According to ICD-11, the distinction between schizophrenia and schizoaffective disorder is BEST described as:
- A Schizoaffective disorder requires mood episodes to be present for the majority of the total duration of the illness after the initial prodrome ✓
- B Schizoaffective disorder requires schizophrenia symptoms to occur exclusively during mood episodes
- C In schizoaffective disorder, psychotic and mood symptoms must each last at least 4 weeks in the same episode
- D Schizoaffective disorder is diagnosed only when mood-incongruent psychosis precedes mood symptoms by at least 2 weeks
Correct answer: A. Schizoaffective disorder requires mood episodes to be present for the majority of the total duration of the illness after the initial prodrome
Explanation
ICD-11 conceptualises schizoaffective disorder as requiring prominent mood episodes (manic, depressive, or mixed) to be present for a substantial portion — the majority — of the total illness duration once established, while also meeting criteria for schizophrenia at other times. This contrasts with DSM-5 where mood episodes must be present for the majority of the total active and residual illness duration. Option D (2-week lead-in of psychosis) is the DSM-5 criterion, not a standalone ICD-11 rule.
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
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