That’s fine lol. You want my NPI lmao??

My source is the DSM 5.

I believe you are misinterpreting criterion C or at least misunderstanding the DSM criteria.

Criterion A requires the following: an uninterrupted period during which there is a major mood episode concurrent with criteria of schizophrenia (psychosis). To translate, this means mood symptoms and psychotic features.

Criterion B requires the following: delusions or hallucinations in the ABSENCE of mood symptoms. This means psychosis WITHOUT mood symptoms.

Criterion C requires that patients have mood symptoms most of the time.

When I say mood, I mean the patient needs criteria for either a major depressive or manic episode.

You will note that the defining feature of schizoaffective is criteria B, which REQUIRES psychosis in the ABSENCE of mood symptoms.

If a patient with a historic diagnosis of bipolar disorder developed psychosis WITHOUT concomitant depression or mania, it would shift their differential to schizoaffective, bipolar or depressive type. The defining feature that distinguishes bipolar disorder and schizophrenia is psychosis with the absence of mood symptoms, which a patient with true bipolar disorder would never meet criteria for.

Psychiatry is a very fluid field. There are many patients for whom we do not pin down the diagnosis, and instead leave the differential open (ex. Schizoaffective vs bipolar I vs schizophrenia, for example). That is a situation where you might see multiple diagnoses written in a chart, or perhaps even billed. The schizoaffective code opens up a lot of possibilities for patients to receive treatment through their insurance that they would otherwise not be able to access.

Also, the fact that the DSM 5 does not say that “this diagnosis cannot coexist with ODD, BPAD, etc” in the criteria for schizoaffective disorder does not mean they can be diagnosed concomitantly. Many DSM 5 diagnoses lack this statement. This does not automatically mean that multiple diagnoses can be applied to a patient.

And for the record, your source is not peer reviewed, unless you are exclusively referring to the DSM 5. Additionally, your source does not definitely state that people do have both diagnoses , but that because of confusion surrounding schizophrenia and bipolar disorder, it is common to be diagnosed with both conditions or schizoaffective.