I had a full psychological exam done on me (they did everything from mood disorders, to ADHD, to personality, to dyslexia, etc) and it came back as sza. My pdoc at the time agreed with it and I was still skeptical about it because I was pretty sure I was just having a really bad episode (which we found out later was true when I almost ended up in the hospital). The two docs after that have completely dismissed the sza diagnosis and have decided it was bipolar w/psychotic features (I go to a learning hospital so I switch docs every 2 years. However now, I have a permanent doc since I got into the mood disorder clinic). I figure this is due to the fact that I only experience psychotic features when I'm really manic. My therapist also agree with my current doctor and now we're all on the same page with the diagnosis.

The way I understood it all (and I could still be wrong) is that sza can happen whenever and however, whereas bipolar with psychosis usually happens when you're mood fluctuates to the extremes and is not always present. Lie I said though, I could be wrong but that was my understand.