Schizoaffective Disorder: Symptoms, Causes, Diagnosis, Treatment, and Prevention
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Schizoaffective Disorder

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Updated on November 19, 2024
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Overview

What Is Schizoaffective Disorder?

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.

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.

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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:

  • 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:

  • Hallucinations Seeing or hearing things that no one else can see or hear
  • Delusions False, sometimes paranoid beliefs regardless of evidence that disproves those beliefs
  • Disorganized or Illogical Thinking A disturbance in thoughts that affects language and communication
  • 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
  • Strange or Unusual Behaviors
  • Difficulty Maintaining Self-Care or Personal Hygiene
  • Trouble Functioning in School, Work, or Social Situations
  • Suicidal Thoughts or Behaviors
Illustrative graphic titled Types of Schizoaffective Disorder Symptom shows hallucinations, delusions, disorganized thinking, depressive episodes and manic episodes. Everyday Health logo
These, among others, are potential symptoms of schizoaffective disorder.Everyday Health

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:

  • 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 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. You’ll also likely 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.

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.

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.

Treatments and Medication Options for Schizoaffective Disorder

Can Schizoaffective Disorder Be Cured?

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.

Schizoaffective disorder is treated with a combination of medication, psychotherapy (talking with a professional therapist), and lifestyle strategies.

Medication Options

Medication for schizoaffective disorder depends on the symptoms someone is experiencing (depressive or bipolar) and severity.

 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:

  • Antipsychotic Drugs These medicines are prescribed to help reduce symptoms such as hallucinations or delusions.
  • Antidepressants These drugs can help lessen symptoms of depression like 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.

Psychotherapy

Common types of psychotherapy for schizoaffective disorder 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

Life skills training is another intervention that can help people manage schizoaffective disorder. Types of life skills training 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 the 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 maintain employment and function better in their communities.

Hospitalization

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.

Coordinated Specialty Care

Coordinated specialty care can also be helpful for schizophrenia spectrum disorders like schizoaffective disorder. This team-based approach to treatment involves meetings with a coordinated care team including clinicians, therapists, and case workers, as well as antipsychotics and other medication.

Electroconvulsive Therapy

If medication or psychotherapy don’t improve your symptoms enough, your doctor may recommend electroconvulsive therapy (ECT). During an ECT session, you’ll be given general anesthesia so that you’re asleep during the session. Then, electrical currents will be passed through your brain to cause a brief, therapeutic seizure that usually lasts one to two minutes. This is thought to lead to changes in the brain that ease the symptoms of schizoaffective disorder.

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 help prevent your symptoms from getting worse.

Lifestyle Changes for Schizoaffective Disorder

Along with medication, psychotherapy, and life skills training, certain self-care and lifestyle strategies can help people with schizoaffective disorder manage their symptoms:

  • Prioritize getting enough sleep each night
  • Avoid drugs and alcohol, which can worsen symptoms
  • Find relaxation and stress management strategies that work for you, such as yoga or meditation
  • Find a support group that allows you to connect with others experiencing similar challenges
  • Ask your treatment team about social services assistance for help with things like daily activities, transportation, and affordable housing

How Long Does Schizoaffective Disorder Last?

As mentioned, schizoaffective disorder is considered a lifelong condition with no cure, but it can be well-managed with proper treatment. Getting the right treatment can help you keep your symptoms at bay and live well with the disorder.

Complications of Schizoaffective Disorder

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

  • Anxiety disorders
  • Alcohol or substance use issues
  • Episodes of aggression, though people with schizoaffective disorder are more likely to be assaulted than assault others
  • Increased risk of being assaulted
  • Family and relationship conflicts
  • Medical conditions like heart disease, obesity, or stroke
  • Social withdrawal
  • Suicidal thoughts or behaviors
  • Unemployment, poverty, or homelessness

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.

 That’s about 3 in every 1,000 people. 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 their late teens or early adulthood, but rarely it can begin as early as one’s childhood or after age 50.

 Schizoaffective disorder happens at the same rate in both men and women, but men often develop the disorder at an earlier age than women.

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.

Support for Schizoaffective Disorder

National Alliance on Mental Illness

NAMI, a national grassroots mental health organization, offers education, advocacy, support, and public awareness to help improve the lives of people and families affected by mental health conditions like schizoaffective disorder. Whether you have this condition or you’re helping a loved one who has it, NAMI provides resources and support to those who need it. You can reach the NAMI HelpLine at 800-950-NAMI (6264) or info@nami.org.

Schizophrenia & Psychosis Action Alliance

S&PAA aims to support people with schizophrenia and psychosis spectrum disorders like schizoaffective disorder and effect systemic change for those living with these conditions. The nonprofit offers support groups for people with schizophrenia, as well as caregivers and families.

Students With Psychosis

Students With Psychosis, which was first founded as a club at Penn State University, is a nonprofit that aims to empower students with psychosis and advocates through collaboration and community-building. There are several ways to stay up to date with Students With Psychosis and connect with others, including a monthly newsletter, a yearly conference, and podcasts.

The Takeaway

  • Schizoaffective disorder is a rare mental health condition that combines features of schizophrenia and a mood disorder like depression or bipolar disorder.
  • People with this condition may experience both symptoms of schizophrenia, such as hallucinations and delusions, as well as symptoms of mania or depression.
  • Although the condition isn’t curable, effective treatments like medication, talk therapy, and life skills training can help people with schizoaffective disorder live well.

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.
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.
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.

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Angela D. Harper, MD

Medical Reviewer
Castle Connolly Top Doctor

Angela D. Harper, MD, is in private practice at Columbia Psychiatric Associates in South Carolina, where she provides evaluations, medication management, and psychotherapy for adults.  

A distinguished fellow of the American Psychiatric Association, Dr. Harper has worked as a psychiatrist throughout her career, serving a large number of patients in various settings, including a psychiatric hospital on the inpatient psychiatric and addiction units, a community mental health center, and a 350-bed nursing home and rehab facility. She has provided legal case consultation for a number of attorneys.

Harper graduated magna cum laude from Furman University with a bachelor's degree and cum laude from the University of South Carolina School of Medicine, where she also completed her residency in adult psychiatry. During residency, she won numerous awards, including the Laughlin Fellowship from the American College of Psychiatrists, the Ginsberg Fellowship from the American Association of Directors of Psychiatric Residency Training, and resident of the year and resident medical student teacher of the year. She was also the member-in-training trustee to the American Psychiatric Association board of trustees during her last two years of residency training.

Harper volunteered for a five-year term on her medical school's admission committee, has given numerous presentations, and has taught medical students and residents. She currently supervises a nurse practitioner. She is passionate about volunteering for the state medical board's medical disciplinary commission, on which she has served since 2015.

She and her husband are avid travelers and have been to over 55 countries and territories.

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Lindsey Konkel

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Lindsey Konkel is an award-winning freelance journalist with more than 10 years of experience covering health, science, and the environment. Her work has appeared online and in print for Newsweek, National Geographic, Huffington Post, Consumer Reports, Everyday Health, Science, Environmental Health Perspectives, UCSF Magazine, American Association for Cancer Research, and others.

She previously worked as an editor and staff writer at Environmental Health News. She holds a master’s degree in journalism from NYU’s Science, Health and Environmental Reporting Program and a bachelor’s degree in biology from College of the Holy Cross.

Konkel lives in Haddon Township, New Jersey, with her husband, daughter, three cats, and dog. When she isn't writing, she handles social media and content marketing for a small veterinary clinic she started with her husband, Neabore Veterinary Clinic.

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Resources
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