Schizophrenia vs. Schizoaffective Disorder

If you have schizophrenia, you may hear voices that aren't real and see things that don't exist. Schizoaffective disorder is a condition that can make you feel detached from reality and can affect your mood.

These two disorders have some things in common. But there are important differences that affect your everyday life and the treatment you get.

Causes

While doctors have studied schizophrenia for years, they still don't know exactly what causes it. Problems with brain chemicals like glutamate and dopamine may play a role. Doctors have also noticed that people with schizophrenia have physical brain differences from others.

There are other things that may also raise your chances of getting schizophrenia. If you take mind-altering drugs, for example, it can bring on some symptoms. You may be more likely to get the illness if your father was older when you were born, or if your mother had contact with certain viruses while she was pregnant, such as influenza.

Researchers have not studied schizoaffective disorder as long as schizophrenia, but they have some clues about what's going on. Genes that control your body's sleep-wake rhythms may contribute to schizoaffective disorder.

Things that are going on in your life may also play a role, such as stressful events. You may also have greater chances of schizoaffective disorder if you have another mental illness or if you have had developmental delays.

Your risk of both schizophrenia and schizoaffective disorder is greater if you have a close relative with it, like a mother, father, brother, or sister.

Symptoms

If you have schizophrenia, you have symptoms that doctors call "psychotic," which means you lose touch with reality. You will see and hear things that aren't real, called hallucinations. You may also have delusions, which means you believe things that aren't true.

Schizoaffective disorder is a little different. It's almost a blend of the symptoms of schizophrenia and another mental health condition called 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.

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Diagnosis

Doctors often diagnose schizophrenia and schizoaffective disorder by checking your symptoms. They may decide you have schizophrenia if you have at least two of these:

  • Hallucinations
  • Delusions
  • Confused speech or thinking
  • Unusual body movements
  • What doctors call "negative" symptoms, such as lack of emotion or withdrawal from social activities

Doctors sometimes find it tricky to diagnose schizoaffective disorder because it combines symptoms of other illnesses. Your doctor will likely say you have schizoaffective disorder if these things are happening to you:

  • Mood problems like depression or mania that happen at the same time as schizophrenia symptoms
  • Delusions or hallucinations for at least 2 weeks that show up without mood disorder symptoms
  • Symptoms of a mood disorder on a regular basis

There are two main types of schizoaffective disorder, depressive type and bipolar type. Your doctor may diagnose you with one of these types based on the kind of mood symptoms you have.

Treatment

Doctors often treat schizophrenia with antipsychotic drugs that help manage delusions and hallucinations. These may be older antipsychotics, like chlorpromazine (Thorazine) or haloperidol (Haldol), or newer antipsychotics, like olanzapine (Zyprexa) or risperidone (Risperdal). Newer antipsychotics often have fewer side effects.

People with schizoaffective disorder often improve on antipsychotics as well. But your doctor may also prescribe a mood stabilizer, such as lithium (Eskalith), to manage your mood symptoms.

Whether you have schizophrenia or schizoaffective disorder, you can benefit from regular talk therapy. During therapy sessions, you may learn strategies to pursue your goals or deal with unwanted thoughts and mood changes.

Everyday Life

Without treatment, both schizophrenia and schizoaffective disorder can cause you to struggle at school, on the job, or at social events. The psychotic symptoms of both disorders, as well as the mood symptoms of schizoaffective disorder, may make you want to withdraw from daily life. But with the right medicine and talk therapy, you can learn to manage your illness.

WebMD Medical Reference Reviewed by Smitha Bhandari, MD on February 21, 2019

Sources

SOURCES:

Mayo Clinic: "Schizophrenia," "Schizoaffective Disorder."

National Institutes of Health: "Schizoaffective Disorder," "Schizophrenia."

National Alliance on Mental Illness: "Mental Health By the Numbers," "Mental Health Medications."

Journal of Psychiatry and Neuroscience: "Maternal Infection During Pregnancy and Schizophrenia."

Ohio Hospital for Psychiatry: "Schizoaffective Disorder."

Schizophrenia Bulletin: "Familial Aggregation and Heritability of Schizophrenia and Co-aggregation of Psychiatric Illnesses in Affected Families."

Cleveland Clinic: "What Is Schizoaffective Disorder (and How Is It Different From Schizophrenia)?"

DSM-5: "Schizoaffective Disorder Diagnostic Criteria," "Schizophrenia Diagnostic Criteria."

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