If you're schizoaffective, chances are you are experiencing a break in reality at some point. That's the insidious part of any schizophreniform disorder. Most people don't find out they're psychotic until they end up in the hospital.

That's a pretty important distinction. There has to be evidence of psychosis in order to make the dx of SZA. You cannot be aware of your psychosis during the psychosis, that's just how it is. Everything seems perfectly normal until you wake up in the psych ward. So you wouldn't be aware if there was a break in reality or not.

See what I'm saying?