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How Schizoaffective Disorder compares to other disorders

There is little information about schizoaffective disorder in children, which usually starts around puberty.  As a parent, you know how seriously it affects your child, but how does it compare to depression and bipolar (manic and depressive states) and schizophrenia?  What is the course of schizoaffective disorder, and how can you help your child’s future?

Schizoaffective disorder is not as serious as schizophrenia,
but more serious than bipolar/depression.

Research conducted in Britain* studied young people who received typical treatment for schizoaffective disorder, schizophrenia, and bipolar/depression who were between the ages of 17 and 30 (average age was 22).  Over a 10 year period, those with schizoaffective disorder improved slightly, better than those with schizophrenia.

Outlook for schizoaffective disorderBehavioral functioning over time for schizoaffective disorder, schizophrenia and affective disorders (depression, bipolar) at four consecutive follow-ups.  (This scale goes from 2 (good) to 6 (poor). A “1” would be the level of a person with no symptoms and who is considered normal.)
*M. Harrow, L. Grossman, Herbener, E. Davies; The British Journal of PsychiatryNov 2000, 177 (5) 421-426

Russian brain diagram

Behavioral functioning is measured by how well a person does in five areas:

  1. Work and social functioning
  2. Adjustment to typical life situations
  3. Capacity for self-care
  4. Appearance of major symptoms
  5. Number of relapses and re-hospitalizations.

Your child will struggle with these, but there’s good news according to a recent landmark study:
Family support improves a patient’s outcome.

Life with a schizoaffective teen,” tells my story, and what steps I discovered which worked to improve my daughter’s functioning and behavior.  This article also provides insights into how children with schizoaffective disorder think.

A new treatment program was developed that altered some well-established practices.  A set of schizophrenia patients received the following support and were later compared with those who had the usual medication approach.

  1. Dosages of antipsychotic medication were kept as low as possible
  2. Help with work or school such as assistance in deciding which classes or opportunities are most appropriate, given a person’s symptoms;
  3. Education for family members to increase their understanding of the disorder;
    (“Efforts to engage and collaborate with family members are often successful during an acute psychotic episode, whether it is the first episode or a relapse, and are strongly recommended.
    –Family Involvement Strongly Recommended by the American Psychiatric Association)
  4. One-on-one talk therapy in which the person with the diagnosis learns tools to build social relationships, reduce substance use and help manage the symptoms.”

Patients who went through this for of treatment made greater strides in recovery over the first two years of treatment than patients who got the usual drug-focused care.  More here.
New Approach Advised to Treat Schizophrenia, Benedict Carey, New York Times, Oct. 20, 2015

“..if you look at the people who did the best—those we caught earliest after their first break with reality—their improvement by the end was easily noticeable by friends and family.”

beautifulbrainThe longer psychotic symptoms stay in an extreme phase,” in which patients become afraid and deeply suspicious,” the more likely the person will be vulnerable to recurring psychosis, and the more difficulty they will have coming out of it and adjusting to normal life.

How to help your child

Be very realistic about what your child can handle in school.  They may be extremely intelligent–but maybe can’t handle too much homework; or class disruptions; or lack of empathy from the teacher.  A parent or school counselor should help your child find low-stress classes or activities, and consider limiting the number of classes per day.  They can only hold it together for so long!  I found it helped my schizoaffective child to take later classes, starting at 10 or 11 am.

Get the whole family on board to make his or her life easier.  Your child might be stressful and a source of irritation for everyone, but family members can help reduce this by taking on the chores your troubled child would ordinarily do; avoid pressuring them about something, or anything; and allow your child to say oddball things without confronting them about how irrational they are or arguing with them.

DIY talk therapy – Here are some ways to guide your child out of their troubled states.



  •  Schizoaffective kids may express anxiety in a tangled web of seemingly unrelated things, and spike them with paranoia about what they mean. Listen carefully, and conduct a gentle interview to explore what truly is bothering them.  It may be as simple as the room being too cold.
  • Give them plenty of time (if you can). A venting session is sometimes all they need.
  • Diplomatically redirect a negative monologue with a comment about something else more positive. This is where it’s useful to hand them a cat or call over a dog, offer tea or juice, or briefly check email.  The point is to break the spell.

Run-on obsessive thoughts

  • Voices and thoughts can be angry, mean, and relentless. Your child may not tell you this is happening, or may simply assume you already know what’s in their head.  Ask him or her if thoughts or voices are pestering them.  If so, show indignation at how wrong it is for them to mistreat your child, “that’s not right that this is happening to you; this is so unfair to you; you deserve better; I want to help if I can…”
  • Encourage your child to ignore the voices/thoughts and they may go away, or encourage them to tell the voices/thoughts to leave them alone. “I refuse to listen to you anymore!”  “Quit pestering me!”   “Back off and leave me alone, you jerk!”  Negative thoughts and voices are just bullies.

Help your child stand up to thought/voice bullies the same as
as you would help any child dealing with a bully.  Seriously, this works.

Life with a schizoaffective teen,” tells my story, and what I discovered that worked to improve my daughter’s functioning and behavior.  It also provides insight into how people with this disorder think.

Take care and have hope.  You can do this.



  • Hello. I am new to this site and was so happy to see the article on schizoaffective disorder. My son is 19 years old and was diagnosed around age 14. I am moving soon to Oregon from Arizona and hope there are programs and living situations in OR for him. Anxiety and Run on thoughts in the article has given me more to look into and consider.

  • mark says:

    as someone who was diagnosed with sza disorder I find the title of this article offensive. I don’t consider myself to be a troubled kid, in fact I excelled at school and extra curricular activities. I was well liked and had friends both male and female. I may have developed sza disorder later in life (24 to be exact) but I don’t like the label nor the stigma that comes along with the term “schizo” to call kids “troubled” on top of that is a double whammy and believe me its a powerful label.
    I think more emphasis should be placed on finding tolerable treatments and perhaps even a cure for psychotic disorders rather than learning how to cope with them. In the meantime lets not label our kids anymore than they already have been by the field of psychiatry and social work who just loves to place people in neat little boxes.

    • Hello Mark,

      Thank you for your comment. First and foremost, I wholeheartedly agree with you that stigma and labeling is wrong and harmful because it victimizes the victims. However, it seems your comment refers to the name of this blog (“Raising Troubled Kids”) rather than the title of this article itself, is this correct? This article and this blog are directed to family members of a young person with these diagnoses, and people who currently care for them, regardless of age. Most readers have a son or daughter who is in their teens and who lives with them, but some are raising children anywhere from 5 to 25 who live with them.

      I completely agree that schizoaffective disorder does not define intelligence. In this article I wrote: “[your child] may be extremely intelligent–but maybe can’t handle too much homework; or class disruptions; or lack of empathy from the teacher.” When a child or young person shows intelligence and giftedness, and are ‘disabled’ by their illness, parents grieve as if it were a death. I grieved and became very depressed when my intelligent daughter went from highest performing in her class, to being unable to attend school at all… or make friends.. or be free of harmful voices.

      It is a credit to your resilience that you have overcome the drawbacks experienced by many. By your comment, you are telling other parents that their child can thrive and lead a good life–you are offering them hope.

      As to the term “troubled,” I struggled with titling this blog so that it did not label or diagnose someone’s son or daughter, or brother or sister. The title also needed to reflect common search terms so as to come up on a search engine. A young person can have behavioral problems for any number of reasons, which may not be caused by mental illness (or substance abuse). “Troubled” seemed a safe compromise. If you review the other posts, I believe you’ll see that my goal is to offer practical and accurate information on treatment as well as on coping.

      Take care,


  • Kirsten says:

    Thank you Margaret. You supported me through the toughest time, so far, of my life. And you never knew it. Your story was like a replica of mine. Just knowing you survived was a great support. Even way over here in New Zealand. It’s been years since i read your first article, and I’m only just ready to contribute. If there is anything I can do to support others on this side of the world let me know.

    • Hello Kristen,
      I’m so glad to learn that the articles about schizoaffective disorder were helpful to you. Thank you for the comment. You asked if there was something you could do to help others in New Zealand, and there is: start a support group for parents

      A blog cannot come close to the value of meeting other parents like oneself, face-to-face, and together sharing your stories. For most, it will be the first time they can talk with someone who doesn’t judge them, who understands, and who cares. That in itself is incredibly healing, and often draws up suppressed emotions that have been adding to parents’ distress. A well-run support group is one of the best things for a struggling parent.

      In my group, I also encourage siblings to attend and the results are remarkable. They are reluctant at first, but I found that attending even once changes everything. They “get it;” they figure out that their family situation is normal for other families like theirs. A light goes on. They hear their parents’ struggles and learn the truth, and they see the Big Picture and they move on.

      Another idea is to write an article for this blog about your experiences–what worked and what didn’t work, and how you and your child and family are getting along. First-hand accounts are very valuable to other caregivers because they are believable and specific. Think about it.

      Take good care,


    • Your personal testimony will offer other parents hope. Life can go on for the child with a mental illness and won’t lead to tragedy but to peace of mind and wellbeing. Any parent of a ‘normal’ adult child will know that their child goes in their own direction no matter what the parent chooses for them. For our children, it’s harder to choose a path because so much is ‘chosen’ for them by the disorder. Our job is to help them with the right fit, and stick it out with them for decades if need be. I haven’t yet met a parent who isn’t doing this already.

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