which required only an assessment of the curr ent period of illness. If the mood symptoms
are present for only a relative ly brief period, the diagnosis is schizophrenia, not schizoaf-
fective disorder. When deciding whether an individual’s presentation meets Criterion C,
the clinician should review the total duration of psychotic illness (i.e., both active and re-
sidual symptoms) and determine when significa nt mood symptoms (untreated or in need
of treatment with antidepressant and/or mo od-stabilizing medication) accompanied the
psychotic symptoms. This determination requir es sufficient histor ical information and
clinical judgment. For example, an individual with a 4-year history of active and residual
symptoms of schizophrenia develops depressi ve and manic episodes that, taken together,
do not occupy more than 1 year during the 4- year history of psycho tic illness. This presen-
tation would not meet Criterion C.
In addition to the five symptom domain areas identified in the diagnostic criteria, the
assessment of cognition, depression, and mani a symptom domains is vital for making crit-
ically important distinctions between the va rious schizophrenia spectrum and other psy-
chotic disorders.
Associated Features Supporting Diagnosis
Occupational functioning is frequently impair ed, but this is not a defining criterion (in
contrast to schizophrenia). Restricted social contact and difficulties with self-care are as-
sociated with schizoaffective disorder, but negative symptoms  may be less severe and less
persistent than those seen in schizophrenia. Anosognosia (i.e., poor insight) is also com-
mon in schizoaffective disorder, but the deficits in insight may be less severe and perva-
sive than those in schizophrenia. Individual s with schizoaffective disorder may be at
increased risk for later developing episodes of  major depressive disorder or bipolar disor-