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Schizophrenia vs. Schizoaffective Disorder

Schizophrenia and schizoaffective disorder are both mental health conditions. They can cause similar symptoms and may have similar treatments. They also can both be challenging to diagnose. However, schizophrenia and schizoaffective disorder are considered different diagnoses.1

What is schizophrenia?

Schizophrenia is a serious mental health condition that causes psychosis. Psychosis impacts a person’s ability to understand reality. Symptoms of schizophrenia include:1,2

  • Hallucinations – Sensing things that are not real
  • Delusions – Strong beliefs in things that are not true
  • Cognitive issues – Changes in the way a person thinks, including struggling to remember things or complete tasks

Some people with schizophrenia may also seem emotionally flat or move very slowly. These are called negative symptoms. These symptoms are sometimes confused with clinical depression.1,2

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What is schizoaffective disorder?

Schizoaffective disorder is one of the 6 types of schizophrenia. It shares many symptoms with schizophrenia. These include hallucinations, delusions, and disordered thinking. However, schizoaffective disorder also involves symptoms of a mood disorder. This means a person also has symptoms of depression or mania.1,3

Symptoms of depression can include:1,3

  • Feeling sad for a long time
  • Low energy or tiredness
  • Feeling worthless or hopeless
  • Thoughts of self-harm

Symptoms of mania can include:1,3

  • Racing and intrusive thoughts
  • Not sleeping
  • Taking unsafe risks
  • Feelings of extreme happiness

Schizoaffective disorder is split into 2 groups depending on the mood disorder: depressive type schizoaffective disorder and bipolar type schizoaffective disorder.1,3

How are schizophrenia and schizoaffective disorder different?

Schizophrenia and schizoaffective disorder are very similar. Some researchers think that they are similar enough that they should not be considered different conditions. But within the current diagnostic standards, there are a few main differences.1,4

People with schizophrenia may feel depressed or have depression. Also, sometimes negative symptoms in people with schizophrenia look like depression. But this is not the same as schizoaffective disorder. In people with schizoaffective disorder, depression or mania symptoms happen at the same time as psychosis symptoms.1-3

The statistics

Schizoaffective disorder is also much less common than schizophrenia. Experts think that about 22 out of every 1,000 people have schizophrenia. They estimate that about 3 out of every 1,000 people have schizoaffective disorder.1,2

However, these numbers may not be fully accurate because people experiencing psychosis may not believe anything is wrong. So, they may not seek a diagnosis. And schizoaffective disorder can be especially hard to diagnose because doctors need a medical history to know if someone has mania or depression. The condition is often misdiagnosed as schizophrenia or bipolar disorder.1-3

How are they diagnosed and treated?

There is no single test that can diagnose schizophrenia or schizoaffective disorder. A doctor or mental health professional must conduct an exam and rule out other conditions. This process may take up to 6 months.1-3

Schizophrenia and schizoaffective disorder often have similar treatments. Both conditions typically are treated with a combination of psychotherapy and medicine.1,3

People with either condition may take antipsychotic medicines to treat symptoms of psychosis. But people with schizoaffective disorder also may need antidepressants to treat depression or mood stabilizers to treat mania.1,3

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