Is there a difference between schizophrenia and schizoid personality disorder?

If you have schizophrenia, you may hear voices that aren't real and see things that don't exist. Schizoaffective disorder is a condition that can make you feel detached from reality and can affect your mood.

These two disorders have some things in common. But there are important differences that affect your everyday life and the treatment you get.

Causes

While doctors have studied schizophrenia for years, they still don't know exactly what causes it. Problems with brain chemicals like glutamate and dopamine may play a role. Doctors have also noticed that people with schizophrenia have physical brain differences from others.

There are other things that may also raise your chances of getting schizophrenia. If you take mind-altering drugs, for example, it can bring on some symptoms. You may be more likely to get the illness if your father was older when you were born, or if your mother had contact with certain viruses while they were pregnant, such as influenza.

Researchers have not studied schizoaffective disorder as long as schizophrenia, but they have some clues about what's going on. Genes that control your body's sleep-wake rhythms may contribute to schizoaffective disorder.

Things that are going on in your life may also play a role, such as stressful events. You may also have greater chances of schizoaffective disorder if you have another mental illness or if you have had developmental delays.

Your risk of both schizophrenia and schizoaffective disorder is greater if you have a close relative with it, like a mother, father, brother, or sister.

Symptoms

If you have schizophrenia, you have symptoms that doctors call "psychotic," which means you lose touch with reality. You will see and hear things that aren't real, called hallucinations. You may also have delusions, which means you believe things that aren't true.

Schizoaffective disorder is a little different. It's almost a blend of the symptoms of schizophrenia and another mental health condition called bipolar disorder.

In bipolar disorder, you have mood swings that include depression and mania. If you have schizoaffective disorder, you can have these bipolar symptoms. But separate from those, you also get psychotic symptoms similar to schizophrenia for at least 2 weeks at a time.

Diagnosis

Doctors often diagnose schizophrenia and schizoaffective disorder by checking your symptoms. They may decide you have schizophrenia if you have at least two of these:

• Hallucinations
• Delusions
• Confused speech or thinking
• Unusual body movements
• What doctors call "negative" symptoms, such as lack of emotion or withdrawal from social activities

Doctors sometimes find it tricky to diagnose schizoaffective disorder because it combines symptoms of other illnesses. Your doctor will likely say you have schizoaffective disorder if these things are happening to you:

• Mood problems like depression or mania that happen at the same time as schizophrenia symptoms
• Delusions or hallucinations for at least 2 weeks that show up without mood disorder symptoms
• Symptoms of a mood disorder on a regular basis

There are two main types of schizoaffective disorder, depressive type and bipolar type. Your doctor may diagnose you with one of these types based on the kind of mood symptoms you have.

Treatment

Doctors often treat schizophrenia with antipsychotic drugs that help manage delusions and hallucinations. These may be older antipsychotics, like chlorpromazine (Thorazine) or haloperidol (Haldol), or newer antipsychotics, like olanzapine (Zyprexa) or risperidone (Risperdal). Newer antipsychotics often have fewer side effects.

People with schizoaffective disorder often improve on antipsychotics as well. But your doctor may also prescribe a mood stabilizer, such as lithium (Eskalith), to manage your mood symptoms.

Whether you have schizophrenia or schizoaffective disorder, you can benefit from regular talk therapy. During therapy sessions, you may learn strategies to pursue your goals or deal with unwanted thoughts and mood changes.

Everyday Life

Without treatment, both schizophrenia and schizoaffective disorder can cause you to struggle at school, on the job, or at social events. The psychotic symptoms of both disorders, as well as the mood symptoms of schizoaffective disorder, may make you want to withdraw from daily life. But with the right medicine and talk therapy, you can learn to manage your illness.

What Are Personality Disorders?

People with personality disorders have long-standing patterns of thinking and acting that differ from what society considers usual or normal. The inflexibility of their personality can cause great distress, and can interfere with many areas of life, including social and work functioning. People with personality disorders generally also have poor coping skills and difficulty forming healthy relationships.

Unlike people with anxiety or depressive disorders, who know they have a problem but are unable to control it, people with personality disorders often are not aware that they have a problem and do not believe they have anything to control. Because they often do not believe they have a problem, people with personality disorders often do not seek treatment.

What Is Schizoid Personality Disorder?

Schizoid personality disorder is one of a group of conditions called "Cluster 'A' " or eccentric personality disorders. People with these disorders often appear odd or peculiar. People with schizoid personality disorder also tend to be distant, detached, and indifferent to social relationships. They generally are loners who prefer solitary activities and rarely express strong emotion. Although their names sound alike and they might have some similar symptoms, schizoid personality disorder is not the same thing as schizophrenia. Many people with schizoid personality disorder are able to function fairly well, although they tend to choose jobs that allow them to work alone, such as night security officers, library, or lab workers.

What Are the Symptoms of Schizoid Personality Disorder?

People with schizoid personality disorder often are reclusive, organizing their lives to avoid contact with other people. Many never marry or may continue to live with their parents as adults. Other common traits of people with this disorder include the following:

• They do not desire or enjoy close relationships, even with family members.
• They choose solitary jobs and activities.
• They take pleasure in few activities, including sex.
• They have no close friends, except first-degree relatives.
• They have difficulty relating to others.
• They are indifferent to praise or criticism.
• They are aloof and show little emotion.
• They might daydream and/or create vivid fantasies of complex inner lives.

How Common Is Schizoid Personality Disorder?

It is difficult to accurately assess the prevalence of this disorder, because people with schizoid personality disorder rarely seek treatment. Schizoid personality disorder affects men more often than women, and is more common in people who have close relatives with schizophrenia.

Schizoid personality disorder usually begins in late adolescence or early adulthood.

What Causes Schizoid Personality Disorder?

Little is known about the cause of schizoid personality disorder, but both genetics and environment are suspected to play a role. Some mental health professionals speculate that a bleak childhood where warmth and emotion were absent contributes to the development of the disorder. The higher risk for schizoid personality disorder in families of schizophrenics suggests that a genetic susceptibility for the disorder might be inherited.

How Is Schizoid Personality Disorder Diagnosed?

If symptoms of this personality disorder are present, the doctor will begin an evaluation by performing a complete medical history and possibly a physical exam. Although there are no lab tests to specifically diagnose personality disorders, the doctor might use various diagnostic tests to rule out physical illness as the cause of the symptoms.

If the doctor finds no physical reason for the symptoms, they might refer the person to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a personality disorder.

How Is Schizoid Personality Disorder Treated?

People with this personality disorder rarely seek treatment, because their thoughts and behavior generally do not cause them distress. When treatment is sought, psychotherapy -- a form of counseling -- is the form of treatment most often used. Treatment likely will focus on increasing general coping skills, as well as on improving social interaction, communication, and self-esteem. Because trust is an important component of therapy, treatment can be challenging for the therapist, because people with schizoid personality disorder have difficulty forming relationships with others. Social skills training also can be an important component of treatment.

Medication is generally not used to treat schizoid personality disorder itself. Medications might, however, be prescribed if the person also suffers from an associated psychological problem, such as depression.

What Are the Complications of Schizoid Personality Disorder?

A lack of social interaction is the main complication of schizoid personality disorder. People with this personality disorder are rarely violent, as they prefer not to interact with people. Co-occurring conditions such as mood disorders, anxiety disorders, and other personality disorders may also be more common than in the general population.

What Is the Outlook for People With Schizoid Personality Disorder?

Although some of their behaviors might be odd, people with schizoid personality disorder are generally able to function in everyday life. However, they might not form meaningful relationships or have families of their own. Studies have shown they may sometimes experience social, financial and work disability.

Can Schizoid Personality Disorder Be Prevented?

There is no known way to prevent schizoid personality disorder.