and schizophrenia can help you have better conversations with care providers. It can help you advocate for yourself or a loved one as well. At Lightfully, we recognize that effective treatment begins with an accurate diagnosis. We also know that each person is much more than their symptoms. Our licensed clinicians get to know our clients as people first. Then they look at the bigger picture of their lives to create personalized, holistic treatment plans.

Are you caring for a loved one who may have schizoaffective disorder or schizophrenia? When you’re ready to learn more about treatment options, reach out to our Admissions Concierge Team. We’ll take the next steps together.