Differences between schizoaffective disorder and bipolar disorder

Bipolar disorder and schizoaffective disorder are two illnesses that can become truly disabling if not treated properly.

Both disorders share symptoms of depression and mania, and the diagnosis is sometimes complicated by difficulties in distinguishing between the two. However, there are important characteristics that differentiate them and that can help to identify them correctly.

In this article we address the main differences between schizoaffective disorder and bipolar disorder, but before we explain what these two mental disorders consist of.

• Related article: "Schizoaffective Disorder: Causes, Symptoms and Treatment"

What is schizoaffective disorder?

Schizoaffective disorder is a chronic mental health condition characterized primarily by symptoms of schizophrenia, such as hallucinations or delusions, and symptoms of a mood disorder, such as mania and depression. Many people with this disorder are often initially misdiagnosed with bipolar disorder or schizophrenia.

Because schizoaffective disorder is less studied than the other two conditions, many interventions are borrowed from its treatment approaches. Schizoaffective disorder

is relatively rare, with a lifetime prevalence of only 0.3%. Men and women experience schizoaffective disorder at the same rate, but men often develop the disease at a younger age.

The specific causes are unknown, but it has been suggested that there may be a combination of genetic and hereditary factors, stress, and structural and functional aspects at the brain level. There are two different types of this disorder: the bolar type, which includes manic episodes and, occasionally, episodes of severe depression; and the depressive type, which only includes depressive symptoms.

Symptoms of schizoaffective disorder that it shares with schizophrenia include: hallucinations, delusions, disorganized thinking, depressed mood, or manic behavior (depending on the type of disorder). You also share symptoms of depression, such as weight gain or loss, lack of energy, feelings of guilt, sleep disturbances, and suicidal thoughts; and symptoms of mania, such as agitation, inflated self-esteem, logorrhea, or increased social, sexual, or work activities.

• You may be interested: "Bipolar Disorder: 10 characteristics and curiosities that you did not know"

Bipolar disorder: definition, types and symptoms

Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual changes in mood, energy, activity levels, and the ability to perform everyday tasks. There are four basic types of bipolar disorder, and they all involve clear changes in mood.

These moods range from extremely euphoric and energetic periods of behavior (known as manic episodes) to very sad or hopeless periods (known as depressive episodes). Less severe manic periods are known as hypomanic episodes.

Hypomania is a mild form of mania, and its symptoms are less intenses. Psychotic symptoms do not usually occur, nor do behavioral changes occur that force the patient to be hospitalized. The person perceives the hypomanic state as a feeling of intense well-being, with an expanded self-esteem and with an increased creative capacity.

In hypomanic states it is not uncommon for the consumption of alcohol and other psychoactive substances to increase. In addition, people in a hypomanic state often start relationships and projects that they later regret when the hypomanic episode ends.

Bipolar disorder can be classified into different types. Let's see which ones below:

Type I bipolar disorder

This type is defined by manic episodes that last at least 7 days, or by manic symptoms that are so severe that the person needs immediate hospital care. As usual, depressive episodes that usually last at least 2 weeks also occur. Depressive episodes with mixed features (having depression and manic symptoms at the same time) are also possible.

Type II bipolar disorder

This type of bipolar disorder is characterized by a pattern of depressive episodes and hypomanic episodes, but not the full manic episodes described in type I bipolar disorder.

Cyclothymic disorder

Also called cyclothymia, this type of bipolar disorder is defined by the numerous periods of hypomanic symptoms and numerous periods of depressive symptoms lasting at least 2 years (1 year in children and adolescents). However, the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode.

Other unspecified bipolar disorders

This category would include all those people who present symptoms of bipolar disorder but who do not coincide with the three previous categories.

Differences between schizoaffective disorder and bipolar disorder

It is often difficult to distinguish between schizoaffective disorder and bipolar disorder, since both diseases share symptoms (euphoria and depression). However, one of the main differences between both disorders is the presence of severe psychotic symptoms, which only occur in schizoaffective disorder.

Schizoaffective disorder would be halfway between schizophrenia and type I bipolar disorder, since its course is similar to the latter although psychotic episodes can be experienced without having to have episodes of mania and depression. When making a diagnosis, it is often more difficult to detect the presence of a schizoaffective disorder; however, the treatment used is similar to that used for bipolar disorder, that is, maintenance antipsychotic medications.

If we stick to psychiatric manuals and nosological classifications, bipolar disorder is a mood disorder that includes severe depression and that ranges from extreme to extreme (from mania to depression) in a very variable way. For its part, schizoaffective disorder is defined at the psychiatric level as a psychosis with affective symptoms (manic or depressive) less acute and more treatable than those of schizophrenia, with which it shares some traits.

Regarding the pharmacological therapeutic approach, research on the treatment of bipolar disorder has advanced modestly in recent years; And when it comes to schizoaffective disorder, there have been considerable advances compared to other diseases such as schizophrenia.

Definitely, schizoaffective disorder involves symptoms similar to those that occur in schizophrenia, with the addition of various affective symptoms, be they depressive or euphoric, or the sum of both types; that is, as the union between schizophrenia and bipolar disorder.

Bibliographic references:

• Benabarre, A., Vieta, E., Colom, F., Martinez-Aran, A., Reinares, M., & Gasto, C. (2001). Bipolar disorder, schizoaffective disorder and schizophrenia: epidemiologic, clinical and prognostic differences. European Psychiatry, 16 (3), 167-172.
• Cosoff, S. J., & Hafner, R. J. (1998). The prevalence of comorbid anxiety in schizophrenia, schizoaffective disorder and bipolar disorder. Australian and New Zealand Journal of Psychiatry, 32 (1), 67-72.
• Szoke, A., Meary, A., Trandafir, A., Bellivier, F., Roy, I., Schurhoff, F., & Leboyer, M. (2008). Executive deficits in psychotic and bipolar disorders – implications for our understanding of schizoaffective disorder. European Psychiatry, 23 (1), 20-25.