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Alright, Im new here. I have been diagnosed as having Psychotic Depression and OCD. I have done alot of research on these issues. But there is something that I fail to understand. What is the specific difference between Psychotic Depression, Schizoaffective, and Schizophrenia, besides the insight and the depression. There has to be more than that seperating these disorders. Can anyone give me some insight.

What I have gathered so far is that with Psychotic Depression. The depression is the prominent disorder. So therefore, my depression got so severe that it created psychosis. People with psychotic depression also tend to have delusions of self persecatory. And it has been said that with psychotic depression, there is much more insight into the disease than people with schizophrenia. Which i believe is total bs.

There has to be much more. i mean, when i was diagnosed i only had one voice. Now lol its unreal. many voice, visuals, tactiles, delusional, i have an alternate reality, as well as ocd with agoraphobic features. Been on medications. they didnt work, all they did was turn me into a zombie lol. not on any now.

i know im rambling and i apologize. im just tring to gain insight on what exactly that i have, and how i can control it better. I just want some answers. What the difference?


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You basically got the difference from Psychotic Depression and Schizoaffective Major depressive type. With psychotic depression, you only recieve psychosis during a depressive state. With Schizoaffective, you have psychosis any or all the time, not pertaining to your mood. Schizophrenia on the other hand (from what my Psychiatrist explains to me) is different. Schizophrenia is more severe in thought processing and negative symptoms. The thought process is disorganized and causes the person to be unable to percieve reality from fantasy. Both Psychotic Depression and SChizoaffective Disorder have a better prognosis than of Schizophrenia.

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The difference in the diagnostic criteria is as Twitch said.

Psychotic depression is depression which is severe enough to result in psychotic symptoms at the peak of mood symptomatic...umm...ness?

Schizophrenia can be diagnosed based soley on delusions and hallucinations (paranoid sz) and can be a bitch to differentite because the prodromal phases (thats leading up to a psychotic phase) often involves depression as a symptom and so does the residual phase (after a psychotic phase). But to be defined as schizophrenia the psychotic symptoms have to last at least 6 months. Really if you have a bout of depression that lasts that long then forget what Twitch said about prognosis cos the outlook for refracctory depression also sucks and can be as dibilitating.

Schizoaffective disorder differentiates itself from psychotic depression by a period of at lleast twp weeks of psychotic symptoms in the absence of mood disturbance.

The difference between schizoaffective disorder and schizophrenia+mood disorder is really complicated and I'm not confident enough to say anything other than for most purposes a dx of schizoaffective would suffice and that is generally what my pdoc lists on lab test etc but for anything more involved like correspondence with my neuro it has to be official and be listed as sz+mood funk+sublties thereof

Then there's mood disorder + psychhotic disorder NOS etc.. it's all very compplicatted annd should be left to the pro's who have studied the stuff.

Physically the difference is still beiing researched... so far we know that the genes that are responsible for each of these disorders are not clumpped together like other disorders like 22q11, but rather spread ouut over the whole dna strand missing patches here and there... and indeed some of these are common tto all of mdd, bp and sz.

These disorders also share some of the same neuro chemicals being funky... just differentiated by where they are up too high and where they are down to low in what regions of teh brain...

I could keep writing but basically the answer is the difference is fuck all... I've said it before and I'll say it again... don't sweat your dx! These things often change over time anyway and gettting the right meds and treatment is what matters most and often the meds are the same for all of these disorders anyway

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  • 1 month later...

These disorders can be very difficult to differentiate... and sometimes it even comes down to the preference of the pdoc.

Schizoaffective disorder differs from major depression w psychotic features because with depression, the psychotic features occur during the depressed state. With schizoaffective the psychotic features occur at the exclusion of a mood disorder for at least 2 weeks. The difference between schizophrenia and schizoaffective disorder is that the mood disorder is more prominent/longer with schizoaffective disorder.

There is certainly a lot of overlap.

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