Schizoaffective disorder is a serious mental illness that has features of two different disorders—schizophrenia and an affective (mood) disorder, either major depressive disorder or bipolar disorder.
Schizophrenia is a brain disorder that distorts the way a person thinks, acts, expresses emotions, perceives reality, and relates to others.
Depression is an illness that is marked by feelings of sadness, worthlessness, or hopelessness. It may also include problems concentrating and remembering details.
Bipolar disorder is characterized by cycling mood changes, including severe highs (mania) and lows (depression).
Schizoaffective disorder is a life-long illness that can impact all areas of daily living, including:
Most people with this disorder have periodic episodes, when their symptoms surface. While there is no cure for schizoaffective disorder, symptoms may often be controlled with treatment, particularly with medications.
Schizoaffective disorder usually begins in the late teen years or early adulthood, often between the ages of 16 and 30. It seems to occur slightly more often in women than in men and is rare in children.
Because people with schizoaffective disorder have symptoms of two separate mental illnesses, it is often misdiagnosed. Some people might be misdiagnosed as having schizophrenia, and others might be misdiagnosed with a mood disorder. As a result, it is difficult to determine exactly how many people actually are affected by schizoaffective disorder.
However, it is believed to be less common than either schizophrenia or affective disorder alone. Estimates suggest that about one in every 200 people (.5 percent) develops schizoaffective disorder at some time during his or her life.
A person with schizoaffective disorder has severe changes in mood and some of the psychotic symptoms of schizophrenia, such as:
Psychotic symptoms may include the inability to tell what is real from what is imagined. Symptoms of schizoaffective disorder might vary greatly from one person to the next and might be mild or severe. Symptoms might include the following:
While the exact cause of schizoaffective disorder is not known, researchers believe that genetic, biochemical, and environmental factors are involved.
If symptoms are present, the doctor will perform a complete medical history and physical examination. Although there are no laboratory tests to specifically diagnose schizoaffective disorder, the doctor might use various diagnostic tests—such as X-rays or blood tests—to rule out physical illness as the cause of the symptoms.
If the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illness.
Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a psychotic disorder. The doctor or therapist bases his or her diagnosis on the person’s report of symptoms, and his or her observation of the person’s attitude and behavior.
The doctor or therapist then determines if the person’s symptoms point to a specific disorder as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is published by the American Psychiatric Association and is the standard reference book for recognized mental illnesses.
According to the DSM-5, a diagnosis of schizoaffective disorder is made if a person has periods of uninterrupted illness and has, at some point, an episode of mania, major depression, or mix of both while also having symptoms of schizophrenia. In addition, the person has a period of at least two weeks of psychotic symptoms without the mood symptoms.
Treatment typically involves medication to stabilize the mood and treat the psychotic symptoms. In addition, psychotherapy (a type of counseling) and skills training might be useful for improving interpersonal, social, and coping skills.
Common side effects of lithium include:
Side effects vary depending on the type of antidepressant medication used, but common side effects include:
Common side effects of antipsychotic medications include:
Possible complications include:
There is no known way to prevent schizoaffective disorder. However, early diagnosis and treatment can help avoid or reduce frequent relapses and hospitalizations, and help decrease the disruption to the person’s life, family, and friendships.
There is no cure for schizoaffective disorder, but treatment has been shown to be effective in minimizing the symptoms, and in helping the person cope with the disorder and improve social functioning.
© Copyright 1995-2020 The Cleveland Clinic Foundation. All rights reserved.
This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 04/21/2014