Schizoaffective Disorder: Understanding the Incidence, Causes, Diagnosis, and Treatment

What is Schizoaffective Disorder?

Schizoaffective disorder (SA) is a disorder that combines the symptoms of schizophrenia (psychosis) with the symptoms of a mood disorder (depression or bipolar) in a complex way. It is sometimes misdiagnosed or not diagnosed at all because it is a relatively uncommon disorder, and it is not fully understood. This overview will go over how common it is, some of the causative factors and the complexities in diagnosis and treatment. We hope this will help to raise awareness of the condition and assist anyone who has a loved one with this problem. This is an informational summary and not a substitute for professional medical advice, diagnosis or treatment.

How Common is Schizoaffective Disorder?

About 0.3 per cent of the population have schizoaffective disorder:  it’s a lot less common than either major depression or bipolar disorder. In about 30 per cent of cases, onset occurs between the ages of 25 and 35, and it is more common in women. Individuals with schizophrenia may have an increased risk for first-degree relatives for schizoaffective disorder, and vice-versa. Individuals, first-degree relatives with bipolar disorder schizophrenia or schizoaffective disorder may have an increased risk for schizoaffective disorder.

What Causes Schizoaffective Disorder?

While the exact cause is still not clear, most experts point to a combination of genetics, brain chemistry and structure, and environment. A family history of a mood disorder or schizophrenia can contribute to risk, as can catching a virus or being malnourished before birth. Stressful events like trauma and substance abuse can trigger onset of or make symptoms worse in people who might be vulnerable.

How is it Diagnosed?

Making a definitive diagnosis of Schizoaffective Disorder can also be challenging, as the symptoms of schizoaffective disorder overlap with those of other mental health diagnoses, such as mood disorders (including distinct phases of depression or mania) and psychotic disorders (including delusional ideas or hallucinatory experiences). Misdiagnosis is common, and this can delay the pathway to the appropriate treatment. Usually, accurate diagnosis involves a thorough evaluation that includes psychiatric assessments and sometimes also brain imaging studies that exclude other diagnoses.

The official DSM criteria (criteria used by psychiatrists to make diagnosis) includes:

  • An uninterrupted period of illness with a major mood episode (manic or depressive) and symptoms of schizophrenia
  • Delusions or hallucinations for at least two weeks without a major mood episode
  • Mood symptoms present for most of the illness
  • Symptoms not caused by substance use


Treatment typically involves a regimen of medications and psychotherapy, as well as things like life-skills training, often combined with ongoing rehabilitation and social support provided by therapists or residential living facilities, sometimes family members as well. Medications can include antipsychotics, mood stabilizers (eg, lithium, valproate) or antidepressants, depending on the symptoms.

Psychotherapy can help to reduce symptoms, improve communication and relationships with others, and increase social and occupational functioning. Ongoing support through rehabilitation, social groups and family therapy can assist in the successful management of the condition.

Difference between Schizoaffective Disorder and Schizophrenia

It is important for clinicians be able to distinguish between schizoaffective disorder and other disorders because different types of treatment might be helpful for different conditions. Discriminating between the different groups of disorders relies on assessing the precise combination of mood and psychotic symptoms over time.


The diagnostic uncertainty of schizoaffective disorder, coupled with the chronic nature of the disorder and challenges it poses for patients, families and caregivers is only made even more difficult by the challenges of different treatment approaches. This a difficult condition to understand and manage for all concerned. However, knowing about the frequency of schizoaffective disorder, its possible origins and treatments should help in the early recognition and diagnosis of such cases, and it should make efforts at treatment more efficient and effective. The research into the etiology and treatment of this and other psychiatric conditions needs to continue. We hope that much more will be known about this and related conditions in the future, allowing diagnosis and treatment to progress further. This article is for information only and should not be used for the diagnosis or treatment of medical conditions. A qualified healthcare professional should be consulted for diagnosis and treatment of any and all medical conditions.