Reviewed by Whitney White, MS CMHC, NCC., LPC
Even though they share many similarities, including part of their name, schizoaffective disorder and schizophrenia have some fundamental differences. In this article, you will learn about what makes these two mental health conditions unique by covering their signs, symptoms, and other features.
What Schizoaffective Disorder & Schizophrenia Have in Common
Before diving into the differences between schizoaffective vs. schizophrenia, it’s important to know what kind of similarities these two disorders have.
These two disorders share a lot in terms of symptoms, and one of the primary ones involves psychotic symptoms. This is where the prefix schizo- comes into play.
Psychotic symptoms, which include hallucinations and delusions, are hallmark signs of schizophrenia, but they’re also present in schizoaffective disorder as well.
Hallucinations can include sensing, such as hearing, feeling, or seeing things that are not there, and delusions can involve false and distorted beliefs that may be paranoid in nature.
Individuals who have either of these disorders can also have disorganized and confused thinking patterns in general and can struggle to make plans, become easily distracted, and have difficulties providing relevant and coherent answers to questions.
People with schizophrenia or schizoaffective disorder can also have similar experiences with their mood and expressing emotion, and they can become socially withdrawn and find enjoyment and pleasure in activities.
However, while there is some common ground here, how a person’s mood is impacted is the main difference between schizophrenia and schizoaffective disorder. In the next section, you will learn more about how mood can be a factor in distinguishing these two disorders apart.
Schizoaffective Disorder Has Characteristics of A Mood Disorder
One of the main things that differentiate schizophrenia versus schizoaffective disorder is that there is more significance in how a person’s mood is affected by the schizoaffective disorder than schizophrenia.
In fact, this is where the suffix -effective comes from in its name. In psychology and psychiatry, the term “affect” refers to mood symptoms and how people express their emotions. For example, euphoria, anger, and sadness are all forms of effect, and in schizoaffective disorder, these can change, and so can a person’s behavior in response to them. 
These mood symptoms are an essential part of distinguishing schizoaffective disorder from schizophrenia, and people can experience mania and depression episodes.
In a manic episode, patients can:
- Be unusually energetic
- Have an inflated sense of self-confidence or euphoria
- Excessively talkative
- Have racing thoughts
- Have a decreased need for sleep
- Become impulsive and make poor-decisions
- Be easily irritated or aggressive.
On the other hand, they can have periods where they have depressive symptoms such as:
- A sad mood or feelings of hopelessness and worthlessness
- A loss of interest or pleasure in hobbies and other activities
- Appetite and weight changes
- Excessive fatigue
- Sleep difficulties, like insomnia or hypersomnia
- Trouble focusing and concentrating
- Suicidal ideation
All of these symptoms have a significant overlap with bipolar disorder, especially bipolar I. In fact, there are two main types of schizoaffective disorder: 
Bipolar Type: characterized by manic and depressive symptoms alongside psychotic symptoms
Depressive Type: characterized by psychotic and depressive symptoms only; no mania
Thus, sometimes it can be difficult to differentiate schizoaffective disorder from other conditions like bipolar disorder and schizophrenia; people with bipolar disorder can also have psychotic symptoms during a manic episode as well, which can make it tricky to distinguish them at first glance.
A mental health professional will most likely need a timeline of these symptoms and know how long they’ve been lasting before coming to a conclusion, and the next section will elaborate on this further.
Schizoaffective Disorder Has Different Diagnostic Guidelines
As mentioned before, diagnosing schizoaffective disorder can be challenging due to its similarities with other conditions. Still, there are a few key aspects that can help people identify it easier.  
- A period during which there is either depression or mania that occurs simultaneously as the signs and symptoms of schizophrenia.
- Delusions or hallucinations last for two or more weeks without symptoms of a mood disorder.
Symptoms that meet the criteria for a manic or depressive episode are present for most of the total duration of the mental disorder.
Therefore, this means that the psychotic symptoms, such as hallucinations and delusions, come and go, and the mood issues are more constant. However, there will need to be a certain amount of time where these psychotics symptoms are not overlapping with the mood ones; there may also be some periods where a person is symptom-free.
In contrast with this, in schizophrenia, psychotic symptoms are the ones that are chronic and always present without medication, and mood symptoms generally do not occur without them.
Sometimes, people with schizophrenia may never experience the same mood disorders that are characteristic of schizoaffective as well, and instead, they can have a completely flat affect. It’s common for individuals to lack emotional expression in their face, voice, and other movements in schizophrenia vs. schizoaffective disorder.
However, this can help doctors make a more accurate diagnosis since varying the moods and emotions are typical of schizoaffective disorder.
There Are Some Differences in Treatment
Because mood disorders are an essential part of schizoaffective disorder, this affects how it is treated. There are some small differences between it and schizophrenia when it comes to getting help.
Because psychotic symptoms are a primary issue with both of these illnesses, people with schizophrenia or schizoaffective disorder need to take antipsychotic medication to help keep hallucinations and delusions under control.
However, those with schizoaffective disorder are typically also prescribed a mood stabilizer, such as lithium, or an antidepressant, to address the mood disorders that help define the condition. These aren’t usually given to people who have schizophrenia, but it’s possible, depending on the individual.
Psychotherapy is another treatment option that people can benefit from when taking medication. While it won’t help the hallucinations and delusions, it can be an effective outlet to let individuals discuss their feeling and emotions and find ways to cope, which can be especially useful for dealing with mood symptoms.
This doesn’t mean that therapy is just for people with schizoaffective disorder, and therapy can also help people learn how to regulate their emotions and develop the skills they need to reintegrate back into society, particularly with employment, and create a stronger connection with their friends and family members.
In many cases, family members can also get involved in therapy and find ways to provide the best support for their loved ones.
While people with these disorders will most likely never be fully independent, and medical treatment will be lifelong, people can still have happy, fulfilling, and productive lives if the symptoms are managed with medication. They receive the necessary support and guidance from others around them.
How To Get Help For Schizoaffective Disorder & Schizophrenia
Schizoaffective disorder and schizophrenia are both severe mental health conditions that require immediate treatment, and to do so, a consultation with a psychiatrist is highly recommended.
Psychiatrists are medical doctors who are also mental health professionals, and they specialize in diagnosing people with psychological disorders and prescribing individuals medication for them, and managing it for them.
People with these disorders struggle to determine what is real or not, and their perception of reality is distorted; and therefore, may not be able to reach out to someone on their own, especially if they believe their delusions and hallucinations are real and don’t recognize that they have a severe mental illness.
If you know someone displaying the signs and symptoms of either of these disorders, it’s important to encourage them to find help and make an appointment with someone who can properly diagnose them and get them on track to healing with medication and therapy.
Meanwhile, you can take this brief and completely free schizophrenia test before your appointment with a psychiatrist, and it can be a great tool for those who are unsure if they are struggling with this condition or not. You may also take one for bipolar disorder, as this can share similarities with schizoaffective disorder.
Hopefully, by reading this article, you’ve learned about some of the essential aspects that separate schizoaffective disorder and schizophrenia from one another and why it’s important when it comes to making a diagnosis. This can impact the course of treatment in a number of ways, but no matter which condition is present, treatment is available for both of them, and people can learn how to keep their symptoms under control and live healthy and fulfilling lives.
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- U.S. National Library of Medicine: MedlinePlus. (2020, August 18). Schizoaffective disorder. Retrieved from https://medlineplus.gov/genetics/condition/schizoaffective-disorder/
- Bhandari, S. (2019, February 21). Schizophrenia vs. Schizoaffective Disorder: The Difference Explained. Retrieved from https://www.webmd.com/schizophrenia/schizophrenia-schizoaffective-disorder
- National Alliance on Mental Illness. (, 2020). Schizoaffective Disorder. Retrieved from https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Schizoaffective-Disorder