Schizoaffective Disorder

Characterized by symptoms of both schizophrenia and bipolar disorder, schizoaffective disorder is a lesser-known disorder that affects roughly 0.3 percent of the population.

Approximately one in every 200 people will develop schizoaffective disorder at one point during their life. Though the disorder is similar to commonly known schizophrenia, schizoaffective disorder has unique characteristics of its own.

What is Schizoaffective Disorder?

Schizoaffective disorder is characterized by a combination of symptoms of schizophrenia, including hallucinations or delusions,  in addition to mood disorder symptoms, like mania and depression. Schizoaffective disorder is a challenging mental illness to live with, especially in the absence of treatment.

Because schizoaffective disorder shares symptoms with both schizophrenia and bipolar disorder, patients may be misdiagnosed unless they choose to seek a facility trained and experienced with working with schizoaffective disorder patients. Untreated schizoaffective disorder can result in problems with functioning during everyday tasks and duties.

Types of Schizoaffective Disorder

The main types of schizoaffective disorder include bipolar type and depressive, characterized by episodes of mania and depression, and depressive type, which presents with only depressive symptoms.

Bipolar Type

Bipolar type of schizoaffective disorder includes episodes of mania and sometimes major depression. This subtype is diagnosed when there is a manic episode presented within the symptoms. Manic episodes are recognized as:

• Increase in energy and activity
• Irritability
• Restlessness
• Inability to sleep
• Reckless behavior

Depressive Type

Depressive type of schizoaffective disorder presents only with major depressive episodes. No manic episodes are present during this type, though they continue to have symptoms of depression in addition to the characteristics of schizophrenia.

Depressive episodes are characterized by:

• Low energy and activity
• Feeling of hopelessness
• Inability to perform everyday tasks

Schizoaffective Disorder vs. Schizophrenia

Schizophrenia is a disorder most people have heard of and many people may even be able to list a few symptoms, however, schizoaffective disorder is not as well known. Schizoaffective disorder occurs in a small percentage of the population and is a combination of schizophrenic symptoms in addition to either depression, mania or both.

Schizophrenia affects roughly one percent of the population. To receive a clinical diagnosis of schizophrenia, these symptoms must be experienced for more than one month:

• Delusions or beliefs with no evidence in reality
• Hallucinations: seeing, hearing, or sensing things that are not real
• Disorganized speech
• Agitated, bizarre behavior or a lack of responsiveness.
• Neglecting personal hygiene
• Lack of interest in activities

The presence of these symptoms typically lasts for at least six months and interferes with self-care, work or relationships. Schizophrenia is generally treated with a combination of medication, therapy, and community support.

Schizoaffective disorder, on the other hand, affects roughly 0.3 percent of the population. A depressive episode requires five or more of the following symptoms during two weeks:

• Depressed mood
• Lack of pleasure in activities formerly enjoyed
• Feelings of guilt or worthlessness
• Difficulty concentrating
• Thoughts of death or suicide
• Changes in weight or appetite
• Changes in sleep
• Slowing of movement
• Lack of energy

Diagnosis of a manic episode requires a period of elevated or irritable mood and increased energy for at least one week and at least three of the following symptoms:

• Increased self-esteem or sense of grandiosity
• Needing less sleep
• Becoming more talkative
• Racing thoughts
• Being easily distracted
• More energy
• Engaging in risky behaviors

Symptoms of Schizoaffective Disorder

There is a variety of symptoms associated with schizoaffective disorder. Symptoms vary depending on the severity of the condition and from one person to another.  Symptoms range from behavior changes, physical signs and mental or psychological alterations.

Psychological Symptoms

Some of the common psychological symptoms of schizoaffective disorder may include:

• Depression and Anxiety
• Euphoria or Mania
• Irritability or anger outbursts
• Inability to express feelings
• Paranoia, hallucinations or delusions
• Disorganized thinking, lack of concentration and confusion
• Suicidal or homicidal thoughts

Behavioral Symptoms

Some common behavioral symptoms of schizoaffective disorder include:

• Trouble falling asleep
• Extreme reactions to criticism
• Self-harm behaviors
• Inappropriate laughter or crying
• Coma-like daze or hyperactivity

Physical Symptoms

The typical physical symptoms of schizoaffective disorder can include:

• Increase or decrease in energy
• Speaking too slowly or too quickly to be understood
• Poor hygiene, disregard for physical appearance
• Increased or decreased appetite
• Weight gain or weight loss

Causes of Schizoaffective Disorder

The exact reason for schizoaffective disorder is unknown, but a combination of factors have been linked to the illness. Three of the main factors that can contribute to the development of the disorder include genetics, stress and drug use.

1. Genetics. Those people with close relatives who have schizophrenia or schizoaffective disorder are at higher risk for development of this disorder than those people who don’t have a family history of schizoaffective disorder or schizophrenia.
2. Stress. Stress can be a contributor to schizoaffective disorder. Events like bereavement, physical illness, car accident or family or relationship problems may lead to the disorder. In particular, traumatic experiences in childhood can increase the chances of developing this condition in the future.
3. Drug Use. Psychoactive drugs like LSD have been linked to the development of schizoaffective disorder. LSD causes visual hallucinations, an altered sense of time and changes in thought processes. These changes, over long term use, could lead to disorders of the mind like schizoaffective disorder.

Diagnosing Schizoaffective Disorder

A doctor will not typically run laboratory tests to diagnose schizoaffective disorder. They have to rely on someone’s medical history, in addition to various assessments like brain imaging (like MRI scans) and blood tests to make sure that a physical illness isn’t the reason for the symptoms.

If the doctor finds no physical reason for the symptoms, they may refer the person to a mental health professional.

Mental health professionals are trained to work specifically with diagnosing and treating patients with mental illnesses. For a person to be diagnosed with schizoaffective disorder, the following must be present:

• A continuous period where there is a major mood episode; manic or depressive, occurring in unison with symptoms of schizophrenia
• Delusions or hallucinations for two weeks or more in the absence of a major mood episode
• Major mood episode symptoms are present for the majority of the duration of the illness
• Symptoms are not only present during drug use

Effects of Schizoaffective Disorder

Effects of schizoaffective disorder likely depend on the severity of the disorder and the patient’s response to the mental illness. It is possible for people who have this disorder to experience several different effects that can cause problems in many areas of someone’s life. Some of the more common effects include:

• Job loss or school expulsion
• Disruption in normal daily activities
• Development of substance addiction
• Relationship and legal problems

Who is at Risk for Schizoaffective Disorder?

There may not be an exact known cause of schizoaffective disorder, however, there are certain risk factors that seem to increase the chances  of developing the illness, including:

• Family history of mental illness
• The presence of other mental health disorders
• Substance abuse
• Being the victim of abuse or neglect
• Developmental delays
• Prenatal exposure to certain toxins or illnesses, such as drugs or alcohol

Statistics on Schizoaffective Disorder

Research has shown that the lifetime rate for schizoaffective disorder has been estimated at 0.3 percent. Higher rates of the disorder have been found in women than in men, which may be linked to the fact that women have higher rates of depression.

There are also differences in the way schizoaffective disorder presents itself in males and females. When considering those people with schizoaffective disorder, men report having more psychotic symptoms and more prolonged illness duration, while women tend to experience more mood symptoms in shorter episodes.

Schizoaffective Disorder and Substance Abuse

Schizoaffective disorder causes emotional pain along with confusing thoughts, mood problems and isolation. People with schizoaffective disorder regularly develop alcohol or drug addiction while trying to self-medicate their pain and unwanted symptoms. Substance abuse can magnify their isolation, mood and thought disorganization.

Substance abuse can worsen schizoaffective symptoms. It may interact in harmful or potentially deadly effects. People with schizoaffective disorder can create more devastation for themselves by frequently using large quantities of alcohol or drugs. Receiving proper dual diagnosis treatment is critical for someone in this situation.

Schizoaffective Disorder Treatment

Treatment for schizoaffective disorder may differ depending on the type and severity of the symptoms, however, most patients usually respond well to a combination of medication, psychotherapy and life skills training. Inpatient treatment or hospitalization may be essential in some cases.

Antipsychotic medications can help manage symptoms like delusions and hallucinations that may be presented by the patient. Mood stabilizers are usually only prescribed for those patients who have been diagnosed with bipolar type. These medications will help to calm the severity of the mania to depression mood alterations. Another medicine prescribed for schizoaffective disorder is antidepressants, to help with depressive type schizoaffective disorder.

Individual cognitive behavioral therapy and family therapy can help individuals with schizoaffective disorder manage and learn to cope with their symptoms. Learning social and vocational skills can assist in reducing loneliness and improve the quality of life for people with schizoaffective disorder. Social skills training can improve communication and interactions with others, at home and work.

If you or a loved one needs treatment for substance abuse and a co-occurring disorder like schizoaffective disorder, The Recovery Village can help. Individuals who struggle with drug or alcohol abuse and co-occurring schizoaffective disorder symptoms can receive compassionate treatment from one of the facilities located across the country. To learn more, call The Recovery Village today to speak with a representative.

Editor – Jennifer Kopf

Jennifer Kopf is a Florida-based writer who likes to balance creative writing with helpful and informative pieces. Her passion for helping people has translated into writing about the importance of treatment for substance use and mental health disorders. Read more

Medically Reviewed By – Krisi Herron, LCDC

Krisi Herron is an Adjunct Psychology Professor, a Licensed Chemical Dependency Counselor and a freelance writer who contributes to several mental health blogs. Read more