[franz kafka]

During my most recent IP stay, my pdoc suggested that I might have schizoaffective disorder.

But my regular pdoc doesn't believe SZA is even a real diagnosis; he thinks it's the same as bipolar with psychotic features.

To make everything more confusing, my tdoc does think it's possible that I have SZA; in her words, I have something between bipolar and schizophrenia.

Has anyone else here had doctors consider both diagnoses? If you have, how did they make their call? Anyone else have a doc who thinks SZA and bipolar with psychotic features is the same diagnosis?

[LacunaCoiler]

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.

That's my understanding too. BP with psychotic features would be where the psychotic features happen within the BP episodes. With SZA, the psychotic features can appear outside of BP mood episodes (ie. When neither mania or depression is present). Hope that helps.

[st0psign]

in BP with psychosis the psychosis only occurs during a mood episode. in SZA psychosis has to be present sometime when you are not in a mood episode.

[franz kafka]

The problem is that it's hard for me to tell sometimes if I'm having mood symptoms. This time around the psychosis part was the most destructive and difficult part of what I was going though. How can I separate the distress caused by those thoughts from depression? I'm not 100% convinced I was depressed.

[st0psign]

psychosis for depression and mania typically exhibit in different ways. the delusions part at least tend to be different between the two. for instance you're not as likely to have grandiose delusions when you're depressed.. doesn't make much sense right? or last time I was depressed with delusions I thought I was dead and in hell for 3 months.

if you were having grandiose delusions when you were down, id say SZA is more likely, but I'm not a Dr... might be something to look into though.

[Kuras]

I'm Bipolar Schizoaffective. SZA can be somewhat difficult to diagnose for some doctors. Psychosis can/does occur for me, even when I'm otherwise fine. It can be benign or malignant. You do, however, need to demonstrate multiple instances of perpetual psychosis for certain lengths of time for a solid diagnosis. I don't know your circumstances but separating agitation/stress from a depressive state comes down to knowing your own body. Examining whether you're exhibiting actual traits of depression versus something else.

[Christopher1990]

I've been told I had sza. I was also told I have a couple other dx that I don't remember. I find it hard to believe anyone could dx you in a few days with something like sza. I don't consider myself sza. I don't know what i am, but the way I look at it it doesn't really matter. Treatment is the same. I've looked on sza forum and really can't identify myself with any such posts.