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.
Schizoaffective disorder and schizophrenia: what do they consist of?
Before delving into the differences between schizoaffective disorder and schizophrenia, let’s learn 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 does it consist of? The DSM-5 diagnostic criteria for schizoaffective disorder include: meeting criterion A for schizophrenia (delusions, hallucinations, disorganized speech… for at least one month) and an uninterrupted period of the illness during which it has ever occurred. a major depressive episode (necessarily including depressed mood) or a manic episode.
That is, in this case psychotic symptoms are combined with mood symptoms Furthermore, it is necessary that no significant emotional symptoms have appeared for at least 2 weeks, but delusions or hallucinations have occurred.
This disorder is somewhat controversial, since there are authors who consider it an independent disorder of schizophrenia, others who consider it as a variant of it, 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 psychotic disorder “par excellence” 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, delusional ideas, disorganized thinking and language, cognitive alterations, avolition, depressive symptoms, flattened affect, etc. Hallucinations and delusions are classic psychotic symptoms which can also appear in other psychotic spectrum disorders beyond schizophrenia.
Specifically, the DSM-5 diagnostic criteria for schizophrenia include: characteristic symptoms such as those we have mentioned (hallucinations, delusional ideas…) that must last at least 1 month, in addition to a socio-occupational dysfunction in the person’s life 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).
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 meeting criterion A of schizophrenia, the criteria for a 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:
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 speech, 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.
On the other hand, 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. Furthermore, for schizoaffective disorder it is added that there must be 2 weeks without notable affective symptoms, but where delusions or hallucinations (psychotic symptoms) do appear (a criterion that is not included in schizophrenia).
2. Episodes/Mood Disorders
In schizophrenia, the existence of a schizoaffective disorder is excluded in order to make the diagnosis. Furthermore, mood disorders are also excluded in this case.
On the other hand, in schizoaffective disorder, mood disturbances must be present for the diagnosis to be made (major depressive episodes or manic episodes).
3. Subtypes
In the DSM-5, the subtypes of schizophrenia are suppressed (in the DSM-IV-TR they were: paranoid, disorganized, catatonic, undifferentiated and residual schizophrenia, and in the ICD-10 simple schizophrenia was also included).
On the other hand, 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
The sixth of the differences between schizoaffective disorder and schizophrenia has to do with the 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 said 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: avolition, 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 of the differences 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 schizoaffective disorder. ; Disorganization of thought is also more common in schizophrenia, as is emotional 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.
