What will happen to someone with schizoaffective disorder who refuses to take antipsychotics?

Psychosis likely: Schizoaffective disorder is a "halfway" diagnosis between schizophrenia and a major mood disorder, eg., major depression or bipolar disorder. An antipsychotic is generally needed to control psychotic symptoms, and sometimes, though not always, will treat the mood disorder as well. (usually antidepressant or mood stabilizers are needed too.) psychosis often persists for long periods if untreated.