What are the differences between schizophrenia and schizoaffective disorder?

People with schizoaffective disorder have the symptoms of both schizophrenia and a mood disorder.

Liz Talago

By Liz Talago

Clinically reviewed by Nick Frye, MS, LCPC
Published on: March 25, 2024
Last updated: February 24, 2025
What are the differences between schizophrenia and schizoaffective disorder?
Key Takeaways
  • Schizoaffective disorder and schizophrenia are both psychotic disorders. This means they can both cause symptoms like hallucinations, delusions, and odd or eccentric behavior.

  • While schizoaffective disorder and schizophrenia share many of the same features, there’s an important distinction between these two conditions. Unlike schizophrenia, schizoaffective disorder also includes symptoms of a mood disorder.

  • While there is no cure for schizoaffective disorder or schizophrenia, you can manage them with the right support. People living with these disorders typically usually benefit from attending therapy and taking medication throughout their lives.

Schizoaffective disorder and schizophrenia are two mental health conditions that fall into the category of psychotic disorders. This means they can both cause psychotic symptoms like hallucinations, delusions, and unusual behavior. Sometimes, even experts have trouble telling the difference between these two conditions because they share so many common characteristics.

However, there’s a key difference between schizophrenia and schizoaffective disorder. While they both cause abnormal thought and behavior patterns, schizoaffective disorder also includes symptoms of a mood disorder. By learning more about this distinction, you can help break down misconceptions and make sure you or your loved ones get the right kind of care.

What is schizophrenia?

Schizophrenia is a serious, long-term mental health condition that affects how a person sees themselves and the world. It can make it difficult for people to think clearly, connect with others, and regulate their emotions.

People living with schizophrenia experience symptoms that can make it difficult to tell what is real and what is not. This may include visual or auditory hallucinations or delusional thinking. In other words, people with unmanaged schizophrenia often see and hear things that aren’t really there.

Dig deeper:

They may also have false, often paranoid thoughts despite there being no evidence that what they believe is true. This type of thinking can cause problems with focus and concentration and make it difficult to complete tasks. People living with schizophrenia may also experience symptoms like difficulty functioning, emotional flatness, and a loss of interest in activities.

More research is needed to better understand the root cause of schizophrenia. However, some known factors may increase your risk of developing the condition.

  • If you have a close relative, like a sibling or parent, who also has schizophrenia, you are six times more likely to develop it yourself.

  • Having certain health complications — like viruses, autoimmune disorders, and prenatal malnutrition — may increase your risk of schizophrenia.

  • If you have irregularities in the areas of the brain that regulate dopamine or glutamate, you may be more likely to develop schizophrenia. Dopamine and glutamate are important chemicals in the brain.

  • Using mind-altering substances during your teen years is correlated with an increase in the psychotic symptoms associated with schizophrenia. This doesn’t mean that substance use causes schizophrenia. Rather, it means that these two things are often connected.

The care you need, when you need it

Learn how Rula can support your mental health journey

What is schizoaffective disorder?

Like schizophrenia, schizoaffective disorder is a serious mental health condition that causes psychotic symptoms like hallucinations and delusions. People living with schizoaffective disorder experience abnormal thought and behavior patterns that interrupt their ability to function in daily life and relate to others.

But what sets schizoaffective disorder apart from schizophrenia is the presence of mood disorder symptoms. This means that, in addition to experiencing psychosis and disorganized thinking, they also live with symptoms of depression or bipolar disorder, like:

  • Extreme shifts in mood

  • Feelings of worthlessness, emptiness, or hopelessness

  • Trouble concentrating

  • Loss of interest in formerly important interests

  • Social isolation

  • Periods of euphoria, high energy, and racing thoughts

  • Engaging in unsafe behaviors

As you might imagine, it can sometimes be difficult to tell the difference between schizoaffective disorder, schizophrenia, and a mood disorder. But to be diagnosed with schizoaffective disorder, a person must:

  • Have periods when psychotic symptoms (like delusions and hallucinations) occur at the same time as mood disorder symptoms

  • Have mood disorder symptoms that are nearly always present

  • Have symptoms that are not the result of harmful substance use

According to research, many of the known risk factors for schizophrenia, like childhood trauma and malnutrition, also apply to schizoaffective disorder.

Dig deeper:

How is schizoaffective disorder different from schizophrenia?

The most important difference between schizoaffective disorder and schizophrenia is the presence of mood disorder symptoms. People living with schizoaffective disorder experience many of the psychotic symptoms associated with schizophrenia. But they also experience periods of depression and/or mania. Schizoaffective disorder is divided into two categories, based on the symptoms a person shows: depressive type and bipolar type.

While there is no cure for schizophrenia or schizoaffective disorder, you can manage them with the right support. For the most part, this involves a combination of therapy and medication. Antipsychotic medications can reduce hallucinations and delusions and improve functioning. But people with schizoaffective disorder can also benefit from mood-stabilizing drugs to help them balance the highs and lows of depression and mania.

Both schizoaffective disorder and schizophrenia require lifelong treatment. Left unmanaged, they can impact safety and lead to self-harm and suicidality. However, one of the most challenging aspects of these disorders is that they often also include something called anosognosia. This means that people with schizophrenia and schizoaffective disorder may have no awareness that their symptoms indicate a mental health condition. This can make it difficult for them to access care without additional support.

Find care with Rula

If someone you care about is showing signs of schizophrenia or schizoaffective disorder, know that early and ongoing intervention can make a huge difference in their safety and quality of life.

At Rula, we’re here to help you take the first step. We can connect you or someone you love with an in-network provider for a professional evaluation, accurate diagnosis, and long-term support. And since we partner with both therapists and psychiatrists, we can help ensure that you get the complete support you need.

Liz Talago
About the author

Liz Talago

Liz Talago, M.ed. is a mental health professional turned content writer and strategist based in the Detroit metro area. As an independent consultant for mental health organizations, Liz creates meaningful connections between brands and their audiences through strategic storytelling. Liz is known for championing diverse perspectives within the mental health industry and translating bold ideas into inspiring, affirming digital experiences.

In her free time, you can find her hiking with her two German Shepherds, puttering around her dahlia garden, or spending time with her family.

Nick Frye, MS, LCPC
About the clinical reviewer

Nick Frye, MS, LCPC

Nick Frye, MS, LCPC holds a Master’s degree in Counseling Psychology from Loyola University Maryland and is a Licensed Clinical Professional Counselor (LCPC) in Maryland. With experience as a substance use disorder counselor and a private practice therapist, he has worked with diverse populations, specializing in depression, anxiety, life transitions, and grief. Passionate about mental health, Nick transitioned from direct patient care to education and mentorship to support both early-career and seasoned professionals in their growth and development as clinicians.

Rula's editorial process

Rula's editorial team is on a mission to make science-backed mental health insights accessible and practical for every person seeking to better understand or improve mental wellness.

Members of Rula’s clinical leadership team and other expert providers contribute to all published content, offering guidance on themes and insights based on their firsthand experience in the field. Every piece of content is thoroughly reviewed by a clinician before publishing.

Read next article
The care you need, when you need it

Learn how Rula can support your mental health journey




Here to help

Emergency

The 988 Suicide and Crisis Lifeline provides 24/7, confidential support with trained crisis counselors.

If you or a loved one is in emotional distress or a suicidal crisis, please call or text 988.