So as a supervisor to psychology/counseling interns and early career mental health professionals, I am often asked to review the differences between schizophrenia and schizoaffective disorder. I think people, who potentially have these disorders, and the loved ones who support them, should also know what symptoms to look for. Here is a mini-primer on both disorders (and I promise not to use too much psychology jargon!)
Schizophrenia spectrum disorder is a group of mental health conditions which share similar symptoms. These symptoms can be divided into two categories: positive and negative.
Positive symptoms include:
- Delusions: False beliefs that are not based in reality. For example, a person with schizophrenia might believe that they are being persecuted by the government or that they have special powers.
- Hallucinations: Seeing, hearing, or feeling things that are not really there. For example, a person with schizophrenia might hear voices talking to them or see people who are not there.
- Disorganized speech: Jumping from topic to topic with no clear direction, problems with communicating in a direct manner, use of nonsense words/making up words, repeating the same phrase or sentences over and over again.
- Disorganized behavior: Inability to think clearly, problems with routine activities like bathing and/or completing chores, writing a lot without any meaning, pacing/walking in circles, wearing clothing not appropriate for the weather, catatonic behavior
Negative symptoms include:
- Blunted affect: Reduced emotional expressiveness.
- Avolition: Lack of motivation or initiative-no matter how much they are verbally prodded or “nagged” by others to complete a task(s).
- Alogia: Responses to questions are one or two word answers, speech is limited, replies to questions may be brief and concrete
- Anhedonia: Everything they used to enjoy is no longer interesting and/or boring. No joy in life.
To be diagnosed with schizophrenia spectrum disorder, a person must experience at least two of these symptoms for at least six months. One of the symptoms must be delusions, hallucinations, or disorganized behavior/speech.
Symptoms of schizophrenia spectrum disorder can vary in severity and may come and go over time. Some people may experience only mild symptoms, while others may have severe symptoms which interfere with their daily lives.
Schizophrenia and schizoaffective disorder share some similarities, but also have some key differences.
Schizophrenia is a chronic mental health condition affecting the way a person thinks, feels, and behaves. People with schizophrenia may experience delusions, hallucinations, disorganized thinking and speech, and negative symptoms such as blunted affect, avolition, alogia, and anhedonia.
Schizoaffective disorder is characterized by symptoms of both schizophrenia and a mood disorder, such as major depressive disorder or bipolar disorder. People with schizoaffective disorder may experience episodes of major depression or mania, as well as symptoms of schizophrenia such as delusions, hallucinations, and disorganized thinking and speech.
Key differences:
- Symptoms: Schizophrenia is characterized by the presence of positive symptoms, such as delusions and hallucinations, as well as negative symptoms. Schizoaffective disorder is characterized by the presence of symptoms of both schizophrenia and a mood disorder.
- Diagnosis: Schizophrenia is diagnosed when a person experiences two or more of the following symptoms for at least six months: delusions, hallucinations, disorganized speech, disorganized behavior, or negative symptoms. Schizoaffective disorder is diagnosed when a person experiences a major depressive or manic episode concurrent with symptoms of schizophrenia for at least two weeks during an episode.
- Treatment: Treatment for both schizophrenia and schizoaffective disorder typically involves a combination of medication and therapy. Medication can help to reduce the symptoms of the condition, while therapy can help people to learn how to manage their symptoms and live a more fulfilling life.
It is important to note that the distinction between schizophrenia and schizoaffective disorder is not always clear-cut. In these cases, a mental health professional can help to make a diagnosis and develop a treatment plan.