Purpose: This study aims to analyze the clinical manifestations, psychosocial factors, and management of a patient with manic-type schizoaffective disorder. The study focuses on auditory hallucinations, aggressive behavior, medication non-adherence, and relapse dynamics. It assumes that biological, psychological, and social factors interact in worsening symptoms and increasing relapse risk. Research Method: This study used a qualitative descriptive case study design involving one patient diagnosed with manic-type schizoaffective disorder. Data were collected through clinical interviews, direct observation, and medical documentation. The data were analyzed descriptively to explore the patient’s biological, psychological, and social conditions related to symptom development, treatment adherence, and relapse. Results and Discussion: The findings showed that the patient experienced dominant auditory hallucinations, aggressive behavior, recurrent medication non-adherence, and psychosocial stressors, including family conflict and bereavement. These factors contributed to symptom exacerbation and relapse risk. The coexistence of psychotic and manic symptoms reflects the complexity of manic-type schizoaffective disorder. Integrated pharmacological treatment, psychotherapy, and family support are essential for symptom control and emotional stabilization. Implications: The findings emphasize the need for holistic management that combines biological, psychological, and social interventions to improve adherence, prevent relapse, and enhance quality of life. Originality: This study provides an in-depth case-based explanation of relapse dynamics in manic-type schizoaffective disorder by integrating clinical and psychosocial perspectives.