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Schizoaffective disorder: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Schizoaffective disorder is characterized by marked mood changes and psychotic symptoms of schizophrenia. This disorder differs from schizophrenia by the presence of one or more episodes with depressive or manic symptoms.
Schizoaffective disorder should be considered when a patient with psychotic symptoms also has mood symptoms. The diagnosis requires that significant mood symptoms (depressive or manic) be present for a significant portion of the episode and that symptoms of schizophrenia are present simultaneously. Differential diagnosis between schizoaffective disorder, schizophrenia, and mood disorders requires a follow-up assessment of symptoms and their progression. The prognosis is somewhat better than for schizophrenia but worse than for mood disorders.
Since schizoaffective disorder is associated with long-term functional impairment in a significant proportion of cases, complex treatment (including medications, psychotherapy, and support groups) is often necessary. In the treatment of the manic type of this disorder, the combined use of antipsychotics with lithium, carbamazepine, or valproate is more effective than monotherapy with antipsychotics. A combination of antipsychotics and antidepressants is usually used to treat the depressive variant of this disorder. Antidepressants should usually be prescribed after stabilization of positive psychotic symptoms. SSRIs are preferred due to their favorable safety profile. Second-generation antipsychotics may be more effective than traditional neuroleptics in the treatment of depression associated with psychosis.