Table of ContentsView AllTable of ContentsSymptomsSymptoms that Distinguish These Two DisordersCausesTreatmentPrevention

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Table of Contents

Symptoms

Symptoms that Distinguish These Two Disorders

Causes

Treatment

Prevention

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Knowing the differences betweenschizoaffective disordervs.schizophreniacan be difficult, especially since both include the core psychotic symptoms of hallucinations, delusions, and disorganized thinking. However, they are two different disorders, each with its own diagnostic criteria and treatment.

For instance, prominent mood features are required for the diagnosis of schizoaffective disorder but not for the diagnosis of schizophrenia.Learn more about key differences in schizoaffective disorder vs. schizophrenia, including those related to their symptoms, causes, diagnosis, and treatment.

If you are concerned that you may have one of thesepsychological disorders, consult a healthcare provider for appropriate diagnosis and treatment.

Symptoms in Common

In both schizoaffective disorder and schizophrenia, all of the diagnostic criteria for schizophrenia are met and include the followingsymptoms:

Hallucinationsare false sensory perceptions and include hearing voices, seeing images, or feeling sensations that are not there.

Delusionsare false beliefs, such as thinking that people are visiting through time travel or that a person is secretly disguised as someone else.

Disorganized thoughts and speechinclude unusual, illogical, or disconnected thoughts that make it difficult to communicate ideas coherently.

Negative symptoms:things that tend to decrease in someone experiencing a psychotic episode, including lowered feelings of pleasure, flattened emotional responses, withdrawal, and difficulty with self-care.

With each of these disorders, the person also lacks insight into these perceptual problems and false beliefs.

For both conditions, the symptoms also usually begin when a person is between the ages of 16 and 30, and oftentimes, there is a family history of schizophrenia, bipolar disorder, or other illness with psychotic features.

While the differences in symptoms are subtle, there are ways to differentiate between the two disorders.For example:

Symptoms For a Person with Schizoaffective Disorder

Two Subtypes of Schizoaffective Disorder

There are two subtypes of schizoaffective disorder:

Symptoms For a Person with Schizophrenia

Compare and Contrast

SchizophreniaHallucinationsDelusionsFlat affectDisorganized thinkingPsychotic symptom persistenceMood symptoms can co-occur but do not persistSchizoaffectiveHallucinationsDelusionsFlat affectDisorganized thinkingPsychotic symptoms are brief and episodicMood symptoms (depression or mania) are concurrent with and persist throughout the course of the psychotic episode

SchizophreniaHallucinationsDelusionsFlat affectDisorganized thinkingPsychotic symptom persistenceMood symptoms can co-occur but do not persist

Hallucinations

Delusions

Flat affect

Disorganized thinking

Psychotic symptom persistence

Mood symptoms can co-occur but do not persist

SchizoaffectiveHallucinationsDelusionsFlat affectDisorganized thinkingPsychotic symptoms are brief and episodicMood symptoms (depression or mania) are concurrent with and persist throughout the course of the psychotic episode

Psychotic symptoms are brief and episodic

Mood symptoms (depression or mania) are concurrent with and persist throughout the course of the psychotic episode

It is important to note that these two conditions are not the same asschizoid personality disorderorschizotypal disorder, which arepersonality disordersthat also impact thinking and the ability to relate to others.People who have these personality disorders do not have the same degree of psychosis and lack of insight that is characteristic of schizophrenia and schizoaffective disorder.

RecapIn schizophrenia, the psychotic symptoms are almost always present, but the mood symptoms come and go or disappear altogether.In schizoaffective disorder, the psychotic symptoms and mood symptoms come and go together, with the mood symptoms being present the majority of the time alongside the psychotic symptoms. There must also be a period of time where psychotic symptoms are present without any mood symptoms to confirm it is not a mood disorder with psychotic features.

Recap

In schizophrenia, the psychotic symptoms are almost always present, but the mood symptoms come and go or disappear altogether.In schizoaffective disorder, the psychotic symptoms and mood symptoms come and go together, with the mood symptoms being present the majority of the time alongside the psychotic symptoms. There must also be a period of time where psychotic symptoms are present without any mood symptoms to confirm it is not a mood disorder with psychotic features.

In schizophrenia, the psychotic symptoms are almost always present, but the mood symptoms come and go or disappear altogether.

In schizoaffective disorder, the psychotic symptoms and mood symptoms come and go together, with the mood symptoms being present the majority of the time alongside the psychotic symptoms. There must also be a period of time where psychotic symptoms are present without any mood symptoms to confirm it is not a mood disorder with psychotic features.

Researchers do not know exactly what causes schizophrenia or schizoaffective disorder. They believe that there are a number of different factors involved.

Genetics are believed to play a role in increasing a person’s risk for developing either condition. Other factors that appear to play a part in causing schizophrenia are similar to schizoaffective disorder, including differences in brain chemistry and abnormalities in the brain.

For both conditions, environmental factors, includingtrauma,stress, orsubstance use,may trigger the onset of symptoms in people who have a genetic predisposition to the condition.

Causes and Risk Factors of Schizophrenia

It is important to distinguish between these two conditions because treatments for each differ. For example, treatment for mood disorder symptoms is necessary for schizoaffective disorder but might not be necessary for schizophrenia.

Most people who are diagnosed with schizophrenia have a chronic and persistent course of illness. Thetreatment of schizophreniarelies mostly on a special group of prescription medications calledantipsychotics.

These include older antipsychotic medications like Haldol (haloperidol) and Thorazine (chlorpromazine). There are also newer medications including Risperdal (risperidone), Zyprexa (olanzapine), Geodon (ziprasidone), Seroquel (quetiapine), Saphris (asenapine), and Latuda (lurasidone).

Maintenance treatment for schizophrenia almost always includes an antipsychotic medication.

The treatment for the psychotic symptoms of schizoaffective disorder also includes antipsychotics.Paliperidone (Invega), an atypical second-generation antipsychotic, is the only FDA-approved medication indicated to treat schizoaffective disorder, although all the other antipsychotic medications are commonly used.

For mood symptoms, people who have schizoaffective disorder are prescribedantidepressantsif they have the depressive type andmood stabilizers, such as valproate orlithium, if they have the bipolar type.

RecapBoth schizophrenia and schizoaffective disorder are typically treated with antipsychotic medications. Schizoaffective disorder is also treated with antidepressants or mood stabilizers. People who have schizophrenia usually do not need to take mood stabilizers or antidepressants, but sometimes these medications are needed in addition to antipsychotics.

Both schizophrenia and schizoaffective disorder are typically treated with antipsychotic medications. Schizoaffective disorder is also treated with antidepressants or mood stabilizers. People who have schizophrenia usually do not need to take mood stabilizers or antidepressants, but sometimes these medications are needed in addition to antipsychotics.

If a person notices symptoms of psychosis or mood problems, it is important to talk to a healthcare provider to receive an appropriate diagnosis. Prompt treatment can help reduce symptom severity and frequency. It can also minimize the detrimental effects that symptoms may have on a person’s life and relationships.

Psychotherapyandskills trainingcan also be beneficial when used alongside medication. It may help people better understand their symptoms, establish goals, and cope with the daily challenges related to the condition.

Final Thoughts

Living with schizoaffective disorder can be similar to living with schizophrenia, except that there is a prominent mood component with schizoaffective disorder.

If you are worried that you are experiencing symptoms of schizophrenia or schizoaffective disorder or a loved one is having symptoms, seek help from a healthcare professional. While these disorders are serious and can interfere substantially with daily life, they can also be managed with proper treatment.

If you or a loved one are struggling with schizophrenia or schizoaffective disorder, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.

If you or a loved one are struggling with schizophrenia or schizoaffective disorder, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.

For more mental health resources, see ourNational Helpline Database.

Catatonic Symptoms in Schizophrenia and Other Conditions

9 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wilson JE, Nian H, Heckers S.The schizoaffective disorder diagnosis: A conundrum in the clinical setting.Eur Arch Psychiatry Clin Neurosci. 2014;264(1):29-34. doi:10.1007/s00406-013-0410-7American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787National Institute of Mental Health.Schizophrenia.Hartman LI, Heinrichs RW, Mashhadi F.The continuing story of schizophrenia and schizoaffective disorder: One condition or two?Schizophr Res Cogn. 2019;16:36-42. doi:10.1016/j.scog.2019.01.001Muñoz-Negro JE, Ibanez-Casas I, de Portugal E, et al.A dimensional comparison between delusional disorder, schizophrenia and schizoaffective disorder.Schizophr Res. 2015;169(1-3):248-254. doi:10.1016/j.schres.2015.10.039Esterberg ML, Goulding SM, Walker EF.Cluster A personality disorders: Schizotypal, schizoid and paranoid personality disorders in childhood and adolescence.J Psychopathol Behav Assess. 2010;32(4):515-528. doi:10.1007/s10862-010-9183-8John M. Eisenberg Center for Clinical Decisions and Communications Science.Antipsychotic medicines for treating schizophrenia and bipolar disorder. In:Comparative Effectiveness Review Summary Guides for Consumers [Internet].Agency for Healthcare Research and Quality.Greenberg WM, Citrome L.Paliperidone palmitate for schizoaffective disorder: A review of the clinical evidence.Neurol Ther. 2015;4(2):81-91. doi:10.1007/s40120-015-0030-4Correll CU, Detraux J, De Lepeleire J, De Hert M.Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder.World Psychiatry. 2015;14(2):119-136. doi:10.1002/wps.20204

9 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wilson JE, Nian H, Heckers S.The schizoaffective disorder diagnosis: A conundrum in the clinical setting.Eur Arch Psychiatry Clin Neurosci. 2014;264(1):29-34. doi:10.1007/s00406-013-0410-7American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787National Institute of Mental Health.Schizophrenia.Hartman LI, Heinrichs RW, Mashhadi F.The continuing story of schizophrenia and schizoaffective disorder: One condition or two?Schizophr Res Cogn. 2019;16:36-42. doi:10.1016/j.scog.2019.01.001Muñoz-Negro JE, Ibanez-Casas I, de Portugal E, et al.A dimensional comparison between delusional disorder, schizophrenia and schizoaffective disorder.Schizophr Res. 2015;169(1-3):248-254. doi:10.1016/j.schres.2015.10.039Esterberg ML, Goulding SM, Walker EF.Cluster A personality disorders: Schizotypal, schizoid and paranoid personality disorders in childhood and adolescence.J Psychopathol Behav Assess. 2010;32(4):515-528. doi:10.1007/s10862-010-9183-8John M. Eisenberg Center for Clinical Decisions and Communications Science.Antipsychotic medicines for treating schizophrenia and bipolar disorder. In:Comparative Effectiveness Review Summary Guides for Consumers [Internet].Agency for Healthcare Research and Quality.Greenberg WM, Citrome L.Paliperidone palmitate for schizoaffective disorder: A review of the clinical evidence.Neurol Ther. 2015;4(2):81-91. doi:10.1007/s40120-015-0030-4Correll CU, Detraux J, De Lepeleire J, De Hert M.Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder.World Psychiatry. 2015;14(2):119-136. doi:10.1002/wps.20204

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Wilson JE, Nian H, Heckers S.The schizoaffective disorder diagnosis: A conundrum in the clinical setting.Eur Arch Psychiatry Clin Neurosci. 2014;264(1):29-34. doi:10.1007/s00406-013-0410-7American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787National Institute of Mental Health.Schizophrenia.Hartman LI, Heinrichs RW, Mashhadi F.The continuing story of schizophrenia and schizoaffective disorder: One condition or two?Schizophr Res Cogn. 2019;16:36-42. doi:10.1016/j.scog.2019.01.001Muñoz-Negro JE, Ibanez-Casas I, de Portugal E, et al.A dimensional comparison between delusional disorder, schizophrenia and schizoaffective disorder.Schizophr Res. 2015;169(1-3):248-254. doi:10.1016/j.schres.2015.10.039Esterberg ML, Goulding SM, Walker EF.Cluster A personality disorders: Schizotypal, schizoid and paranoid personality disorders in childhood and adolescence.J Psychopathol Behav Assess. 2010;32(4):515-528. doi:10.1007/s10862-010-9183-8John M. Eisenberg Center for Clinical Decisions and Communications Science.Antipsychotic medicines for treating schizophrenia and bipolar disorder. In:Comparative Effectiveness Review Summary Guides for Consumers [Internet].Agency for Healthcare Research and Quality.Greenberg WM, Citrome L.Paliperidone palmitate for schizoaffective disorder: A review of the clinical evidence.Neurol Ther. 2015;4(2):81-91. doi:10.1007/s40120-015-0030-4Correll CU, Detraux J, De Lepeleire J, De Hert M.Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder.World Psychiatry. 2015;14(2):119-136. doi:10.1002/wps.20204

Wilson JE, Nian H, Heckers S.The schizoaffective disorder diagnosis: A conundrum in the clinical setting.Eur Arch Psychiatry Clin Neurosci. 2014;264(1):29-34. doi:10.1007/s00406-013-0410-7

American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR); 2022. doi:10.1176/appi.books.9780890425787

National Institute of Mental Health.Schizophrenia.

Hartman LI, Heinrichs RW, Mashhadi F.The continuing story of schizophrenia and schizoaffective disorder: One condition or two?Schizophr Res Cogn. 2019;16:36-42. doi:10.1016/j.scog.2019.01.001

Muñoz-Negro JE, Ibanez-Casas I, de Portugal E, et al.A dimensional comparison between delusional disorder, schizophrenia and schizoaffective disorder.Schizophr Res. 2015;169(1-3):248-254. doi:10.1016/j.schres.2015.10.039

Esterberg ML, Goulding SM, Walker EF.Cluster A personality disorders: Schizotypal, schizoid and paranoid personality disorders in childhood and adolescence.J Psychopathol Behav Assess. 2010;32(4):515-528. doi:10.1007/s10862-010-9183-8

John M. Eisenberg Center for Clinical Decisions and Communications Science.Antipsychotic medicines for treating schizophrenia and bipolar disorder. In:Comparative Effectiveness Review Summary Guides for Consumers [Internet].Agency for Healthcare Research and Quality.

Greenberg WM, Citrome L.Paliperidone palmitate for schizoaffective disorder: A review of the clinical evidence.Neurol Ther. 2015;4(2):81-91. doi:10.1007/s40120-015-0030-4

Correll CU, Detraux J, De Lepeleire J, De Hert M.Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder.World Psychiatry. 2015;14(2):119-136. doi:10.1002/wps.20204

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