Schizoaffective Disorder 105
matic event and characteristic symptom features relating to reliving or reacting to the event
are required to make the diagnosis. 
Autism spectrum disorder or communication disorders. These disorders may also have
symptoms resembling a psychotic episode but are distinguished by their respective defi-
cits in social interaction with repetitive an d restricted behaviors and other cognitive and
communication deficits. An individual with autism spectrum disord er or communication
disorder must have symptoms that meet fu ll criteria for schizophrenia, with prominent
hallucinations or delusions for at least 1 mont h, in order to be diagnosed with schizophre-
nia as a comorbid condition.
Other mental disorders associated with a psychotic episode. The diagnosis of schizo-
phrenia is made only when the psychotic episode  is persistent and not attributable to the
physiological effects of a subs tance or another medical condit ion. Individuals with a de-
lirium or major or minor neurocognitive disorder may present with psychotic symptoms,
but these would have a temporal relationship to the onset of cognit ive changes consistent
with those disorders. Individuals with subs tance/medication-induced psychotic disorder
may present with symptoms char acteristic of Criterion A for schizophrenia, but the sub-
stance/medication-induced psyc hotic disorder can usually be distinguished by the chron-
ological relationship of subs tance use to the onset and remi ssion of the psychosis in the
absence of substance use. 
Comorbidity 
Rates of comorbidity with substance-relate d disorders are high in schizophrenia. Over
half of individuals with schizophrenia have  tobacco use disorder and smoke cigarettes
regularly. Comorbidity with anxiety disorder s is increasingly recognized in schizophre-
nia. Rates of obsessive-compulsive disorder and panic disorder are elevated in individuals