Does Schizoaffective Disorder Cause Sexual Indiscretion?

Reader’s Question

I recently dated a 28-year-old man diagnosed with schizoaffective disorder. Two months into the relationship he admitted that after a night of heavy drinking he had slept with someone else. Completely remorseful, he told me that he sexually fantasises about most women that he meets. He admitted that in all previous relationships he had constantly fantasised about other women and that given the opportunity he would have slept with them. I have read that sexual indiscretions can be related to manic periods, however this appears to be a constant pattern of thinking for him. Is this type of behaviour symptomatic of schizoaffective disorder?

Our Clinical Psychologist’s Reply

It’s highly unlikely that his sexual indiscretions are related to Schizoaffective Disorder. Schizoaffective Disorder is a severe psychiatric disorder — a combination of schizophrenic symptoms such as hallucinations, paranoia, delusions, thought problems — and a mood component such as depression or hypomania. In this disorder, changes in mood come and go but the schizophrenic symptoms typically remain — despite the mood.

In a way, frequent sexual fantasies are not uncommon and are not considered a symptom of a psychiatric condition. Sexual indiscretions, however, are typically a behavior and attitude issue and not related to either normal sexual fantasy/drive or a severe psychiatric illness. I suspect your friend has problems with sexual behavior — then uses his diagnosis of Schizoaffective Disorder as an excuse. In my own experience, I’ve never seen an individual with a true/valid Schizoaffective Disorder who is also a romantic romeo or player. The schizophrenic symptoms are much too socially disabling, even when medications have brought the disorder under partial control.

In short, in my opinion he’s using a creative excuse for his sexual behavior — but it’s still an excuse. The devil or Schizoaffective Disorder doesn’t make him do it. When you state you “recently dated”, I assume you’re not still dating him. That’s probably a good choice.