diagnosis is really mostly for billing and guiding treatment. My diagnosis is Bipolar I w/a psychotic component, but a lot of doctors would call it Schizoaffective, maybe Schizophrenia with a mood disorder.

The big issue is getting effective and appropriate treatment and avoiding ineffective and possibly harmful ones. For instance, some people with the Bipolar I diagnosis are given stimulants. Most people with Schizophrenia or Schizoaffective labels are not prescribed stimulants, because stimulants can be damaging to those with a heavy psychotic component to their problems.