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.
When comparing schizoaffective vs. schizophrenia, it’s easy to see why the two are often confused. Both fall under the category of psychotic disorders and can cause symptoms like hallucinations, delusions, and disorganized thinking.
However, the key difference is that schizoaffective disorder includes both psychotic symptoms and mood symptoms, like depression or mania. Schizophrenia involves psychotic symptoms without a consistent mood component.
Because these conditions share so many similarities, even experts can sometimes have trouble distinguishing between them. Understanding this distinction can help reduce stigma, clear up misconceptions, and ensure that you or your loved ones receive the right diagnosis and treatment.
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.
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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.
Note: You may still see the term paranoid schizophrenia used online or in older resources. This term referred to a subtype marked by prominent delusions or auditory hallucinations, but it’s no longer part of the official diagnosis. Today, schizophrenia is recognized as one condition that can include a range of symptoms and severity levels.
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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.
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How is schizoaffective disorder different from schizophrenia?
Schizoaffective disorder and schizophrenia have many similarities, but one key difference separates them. Schizoaffective disorder includes both psychotic symptoms and mood symptoms, while schizophrenia involves psychotic symptoms without a lasting mood component. Understanding these differences can make it easier to recognize each condition and find the right kind of support.
Is schizoaffective a type of schizophrenia?
It’s a common misunderstanding, but schizoaffective disorder is not a type of schizophrenia. Both are psychotic disorders, meaning they can cause hallucinations, delusions, and disorganized thoughts or behavior.
The main difference is that schizoaffective disorder also involves mood episodes, like depression or mania. Because of this, it’s divided into two types:
Depressive type includes periods of major depression.
Bipolar type includes both manic and depressive episodes.
In short, schizophrenia mainly affects how you think and perceive reality, while schizoaffective disorder affects both thinking and mood.
Can schizoaffective disorder turn into schizophrenia?
Schizoaffective disorder doesn’t usually turn into schizophrenia, but the two can look very similar — especially early on. Sometimes, a person may receive one diagnosis and later be re-diagnosed as more information about their symptoms becomes clear.
The biggest difference is in mood symptoms. In schizophrenia, mood changes might appear occasionally but don’t last long or define the condition. In schizoaffective disorder, mood symptoms are consistent and a key part of the diagnosis.
Which is more serious?
Both schizoaffective disorder and schizophrenia are serious mental health conditions that need ongoing treatment. One is not necessarily more severe than the other, but they can affect people differently.
Treatment often combines therapy and medication. Without treatment, both conditions can make daily life harder and increase the risk of self-harm or suicidal thoughts.* Some people also experience anosognosia, which means they don’t realize they have a condition, making it harder to seek help. With consistent care and support, many people with either condition can manage their symptoms and live meaningful, stable lives.
*If you or a loved one is experiencing suicidal thoughts or thoughts about harming themself or others, please call or text 988 on any phone for the Suicide & Crisis lifeline, contact a local crisis line, or head to the emergency room immediately. Any of these resources will ensure that the person in crisis receives support right away. For more information on getting help, go to 988lifeline.org
If experiencing a life-threatening emergency or you need immediate help, please call 911.
Schizophrenia and schizoaffective disorder can look similar, but understanding the difference helps you or your loved one get the right care. Clarity brings hope — and with support, living well with either condition is absolutely possible.
Brandy Chalmers, LPC
Clinical reviewer
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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
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
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.
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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.
