Delusions or hallucinations must be present for at least 2 weeks in the absence of a major mood episode at some point during the lifetime of the illness. This criterion defines which condition?

• A. Schizophrenia
• B. Schizoaffective disorder
• C. Delusional disorder
• D. Bipolar with psych features

Answer: (B)

The key idea is that psychotic symptoms can occur outside of mood states in this condition. For schizoaffective disorder, there must be a period of at least two weeks in which delusions or hallucinations are present without any major mood episode. At other times, mood disturbances (depressive or manic) are present for a substantial portion of the illness, but the crucial feature that sets this apart is that psychosis can exist independently of mood symptoms for a meaningful stretch.

This helps distinguish it from mood disorders with psychotic features, where psychosis occurs only during mood episodes, and from schizophrenia, where mood symptoms aren’t a defining part of the illness and there isn’t a required two-week mood-free psychosis period.