What are the differences between schizophrenia and schizoaffective disorder?

Schizoaffective disorder and schizophrenia are two mental health conditions that fall into the category of psychotic disorders. This means they can both cause psychotic symptoms like hallucinations, delusions, and unusual behavior. Sometimes, even experts have trouble telling the difference between these two conditions because they share so many common characteristics. 

However, there’s a key difference between schizophrenia and schizoaffective disorder. While they both cause abnormal thought and behavior patterns, schizoaffective disorder also includes symptoms of a mood disorder. By learning more about this distinction, you can help break down misconceptions and make sure you or your loved ones get the right kind of care.

What is schizophrenia?

Schizophrenia is a serious, long-term mental health condition that affects how a person sees themselves and the world. It can make it difficult for people to think clearly, connect with others, and regulate their emotions. 

People living with schizophrenia experience symptoms that can make it difficult to tell what is real and what is not. This may include visual or auditory hallucinations or delusional thinking. In other words, people with unmanaged schizophrenia often see and hear things that aren’t really there. 

They may also have false, often paranoid thoughts despite there being no evidence that what they believe is true. This type of thinking can cause problems with focus and concentration and make it difficult to complete tasks. People living with schizophrenia may also experience symptoms like difficulty functioning, emotional flatness, and a loss of interest in activities. 

More research is needed to better understand the root cause of schizophrenia. However, some known factors may increase your risk of developing the condition.

• If you have a close relative, like a sibling or parent, who also has schizophrenia, you are six times more likely to develop it yourself.
• Having certain health complications — like viruses, autoimmune disorders, and prenatal malnutrition — may increase your risk of schizophrenia.
• If you have irregularities in the areas of the brain that regulate dopamine or glutamate, you may be more likely to develop schizophrenia. Dopamine and glutamate are important chemicals in the brain.
• Using mind-altering substances during your teen years is correlated with an increase in the psychotic symptoms associated with schizophrenia. This doesn’t mean that substance use causes schizophrenia. Rather, it means that these two things are often connected.

What is schizoaffective disorder?

Like schizophrenia, schizoaffective disorder is a serious mental health condition that causes psychotic symptoms like hallucinations and delusions. People living with schizoaffective disorder experience abnormal thought and behavior patterns that interrupt their ability to function in daily life and relate to others. 

But what sets schizoaffective disorder apart from schizophrenia is the presence of mood disorder symptoms. This means that, in addition to experiencing psychosis and disorganized thinking, they also live with symptoms of depression or bipolar disorder, like:

• Extreme shifts in mood
• Feelings of worthlessness, emptiness, or hopelessness 
• Trouble concentrating
• Loss of interest in formerly important interests
• Social isolation
• Periods of euphoria, high energy, and racing thoughts
• Engaging in unsafe behaviors

As you might imagine, it can sometimes be difficult to tell the difference between schizoaffective disorder, schizophrenia, and a mood disorder. But to be diagnosed with schizoaffective disorder, a person must:

• Have periods when psychotic symptoms (like delusions and hallucinations) occur at the same time as mood disorder symptoms
• Have mood disorder symptoms that are nearly always present
• Have symptoms that are not the result of harmful substance use

According to research, many of the known risk factors for schizophrenia, like childhood trauma and malnutrition, also apply to schizoaffective disorder.

How is schizoaffective disorder different from schizophrenia?

The most important difference between schizoaffective disorder and schizophrenia is the presence of mood disorder symptoms. People living with schizoaffective disorder experience many of the psychotic symptoms associated with schizophrenia. But they also experience periods of depression and/or mania. Schizoaffective disorder is divided into two categories, based on the symptoms a person shows: depressive type and bipolar type.

While there is no cure for schizophrenia or schizoaffective disorder, you can manage them with the right support. For the most part, this involves a combination of therapy and medication. Antipsychotic medications can reduce hallucinations and delusions and improve functioning. But people with schizoaffective disorder can also benefit from mood-stabilizing drugs to help them balance the highs and lows of depression and mania.

Both schizoaffective disorder and schizophrenia require lifelong treatment. Left unmanaged, they can impact safety and lead to self-harm and suicidality. However, one of the most challenging aspects of these disorders is that they often also include something called anosognosia. This means that people with schizophrenia and schizoaffective disorder may have no awareness that their symptoms indicate a mental health condition. This can make it difficult for them to access care without additional support.

Find care with Rula

If someone you care about is showing signs of schizophrenia or schizoaffective disorder, know that early and ongoing intervention can make a huge difference in their safety and quality of life. 

At Rula, we’re here to help you take the first step. We can connect you or someone you love with an in-network provider for a professional evaluation, accurate diagnosis, and long-term support. And since we partner with both therapists and psychiatrists, we can help ensure that you get the complete support you need. 

Find care with Rula