8 differences between schizoaffective disorder and schizophrenia
Schizoaffective disorder and schizophrenia are two mental disorders that fall under the category of psychotic disorders. Psychotic disorders include two typical symptoms: delusions and hallucinations (although there are more).
These two disorders, although they have certain similarities, are quite different. But… what are the differences between schizoaffective disorder and schizophrenia? In this article we will get to know them.
Schizoaffective disorder and schizophrenia: what are they?
Before delving into the differences between schizoaffective disorder and schizophrenia, let’s learn about what each of these mental disorders consists of.
1. Schizoaffective disorder
Schizoaffective disorder belongs to the group of psychotic disorders. That is, it is included in this category along with others such as schizophrenia or delusional disorder. Its prevalence is 0.3% of the population , according to the DSM-5 (Diagnostic Manual of Mental Disorders).
But what is it? The DSM-5 diagnostic criteria for schizoaffective disorder include: fulfillment of schizophrenia criterion A (delusions, hallucinations, disorganized language, etc., for at least one month) and an uninterrupted period of illness during which a major depressive episode (necessarily involving a depressed mood) or a manic episode has occurred.
That is, in this case psychotic symptoms are combined with mood symptoms . In addition, it is necessary that for at least 2 weeks no major affective symptoms have appeared but delusions or hallucinations have occurred.
This disorder is somewhat controversial, as there are authors who consider it to be a disorder independent of schizophrenia, others who consider it to be a variant of schizophrenia, and others as a variant of mood disorders. Finally, others believe that it is a transitional state between schizophrenia and mood disorders.
2. Schizophrenia
Schizophrenia is the “quintessential” psychotic disorder . Around 0.3 and 0.7% of the world’s population suffer from schizophrenia, according to the latest edition of the DSM-5. It is a very disabling mental disorder, although there are interindividual variabilities, and with psychological and pharmacological treatment the disease can be managed.
Schizophrenia includes a number of symptoms such as: hallucinations, delusions, disorganized thinking and language, cognitive impairment, abulia, depressive symptoms, flattened affect, etc. Hallucinations and delusions are the classic psychotic symptoms , which can also appear in other disorders of the psychotic spectrum beyond schizophrenia.
Specifically, the DSM-5 diagnostic criteria for schizophrenia include: characteristic symptoms such as those we have mentioned (hallucinations, delusional ideas…) which must last at least 1 month, in addition to socio-occupational dysfunction in the person’s life and the presence of continuous signs of the disorder which must last at least 6 months (this includes the prodromal and residual period of the disease).
8 Differences between schizoaffective disorder and schizophrenia
As we have seen, schizoaffective disorder and schizophrenia are two independent disorders. Their fundamental difference is that in schizoaffective disorder, in addition to meeting criterion A of schizophrenia, the criteria of major depressive episode or bipolar depressive episode are met.
In addition to this, there are more differences between the two. So, without further ado, let’s look at the 8 differences between schizoaffective disorder and schizophrenia:
Duration criteria
The first of the differences between schizoaffective disorder and schizophrenia concerns the criteria of duration.
The diagnostic criteria of schizophrenia require that characteristic symptoms such as delusional ideas, hallucinations, disorganized language, etc. have appeared . , for at least 1 month (or less if the symptoms have been successfully treated). In addition, there must be continuous signs of the alteration for at least 6 months.
In contrast, in schizoaffective disorder, criteria include: the same monthly criteria as schizophrenia (minimum 1 month duration of symptoms), but not the 6 months of schizophrenia. In addition, for schizoaffective disorder it is added that there must be 2 weeks without noticeable affective symptoms, but where delusions or hallucinations (psychotic symptoms) do appear (criterion that is not included in schizophrenia).
2. Episodes/Mood Disorders
In schizophrenia it is excluded that a schizoaffective disorder exists in order to make the diagnosis. In addition, mood disorders are also excluded in this case.
In schizoaffective disorder, on the other hand, mood disturbances must be present in order to make the diagnosis (major depressive episodes or manic episodes).
3. Subtypes
In DSM-5 the subtypes of schizophrenia are suppressed (in DSM-IV-TR they were: paranoid, disorganized, catatonic, undifferentiated and residual schizophrenia, and in ICD-10 simple schizophrenia was also included).
In contrast, schizoaffective disorder includes the following subtypes: bipolar type (if the disorder includes any manic episodes) and depressive type (if it includes major depressive episodes).
4. Prognosis
Another difference between schizoaffective disorder and schizophrenia concerns the prognosis of the disorder. Thus, the prognosis of schizoaffective disorder is better than that of schizophrenia (although worse than that of mood disorders).
5. Prevalence
While the prevalence of schizophrenia ranges from 0.3 to 0.7% according to DSM-5 (DSM-IV-TR was 1%), the prevalence of schizoaffective disorder is lower, at 0.3% according to DSM-5 .
6. Affective symptoms
The sixth of the differences between schizoaffective disorder and schizophrenia has to do with affective symptoms (anhedonia, sadness, mania…).
On the one hand, affective (mood) symptoms are of great importance in schizoaffective disorder; so much so that their presence is fundamental to the diagnosis of the disorder. As we have seen, there must be, at some point, a manic episode or a major depressive episode.
On the other hand, in the case of schizophrenia, affective symptoms are not essential to make the diagnosis , although they often appear in the form of negative symptoms such as: abulia, restricted emotional expression, flat affect, depressive symptoms, etc. Furthermore, in schizophrenia neither major depressive episodes nor manic episodes usually appear.
7. Start
The onset of the disorder is another difference between schizoaffective disorder and schizophrenia; thus, in schizoaffective disorder, the onset is often acute, and in schizophrenia, insidious .
8. Other differences between schizoaffective disorder and schizophrenia
Other differences between schizoaffective disorder and schizophrenia refer to the frequency (or presence/absence) of certain symptoms, such as: auditory hallucinations, although they may occur in both disorders, are more common in schizophrenia than in schizoaffective disorder; disorganization of thought is also more common in schizophrenia, as is emotional flattening. On the other hand, the poverty of language is also more marked in schizophrenia .
Finally, the symptom of confusion is more prevalent in schizoaffective disorder than in schizophrenia, where it does not usually appear.
Bibliographic references:
- American Psychiatric Association -APA- (2002). Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. Barcelona: Masson.
- American Psychiatric Association (APA) (2014). DSM-5. Diagnostic and statistical manual of mental disorders. Madrid: Panamericana.
- Belloch, A., SandÃn, B. and Ramos, F. (2010). Manual of Psychopathology. Volume I and II. Madrid: McGraw-Hill.
- Lermanda, V., Holmgren, D., Soto-Aguilar, F. and Sapag, F. (2013). Schizoaffective disorder. How much schizophrenia? How much bipolar? Chilean Journal of Neuropsychiatry, 51(1): 46-60.
- WHO (2000). ICD-10. International Classification of Diseases, Tenth Edition. Madrid. Pan-American.