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5 ways schizoaffective disorder and borderline schizophrenia are different

One may hear voices that aren’t real and see things that do not exist if they have schizophrenia. On the other hand, schizoaffective disorder is a condition that can affect one’s mood and make them feel detached from reality. Although both of these disorders have some things in common, there are substantial differences that affect everyday life and the treatment that is recommended for each of these disorders, respectively. Schizoaffective disorder is a combination of schizophrenia symptoms with either mania or depression and occurs in a tiny percentage of the population.


Roughly 1% of the population is affected by schizophrenia. While men typically develop this disorder in their early 20s, women usually develop it in their late 20s or early 30s. The following symptoms must be experienced for more than a month to receive a clinical diagnosis of schizophrenia:

  • Hallucinations: Hearing, seeing, or sensing things that are not real.

  • Delusions: Thoughts that have no evidence in reality.

  • Disorganized speech: Meaningless sentences or words that do not fit together.

  • Catatonic behavior: Lack of responsiveness or agitated behavior.

Schizoaffective disorder

Roughly 0.3% of the population is affected by schizoaffective disorder, with men developing the disorder earlier than women. A person afflicted with schizoaffective disorder exhibits schizophrenic symptoms and a mood episode, including mania and depression. A depressive episode requires at least 5 of the following symptoms during two weeks:

  • Depressed mood.

  • Lack of pleasure in activities once enjoyed.

  • Changes in appetite and weight.

  • Isolating themselves.

  • Feeling guilty or worthless.

  • Suicidal thoughts.

  • Changes in sleep.

  • Difficulty concentrating.

  • Slowing of movement.

A manic episode requires a period of irritable or elevated mood and increased energy or activity for at least one week, and has the person exhibit 3 or more of the following symptoms:

  • Increased sense of grandiosity or self-esteem.

  • Becoming more talkative.

  • Requiring less sleep.

  • Easily becoming distracted.

  • Engaging in risky behavior.

  • Increase in goal-directed activity.

An individual with schizoaffective disorder sometimes only experiences depressive episodes and schizophrenic symptoms. It is known as Depressive Type Schizoaffective Disorder. An individual who experiences schizophrenic symptoms during mania or depressive episodes or mania is said to have Bipolar Type Schizoaffective Disorder.

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Differences between schizoaffective disorder & borderline schizophrenia:

Schizophrenia and schizoaffective disorder can be differentiated on the following grounds:

  1. Duration of mood episodes: An individual affected with schizoaffective disorder is likely to experience extreme mood symptoms that account for more than 50% of the total illness duration. While a person with schizophrenia may also experience mood episodes, the duration of the mood is brief compared to the duration of the psychotic symptoms.

  2. Durations of the psychotic symptoms and the disease: In schizoaffective disorder, the psychotic symptoms tend to come and go, while the psychotic symptoms in schizophrenia tend to be persistent. Most people who are diagnosed with schizophrenia have a persistent and chronic course of illness in terms of the course of the disease. Most people diagnosed with schizoaffective disorder, on the other hand, experience episodes of symptoms and, in comparison to people who have schizophrenia, are more likely to have symptom-free intervals.

  3. The relationship between psychotic symptoms and mood symptoms is that mood symptoms are not expected to occur without psychotic symptoms in schizophrenia. The mood symptoms may come and go, but the psychotic symptoms are almost always present. However, the psychotic symptoms may or may not be present when a person is experiencing mania or depression in schizoaffective disorder. Therefore, the schizoaffective disorder’s accurate diagnosis demands that the psychotic symptoms be present for at least a couple of weeks when a person is not facing any severe mood symptoms.

  4. Treatment differences: Schizophrenia treatment is mostly reliant on a special category of prescription medications, known as antipsychotics. Antipsychotics include haloperidol (older antipsychotics), risperidone, and quetiapine (newer medications). Antipsychotic treatment is the go-to maintenance treatment for schizophrenia. Antipsychotics are also included in the treatment for psychotic symptoms in schizoaffective disorder. The only medication approved by the FDA to treat the schizoaffective disorder is paliperidone (Invega). It is an ‘atypical’ second-generation antipsychotic. People who have depressive type schizoaffective disorder are prescribed antidepressants, and mood stabilizers (like lithium or valproate) if they have the bipolar type. People who have schizophrenia do not usually need to take antidepressants or mood stabilizers.

  5. Differences in the cause: Doctors and researchers alike still do not exactly know what causes schizophrenia, despite years of studying it. However, it is believed that problems with brain chemicals like dopamine and glutamate might play a role. Doctors have also noticed that people who have schizophrenia have physical brain differences from others. Researchers have some clues about the schizoaffective disorder, even though they have not studied it for as long as schizophrenia. It is believed that genes that control the body’s sleep-wake rhythms may play a role in schizoaffective disorder. You may also have higher chances of schizoaffective disorder if you have had developmental delays or another mental illness.

The differences between schizoaffective disorder and borderline schizophrenia lie in the duration of mood episodes, treatment prescribed, the origin, the relationship with psychotic symptoms, and the duration of the psychotic symptoms and the disease.


Image credits: Getty Images

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