One of the most confusing conditions is schizoaffective disorder. Some people may have symptoms of both a depressive disorder and schizophrenia at the same time, or they may have symptoms of schizophrenia without mood symptoms. Many individuals with schizoaffective disorder are originally diagnosed with manic depression. Someone who experiences psychosis for three or four weeks while in a manic phase does not have schizoaffective disorder. However, if delusions or hallucinations continue after the mood has stabilized and are accompanied by other symptoms of schizophrenia such as catatonia, paranoia, bizarre behavior, or thought disorders, a diagnosis of schizoaffective disorder may be appropriate.
Accurate diagnosis is easier once the acute psychotic episode is under control.
Distinguishing between bipolar disorder and schizophrenia can be particularly difficult in an adolescent, since at that age psychotic features are especially common during manic periods. Because schizoaffective disorder is so complicated, misdiagnosis is common. Some people may be misdiagnosed as having schizophrenia. Others may be misdiagnosed as having bipolar disorder. And those diagnosed as having schizoaffective disorder may actually have schizophrenia with prominent mood symptoms.