Schizoaffective disorder is a mental health condition characterized by symptoms of schizophrenia and mood disorders, such as depression and mania. Researchers have identified two types of schizoaffective disorder, both of which are marked by schizophrenia symptoms: ¹

• Bipolar Type – Includes episodes of mania and, in some cases, major depression.

• Depressive Type – Includes major depressive episodes.

Since schizoaffective disorder affects everyone differently, it may be difficult for a doctor to initially diagnose. Furthermore, these symptoms overlap with other medical conditions.

Schizoaffective disorder almost always leads to problems in daily life, such as at work or in relationships. For this reason, it’s important to receive help as soon as possible.

Symptoms

Schizoaffective disorder symptoms are divided into two categories:

• Psychotic Symptoms – Related to schizophrenia, such as hallucinations and delusions.

• Mood Disorder Symptoms – Related to bipolar disorder or depression.

While it’s not clear how long it takes this condition to develop, most people are diagnosed after a major mood episode (either manic or depressed) and at least two weeks of psychotic symptoms.

Common symptoms of schizoaffective disorder that involve these two sets include: ²

• Abnormal behaviors
• Delusions (having false beliefs even though evidence for the contrary exists)
• Depressive symptoms (i.e. feeling empty, sad, and worthless)
• Difficulty with communication and speech
• Hallucinations (i.e. hearing voices or seeing things that aren’t there)
• Inability to function in work, school, or social events
• Manic symptoms (i.e. increased energy, behaviors out of character)
• Problems with personal care (i.e. hygiene and physical appearance)

Suicidal Thoughts and Behaviors

Schizoaffective disorder may lead to suicidal ideation (thoughts and behaviors relating to suicide), especially in those who struggle with the depressive type. ³

If you or a loved one has been contemplating suicide, you need to reach out for help immediately. In an emergency, it’s vital to call 911 or go to your nearest hospital emergency room. For other cases, you can reach out to the 988 Suicide & Crisis Lifeline.

Risk Factors

Researchers still don’t know what causes schizoaffective disorder. However, they’ve found that those in the following circumstances are more vulnerable to the condition:

• Genetics – If you have a close family member (i.e. parent, sibling) with schizoaffective disorder, schizophrenia, or bipolar disorder, you’re more likely to struggle with it. ⁴

• Stressful Events – Sometimes, symptoms of the condition develop after a person undergoes a stressful or traumatic event. ⁵

• Substance Use Disorder – Certain mind-altering drugs may worsen symptoms of those with or susceptible to schizoaffective. However, it’s unlikely that drug use itself will cause this condition. ⁶

Complications

If you struggle with schizoaffective disorder, you’re at an increased risk of:

• Alcohol and other substance abuse
• Anxiety disorders
• Health complications
• Poverty and homelessness
• Problems with family and other interpersonal relationships
• Social isolation
• Suicidal ideation
• Work difficulties (i.e. unemployment)

Diagnosis

If you believe you struggle with schizoaffective disorder, you’ll want to receive a diagnosis from a mental health professional. To come to this diagnosis, you’ll have to take:

• Physical Exams – to determine that your symptoms aren’t due to another underlying complication.

• Tests and Screenings – to figure out if there’s an underlying condition or if drug or alcohol abuse is furthering symptoms.

• Psychiatric Evaluation – to learn more about your symptoms, mood, delusions, hallucinations, and how vulnerable you are to suicide. Furthermore, a psychiatrist will ask about your family and personal history to give you a more accurate diagnosis.

Treatment

When it comes to treating schizoaffective disorder, the best route is a combination of medication, psychotherapy, and training for life skills. While this condition cannot be cured, this combination can help greatly decrease the severity of symptoms and provide long-term fulfillment in patients. ⁷

Medication

Since schizoaffective disorder affects everyone differently, your doctor will give you one (or more) of the following medications based on your symptoms:

• Antipsychotics – Approved by the Food and Drug Administration (FDA) for schizoaffective disorder, the antipsychotic paliperidone (Invega) has been found to help with psychotic symptoms, such as hallucinations and delusions. ⁸

• Mood-Stabilizing Medication – For those who struggle with the bipolar type, mood stabilizers can help even out mania highs and depression lows.

• Antidepressants – If you struggle with depression through schizoaffective disorder, then you may benefit from antidepressant medication.

Psychotherapy

Alongside medication, psychiatrists will also recommend psychotherapies (also known as talk therapies), including:

• Individual Therapy – One-on-one sessions where you help to identify and normalize thought patterns. Through this, you’ll be able to reduce symptoms and build up strengths through life (i.e. relationships, work, etc.).

• Family or Group Therapy – You may find therapy more effective if you can discuss your problems with others. Group therapy helps to create a support system and reduce social isolation found in psychotic disorders.

Life-Training

To further reduce isolation and improve your quality of life, you may find the following helpful:

• Social Skills Training – A practice where you’ll learn how to improve communication and social interactions found in everyday activities. This training can help you readjust condition-specific behaviors and develop new skills. ⁹

• Vocational Rehabilitation and Supported Employment – If you struggle with finding and/or maintaining a job, this practice can help prepare you better. ¹⁰

Final Word

While schizoaffective disorder isn’t curable, there are several ways to help reduce symptoms. Through treatment, many schizoaffective patients can live fulfilling lives and manage themselves in professional and social environments.

References

¹ Wy TJP, Saadabadi A. Schizoaffective Disorder. 2023 Mar 27. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 31082056.

² Miller JN, Black DW. Schizoaffective disorder: A review. Ann Clin Psychiatry. 2019 Feb;31(1):47-53. PMID: 30699217.

³ Harkavy-Friedman JM, Nelson EA, Venarde DF, Mann JJ. Suicidal behavior in schizophrenia and schizoaffective disorder: examining the role of depression. Suicide Life Threat Behav. 2004 Spring;34(1):66-76. doi: 10.1521/suli.34.1.66.27770. PMID: 15106889.

⁴ Cardno AG, Owen MJ. Genetic relationships between schizophrenia, bipolar disorder, and schizoaffective disorder. Schizophr Bull. 2014 May;40(3):504-15. doi: 10.1093/schbul/sbu016. Epub 2014 Feb 24. PMID: 24567502; PMCID: PMC3984527.

⁵ Vardaxi CC, Gonda X, Fountoulakis KN. Life events in schizoaffective disorder: A systematic review. J Affect Disord. 2018 Feb;227:563-570. doi: 10.1016/j.jad.2017.11.076. Epub 2017 Nov 15. PMID: 29172048.

⁶ Archibald L, Brunette MF, Wallin DJ, Green AI. Alcohol Use Disorder and Schizophrenia or Schizoaffective Disorder. Alcohol Res. 2019 Dec 20;40(1):arcr.v40.1.06. doi: 10.35946/arcr.v40.1.06. PMID: 31886105; PMCID: PMC6927747.

⁷ Cascade E, Kalali AH, Buckley P. Treatment of schizoaffective disorder. Psychiatry (Edgmont). 2009 Mar;6(3):15-7. PMID: 19724749; PMCID: PMC2719459.

⁸ Greenberg WM, Citrome L. Paliperidone Palmitate for Schizoaffective Disorder: A Review of the Clinical Evidence. Neurol Ther. 2015 Dec;4(2):81-91. doi: 10.1007/s40120-015-0030-4. Epub 2015 Jul 23. PMID: 26662360; PMCID: PMC4685865.

⁹ Kopelowicz A, Liberman RP, Zarate R. Recent advances in social skills training for schizophrenia. Schizophr Bull. 2006 Oct;32 Suppl 1(Suppl 1):S12-23. doi: 10.1093/schbul/sbl023. Epub 2006 Aug 2. PMID: 16885207; PMCID: PMC2632540.

¹⁰ Au DW, Tsang HW, So WW, Bell MD, Cheung V, Yiu MG, Tam KL, Lee GT. Effects of integrated supported employment plus cognitive remediation training for people with schizophrenia and schizoaffective disorders. Schizophr Res. 2015 Aug;166(1-3):297-303. doi: 10.1016/j.schres.2015.05.013. Epub 2015 Jun 1. PMID: 26044114.