Mental illness can often feel overwhelming to those who struggle to understand the signs and symptoms. Doctors, psychiatrists, and other mental health professionals are trained to diagnose mental illness, but knowing the signs of various disorders can help connect you with the proper treatment and improve the quality of your life.

Most people have heard of schizophrenia and can list some of the symptoms, but schizoaffective disorder is less well known. Schizoaffective disorder, which occurs in a very small percentage of the population, is a combination of schizophrenia symptoms with either depression or mania. Here are the major differences between the two disorders.


Schizophrenia affects roughly 1% of the population. Men typically develop schizophrenia in their early 20s; women typically develop it in their late 20s or early 30s.1 In order to receive a clinical diagnosis of schizophrenia, the following symptoms must be experienced for more than a month:

  • Delusions – Beliefs that have no evidence in reality.
  • Hallucinations – Seeing, hearing, or sensing things that aren’t real.
  • Disorganized speech – Meaningless words or sentences that don’t fit together.
  • Disorganized or catatonic behavior – Agitated or bizarre behavior or a lack of responsiveness.
  • General apathy– neglecting personal hygiene, lack of interest in activities, or a lack of facial expressions.2

The presence of these symptoms typically lasts for at least 6 months, unless mitigated by treatment. They must interfere with self-care, work, or relationships, and cannot be caused by the drugs or alcohol. Schizophrenia is treated with a combination of medication, therapy, and community support.

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Schizoaffective Disorder

 Schizoaffective disorder affects roughly 0.3% of the population. Men typically develop schizoaffective disorder earlier than women.3 A person with schizoaffective disorder exhibits the symptoms of schizophrenia (listed above) in addition to a mood episode including depression and mania.4

A depressive episode requires five or more of the following symptoms during a two-week period:

  • depressed mood
  • lack of pleasure in activities formerly enjoyed
  • changes in weight or appetite
  • changes in sleep
  • slowing of movement
  • lack of energy
  • feelings of guilt or worthlessness
  • difficulty concentrating
  • thoughts of death or suicide

A manic episode requires a period of elevated or irritable mood and increased activity or 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 goal-directed activity (energy)
  • engaging in risky behaviors (i.e. sexual, financial, etc.)

Sometimes an individual with schizoaffective disorder only experiences schizophrenia symptoms and depressive episodes. This is known as depressive type schizoaffective disorder. A person who experiences schizophrenia symptoms during mania or during mania and depressive episodes has bipolar type schizoaffective disorder.

Schizoaffective disorder is treated with a combination of medication, therapy, and community support (from, e.g., family and friends). Individuals with schizoaffective disorder are at particular risk for developing co-occurring disorders such as substance use disorders.

What the Doctor Will Want to Know

 If you or a loved one are being evaluated for schizophrenia or schizoaffective disorder, a doctor may ask questions which include the following:

  • Personal hygiene. Good or poor?
  • Is the person generally cooperative or easily agitated?
  • Do the facial expressions match the mood?
  • Does the patient make eye contact?
  • Are the movements slow, as if the person is moving through water?
  • Do words and sentences follow a normal thought process?
  • Does the person appear depressed or manic?
  • Does he or she have a grandiose sense of self?
  • Does the patient know his name? Can he tell you the day of the week?
  • Does the patient respond to stimuli that are imaginary?
  • Does the patient have paranoid thoughts?
  • Are they experiencing suicidal thoughts?
  • Has the patient recently used drugs and alcohol?5

The symptoms of schizophrenia or schizoaffective disorder can be managed through treatment, so it’s important to find the right care. People with either diagnosis can live healthy and full lives.

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Last Updated: Jul 17, 2019