Schizoaffective Disorder vs Schizophrenia
Schizoaffective disorder is considered the bridge between a pure mood disorder, disorders like major depression or bipolar disorder and a psychotic disorder like schizophrenia. This is important because psychosis can appear in both major depression with psychotic features and bipolar disorder on its own.
Schizoaffective disorder is distinguished from both largely by its timeline. So let’s run through the dsm-5 criteria for schizoaffective disorder.
The dsm-5 is the great big book of psychiatry.
The first criterion for schizoaffective disorder is an uninterrupted period of illness during which there is a major mood episode, either depressive or manic concurrent with the positive or negative symptoms of schizophrenia.
This is going to be for one month with positive and negative symptoms and for at least two weeks without mood symptoms at all.
Additionally, symptoms that meet criteria for a major mood episode are present for the majority of the total lifetime duration of the illness. It’s quite typical for schizoaffective disorder to begin with a bout of major depression.
It’s also worth noting that the prodromal period of both schizophrenia and schizoaffective disorder is usually quite frequently misdiagnosed as major depression or a generalized anxiety when it first starts out.
The prodrome is a period of both psychotic disorders where it’s just starting out usually happens in late adolescence, early adulthood. It’s a period where the psychotic symptoms haven’t quite kicked in yet.
These are very early stages and it’s very common for psychiatrists to think that this is just simply depression or anxiety.
This is a much less severe version of a mental illness, because there’s no surefire way to diagnose or detect the prodrome until after the active phase of schizophrenia has already begun. So, what happens is the prodrome can only be diagnosed in retrospect.
The person starts out with slight personality changes and the mood changes. They become more anxious and more sad. They’re beginning to seclude themselves in their bedrooms. They won’t come out, won’t eat, and won’t talk to friends. They can also begin to hear voices. They’ve begun to believe that people have stuck cameras in their bedroom. They think that they’re being watched or being followed. Then by at that point, they can be diagnosed with schizophrenia if it’s been six months.
If your doctor puts you on a medication for a reason, do not insist on stopping it. There is no reason to rush something like this. You will get the diagnosis if it’s meant to be you. You don’t want to force yourself into a psychotic fit.
Finally, the last criterion for schizoaffective disorder is to rule out any other medical conditions and drugs as a cause for your hallucinations, positive symptoms, negative symptoms. All of those mood disorders and hormonal issues like hypothyroidism can cause these symptoms as well.
The difference between schizophrenia and schizoaffective disorder is both the timeline or absence of mood symptoms. Schizophrenia has no mood symptoms. You can be depressed and have schizophrenia, but you cannot have schizophrenia and schizoaffective disorder based on the timeline.
Furthermore, schizophrenia requires six months minimum to diagnose. If you have these symptoms for less than six months, you can be diagnosed with brief psychotic disorder if you don’t have the mood symptoms.