Schizophrenia and schizoaffective disorder are mental illnesses that affect an individual’s ability to function in everyday life. Although there are many similarities between these conditions, they are considered separate disorders by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) — a comprehensive tool used to diagnose all known mental health conditions. Knowing and understanding different signs and symptoms of each condition can lead to the proper diagnosis and appropriate prescribed treatment plan. Several treatment options exist for treating schizophrenia and schizoaffective disorder that can enhance the quality of life for affected persons.

Schizophrenia Signs and Symptoms

Schizophrenia is a psychotic disorder that affects the way a person thinks, behaves or feels. Licensed medical professionals use three categories to describe the symptoms of schizophrenia: positive, negative and cognitive symptoms.

  • Positive symptoms refer to behaviors that cause a person to “lose touch with reality.” These may include hallucinations (seeing, hearing or feeling things that are not there), delusions (false beliefs), irrational thinking (patterns of disorganized thoughts) or unusual body movements.
  • Negative symptoms involve the disruption of normal behaviors and emotions. For instance, these symptoms may include a lack of satisfaction in everyday life, diminished facial expressions, speaking in a low tone of voice or even refraining from social activities.
  • Cognitive symptoms impair an individual’s decision-making abilities and mental agility, which in turn may affect learning and the ability to function in everyday situations.

Schizoaffective Disorder Signs and Symptoms

Schizoaffective disorder is distinct from schizophrenia and other individual mood disorders such as bipolar disorder or depression. In particular, schizoaffective disorder can be distinguished from schizophrenia by several symptoms:

  • Persistent mood behaviors
  • Lethargy (lack of energy)
  • Poor appetite
  • Suicidal ideation
  • Lack of motivation
  • Problems communicating

Challenges in Diagnosis

In some instances, it is difficult to ascertain whether an individual has schizophrenia or a schizoaffective disorder. Schizoaffective disorder encompasses schizophrenia symptoms plus those of a mood disorder. The two types of schizoaffective disorder that help distinguish this disorder from schizophrenia are:

  • The bipolar type, which includes episodes of mania and sometimes depression
  • The depressive type, which involves persistent sadness or apathetic behavior.

Differences in Treatment

Depending on the diagnosis of either schizophrenia or schizoaffective disorder, there are treatment options available for both. Some common treatments include:

  • Antipsychotic medications
  • Psychosocial treatments
  • Coordinated specialty care
  • Antidepressants
  • Mood stabilizers

Schizophrenia Treatment

Antipsychotics, also known as neuroleptics, are prescribed to help patients with schizophrenia manage psychotic behaviors such as delusions and hallucinations. These medications are available in pill form or injectable forms and require administration by medical professionals. Common orally available antipsychotic medications for schizophrenia include:

  • Chlorpromazine
  • Fluphenazine
  • Perphenazine
  • Thioridazine
  • Thiothixene
  • Trifluoperazine

Injectable antipsychotics are administered less frequently and have similar effects as their orally available counterparts. Some examples of injectable antipsychotics are:

  • Apriproprazle
  • Paliperidone
  • Haloperidol
  • Risperidone

Additionally, individuals may benefit from group or individual therapy that focuses on improving self-worth.

Schizoaffective Disorder Treatment

Individuals who are diagnosed with schizoaffective disorder usually respond well to antipsychotics such as paliperidone (Invega) or risperidone (Risperdal) for symptom management. Based on a depressive or bipolar schizoaffective disorder diagnosis, mood-stabilizers may be prescribed, including:

  • Lithium
  • Valproic acid
  • Divalproex
  • Carbamazepine
  • Lamotrigine

Antidepressants may also be prescribed to patients, including:

  • Venlafaxine
  • Duloxetine
  • Desvenlafaxine
  • Bupropion

Other treatments for this disorder may consist of transcranial magnetic stimulation (TMS) or electroconvulsive therapy (ECT). These therapies involve electrically stimulating the brain while an individual is under anesthesia. TMS or ECT are routinely performed in patients who have not responded to medication or psychotherapy.

Prognosis and Outlook

Although the outlook is hard to predict for both schizophrenia and schizoaffective disorder, symptoms can be managed with proper and ongoing treatment regimens. In individuals that only have experienced one psychotic episode, about 27% of individuals have a resulting poor outcome, and most individuals have a good outcome or prognosis (42%). Unfortunately, relapse beyond a first psychotic episode occurs often for schizophrenic and schizoaffective individuals.

Another study showed that 43% of schizophrenic patients were clinically remitted due to their symptoms, while 54% of schizoaffective patients were hospitalized. Recovery for schizophrenic patients was at nearly 6.5% but was higher in schizoaffective patients at 22.7%. Interestingly, both groups of patients were taking antipsychotics, whereas a majority of schizoaffective patients were on concurrent mood stabilizers and antidepressants.

Key Points: Schizophrenia vs. Schizoaffective Disorder

  • Schizophrenia has three categories of symptoms: positive, negative and cognitive
  • Individuals with a schizoaffective disorder exhibit symptoms of schizophrenia as well as those of a mood disorder
  • There are two types of schizoaffective disorder: the bipolar type and the depressive type
  • The treatment of schizophrenia and schizoaffective disorder consists of antipsychotic medications and psychotherapy
  • Treatment for schizoaffective disorder may include mood and antidepressant medication in addition to antipsychotic medication.

If you or a loved one are living with schizophrenia or a schizoaffective disorder and co-occurring addiction, please contact The Recovery Village for information about treatment options.