8 differences between schizoaffective disorder and schizophrenia
Schizoaffective disorder and schizophrenia are two mental disorders that we find within 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 are going to know them.
- Related article: "What is psychosis? Causes, symptoms and treatment"
Schizoaffective disorder and schizophrenia: what are they?
Before delving into the differences between schizoaffective disorder and schizophrenia, we are going to know 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 DSM-5 (Diagnostic Manual of Mental Disorders).
But what does it consist of? DSM-5 diagnostic criteria for schizoaffective disorder include: Schizophrenia criterion A is met (delusions, hallucinations, disorganized language... during at least one month) and an uninterrupted period of illness during which a major depressive episode (necessarily including depressive mood) or an episode maniac.
That is, in this case psychotic symptoms are combined with mood symptoms. In addition, it is necessary that for at least 2 weeks there have been no significant affective symptoms but delusions or hallucinations.
This disorder is somewhat controversial, since there are authors who consider it an independent disorder of the schizophrenia, others who consider it as a variant of it, and others as a variant of the disorders of the mood. 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 suffers 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 controlled.
Schizophrenia includes a series of symptoms such as: hallucinations, delusions, disorganized thinking and language, cognitive disturbances, apathy, 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 mentioned above (hallucinations, delusions ...) that must last at least 1 month, in addition to a socio-labor dysfunction in the life of the person and the presence of continuous signs of the alteration that must last at least 6 months (this includes the prodromal and residual period of the disease).
- You may be interested: "What is schizophrenia? Symptoms and Treatments"
8 Differences between schizoaffective disorder and schizophrenia
As we have seen, schizoaffective disorder and schizophrenia are two independent disorders. Its fundamental difference is that in schizoaffective disorder, in addition to fulfilling criterion A of schizophrenia, the criteria for a major depressive episode or depressive episode are met bipolar.
In addition to this, there are more differences between the two. So, without further ado, let's see the 8 differences between schizoaffective disorder and schizophrenia:
1. Duration criteria
The first of the differences between schizoaffective disorder and schizophrenia refers to the duration criteria.
The diagnostic criteria for schizophrenia require that characteristic symptoms such as delusions, hallucinations, disorganized language, etc., for at least 1 month (or less if 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, the criteria include: the same monthly criterion of schizophrenia (minimum duration of one month of symptoms), but not the 6 months of schizophrenia. In addition, for schizoaffective disorder it is added that there must be 2 weeks without notable affective symptoms, but where delusions or hallucinations do appear (psychotic symptoms) (a criterion that is not included in the schizophrenia).
2. Episodes / Mood Disorders
In schizophrenia, the existence of a schizoaffective disorder is excluded in order to make the diagnosis. Furthermore, in this case, mood disorders are also excluded.
In contrast, in schizoaffective disorder, mood disturbances must be present for the diagnosis to be made (major depressive episodes or manic episodes).
3. Subtypes
In DSM-5 the subtypes of schizophrenia are suppressed (in DSM-IV-TR they were: paranoid schizophrenia, disorganized, catatonic, undifferentiated and residual, and schizophrenia was also included in the ICD-10 simple).
In contrast, schizoaffective disorder includes the following subtypes: bipolar type (if the disorder includes a manic episode) and depressive type (if it includes major depressive episodes).
4. Forecast
Another difference between schizoaffective disorder and schizophrenia refers to 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 between 0.3 and 0.7% according to the DSM-5 (the DSM-IV-TR placed it at 1%), the prevalence of schizoaffective disorder is lower, standing at 0.3% according to the 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 its presence is essential to be able to diagnose this 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 frequently appear in the form of negative symptoms such as: apathy, restricted emotional expression, flat affect, depressive symptoms, etc. In addition, 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; So, in schizoaffective disorder, the onset is usually 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 can occur in both disorders, appear more frequently in schizophrenia than in the disorder schizoaffective; disorganized thinking is also more common in schizophrenia, as is affective flattening. On the other hand, language poverty 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., Sandín, 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 of schizophrenia? How much bipolar? Chilean journal of neuro-psychiatric, 51 (1): 46-60.
- WHO (2000). ICD-10. International Classification of Diseases, Tenth Edition. Madrid. Pan American.
