Schizoaffective Disorder: Causes, Signs, Treatment

Medically Reviewed by Jabeen Begum, MD on March 14, 2024
7 min read

Schizoaffective disorder is a chronic mental health condition that involves symptoms of both schizophrenia and a mood disorder like major depressive disorder or bipolar disorder. In fact, many people with schizophrenia are incorrectly diagnosed at first with depression or bipolar disorder.

Scientists don’t know for sure if schizoaffective disorder is related mainly to schizophrenia or a mood disorder. But it’s usually viewed and treated as a combination of both conditions.

Only a tiny number of people get schizoaffective disorder: 0.3% of the population. People assigned female at birth are more likely to get the condition, but those assigned male may have it at a younger age. Doctors can help manage it, but most people diagnosed with it have relapses. People who have it often have problems with substance use as well.


There are two types. Each has some schizophrenia symptoms:

  • Schizoaffective disorder bipolar type: Episodes of mania (extreme highs) and sometimes major depression (severe lows). There may also be times when you have a boost in energy, and you're more cranky; then you'll be sad and have low energy. 
  • Schizoaffective disorder depressive type: Only major depressive episodes (depression). You may have a hard time finishing daily tasks and could also feel hopeless.

Schizoaffective disorder is almost a blend of the symptoms of schizophrenia and bipolar disorder. In bipolar disorder, you have mood swings that include depression and mania. If you have schizoaffective disorder, you can have these bipolar symptoms. But separate from those, you also get psychotic symptoms similar to schizophrenia for at least 2 weeks at a time. 

The symptoms can vary greatly from person to person and can be mild or severe. They may include:

  • Delusions: False, sometimes strange beliefs that the person refuses to give up, even when they get the facts
  • Depression symptoms: Feeling empty, sad, or worthless, having a poor appetite, losing or gaining weight, or sleeping too much or too little
  • Hallucinations: Sensing things that aren't real, such as hearing voices
  • Trouble keeping up with hygiene: Not staying clean or keeping up appearance
  • Mania or sudden, out-of-character jumps in energy levels or happiness, racing thoughts, talking more or faster than usual, a decreased need for sleep, or risky behavior
  • Problems with speech and communication, only giving partial answers to questions, or giving unrelated answers (The doctor may call this disorganized thinking.)
  • Trouble at work, school, or in social settings

If you're having suicidal thoughts, get help right away. Call your doctor or the Suicide and Crisis Lifeline at 988. You can talk to someone anytime. Call 911 if you or a loved one is in immediate danger.


Scientists don’t know the exact cause. Risk factors for schizoaffective disorder include:

Genetics. You may inherit a tendency to get features linked to schizoaffective disorder from your parents.

Brain chemistry and structure. If you have schizophrenia and mood disorders, you might have problems with brain circuits that manage mood and thinking. Schizophrenia is also tied to lower levels of dopamine, a brain chemical that also helps manage these tasks.

Environment. Some scientists think things like viral infections or highly stressful situations could play a part in getting schizoaffective disorder if you’re at risk for it. How that happens isn’t clear.

Drug use. Taking mind-altering drugs (Your doctor may call them psychoactive or psychotropic drugs.)

Schizoaffective disorder usually begins in the late teen years or early adulthood, often between ages 16 and 30. It seems to happen slightly more often in people assigned female at birth. It's rare in children.

Because schizoaffective disorder combines symptoms that reflect two mental illnesses, it’s easily confused with other psychotic or mood disorders. Some doctors may diagnose schizophrenia. Others may think it’s a mood disorder. As a result, it’s hard to know how many people actually have schizoaffective disorder. It’s probably less common than either schizophrenia or mood disorders alone.

There are no laboratory tests to specifically diagnose schizoaffective disorder, so doctors rely on your medical history and your answers to certain questions. (Doctors call this the clinical interview.) They also use various tests, such as brain imaging (like MRI scans) and blood tests, to make sure that another type of illness or drug isn't causing your symptoms.

If the doctor finds no physical cause, they may refer you to a psychiatrist or psychologist. These mental health professionals are trained to diagnose and treat mental illnesses. They use specially designed interview and assessment tools to evaluate a person for a psychotic disorder.

In order to get diagnosed with schizoaffective disorder, you must have:

  • Periods of uninterrupted illness
  • An episode of mania, major depression, or a mix of both
  • Symptoms of schizophrenia
  • At least two periods of psychotic symptoms, each lasting 2 weeks. One of the episodes must happen without depressive or manic symptoms.


Treatment includes:

Schizoaffective disorder drugs

What you take depends on whether you have symptoms of depression or bipolar disorder, along with symptoms that suggest schizophrenia. 

Antipsychotics. The main medications that doctors prescribe for psychotic symptoms, such as delusions, hallucinations, and disordered thinking, are called antipsychotics. All these drugs can probably help with schizoaffective disorder, but paliperidone extended-release (Invega) is the only drug that the FDA has approved to treat it. 

Antidepressants or mood stabilizers. For mood-related symptoms, you might take an antidepressant medication or a mood stabilizer, like lithium (Eskalith).

Schizoaffective disorder therapy

Psychotherapy. The goal of this type of counseling is to help you learn about your illness, set goals, and manage everyday problems related to the disorder. Family therapy can help families get better at relating to and helping a loved one who has schizoaffective disorder.

Other therapies

Skills training. This generally focuses on work and social skills, grooming and self-care, and other day-to-day activities, including money and home management.

Hospitalization. Psychotic episodes may require a hospital stay, especially if you’re suicidal or threaten to hurt others.

Electroconvulsive therapy. This treatment may be an option for adults who don’t respond to psychotherapy or medications. It involves sending a quick electric current through your brain. (You’ll get a type of medicine called general anesthesia to help you sleep through it.) It causes a brief seizure. Doctors use it because they think it changes your brain chemistry and may reverse some conditions.

This condition may raise your risk of:

  • Alcohol or other substance abuse problems
  • Anxiety disorders
  • Conflict with family, friends, co-workers, and otherss
  • Poverty and homelessness
  • Significant health problems
  • Social isolation
  • Suicide, suicide attempts, or suicidal thoughts
  • Unemployment
  • Putting yourself in risky situations


You can’t prevent the condition. But if you’re diagnosed and start treatment as soon as possible, it can help you avoid or ease frequent relapses and hospitalizations and help cut the disruptions in your life, family, and friendships.

Schizoaffective disorder is a condition that needs consistent care and help. People with this disorder can benefit from a few things:

Understand the disorder. Learning about schizoaffective disorder can help you maintain your treatment plan and help friends and family understand what you're going through.

Watch for warning signs. Recognize things that might worsen symptoms or stop daily activities. Figure out ahead of time what you'll do if symptoms come back. Contact your doctor or therapist if it feels like things are getting worse.

Join a support group. Being part of a support group can connect you with others with similar challenges. It can also help family and friends cope with your illness.

Ask about social services. Services are available that can help with things like finding affordable housing, transportation, and daily activities.

Avoid drugs, tobacco, and alcohol. These substances can make schizoaffective symptoms worse or hinder medications. If you have a problem with substance misuse, get the proper treatment for it.

How can I help someone with schizoaffective disorder?

To support a loved one, learn about the condition, including symptoms and treatment. Then, find out how to help them if you're concerned about their mental state, including calling their doctor or therapist. Ask your loved one if they have a crisis plan. If they don't, offer to help make one.



Schizoaffective disorder has the features of schizophrenia, like hallucinations, delusions, and disorganized thinking, along with those of a mood disorder, like mania and depression. At first, it’s often misdiagnosed as one of the two.

As a result, schizoaffective disorder treatment often pairs antipsychotics with antidepressants, while schizophrenia treatment centers on antipsychotics. Both conditions rely on therapy.

Schizoaffective disorder is an ongoing mental health condition combining symptoms of schizophrenia and mood disorders. Its causes are unclear but likely involve genetic, brain chemistry, environmental, and substance use factors, with symptoms typically emerging in late teens to early adulthood. Treatment involves a combination of medication, psychotherapy, skills training, and sometimes hospital stays or electroconvulsive therapy to manage symptoms and prevent complications like substance abuse and social isolation.

What is the life expectancy of someone with schizoaffective disorder?
One study looked at the life expectancy of people with serious mental illnesses like schizoaffective disorder, schizophrenia, and bipolar disorder. Over the period of a decade, life expectancy increased for both men and women with these conditions. But it's still lower than the general population at around 65 years old for men and 69 for women.