I don't know about schizoaffectve bipolar, but I was just diagnosed "bipolar"... I don't even know if they made a distinction when I was I the hospital. I was definitely manic and psychotic. (Great descriptions above of psychosis!)
All they gave me was lithium, but the delusions didn't stop 'til I took an AP, zyprexa.
I was told that it was caused by a (Dr. supervised)decrease in my antidepressant. Or it was postpartum related.
I take my meds religiously and hope I always do. I never want to go back to that hell!