Schizophreniform disorder is a psychotic illness with symptoms similar to schizophrenia, lasting less than six months. Like schizophrenia, it is a type of “psychosis” in which a person cannot distinguish what is real from what is imagined; it also affects how people think, act, express emotions, and relate to things.
If symptoms last more than six months, doctors consider the person to have schizophrenia rather than the schizophreniform disorder.
Symptoms of schizophreniform disorder
Both schizophrenia and schizophreniform disorder, as defined in the Diagnostic and Statistical Manual of Mental Disorders, have the same symptoms and essential characteristics except for two differences: The level of functional impairment and the duration of symptoms. The disturbance in social, work, or academic functioning is generally present in schizophrenia, particularly near the first diagnosis, but such disruption may or may not be present in schizophreniform disorder.
In schizophreniform disorder, symptoms (including prodromal, active, and residual phases) must last for at least one month but no longer than six months. In contrast, in schizophrenia, symptoms must be present for 6 months.
If symptoms have persisted for at least a month, a provisional diagnosis of schizophreniform disorder can be made while waiting to see if recovery occurs; if symptoms resolve within six months of onset, the provisional qualifier is removed from the diagnosis. However, if symptoms persist for six months or more, the diagnosis of schizophreniform disorder should be reviewed.
Like schizophrenia, symptoms can include:
- Delusions (false beliefs that the person refuses to give up, even after learning the facts).
- Hallucinations (seeing, hearing, or feeling things that are not real).
- Disorganized speech, such as being nonsensical, using nonsense words, and jumping from topic to topic.
- Strange behavior such as walking in circles or constantly writing.
- Lack of energy.
- Poor grooming habits.
- Loss of interest or pleasure in life.
- Distance from family, friends, and social activities.
Schizophreniform disorder often results in a loss of everyday life, social skills and significant problems at school or work.
Although schizophrenia affects men and women equally, the onset is generally earlier in men, appearing between 18 and 24, while the beginning in women is most common between the ages of 24 and 35. It is essential to look for a diagnosis and treatment when one or more of these acute symptoms appear.
What Causes Schizophreniform Disorder?
Although the exact cause is unknown, researchers believe genetic, biochemical, and environmental factors are involved.
The tendency to develop a schizophreniform disorder can be transmitted from parents to children; this increases the risk of developing the disease compared to the general population. However, this does not guarantee that the disorder will be transmitted.
People with schizophrenia and schizophreniform disorder may have an imbalance of certain chemicals in the brain. These chemicals, called neurotransmitters, are substances that help nerve cells in the brain send messages to each other; an imbalance in these chemicals can interfere with the transmission of messages, leading to symptoms.
Evidence suggests that certain environmental factors may trigger schizophreniform disorder in people who have inherited a tendency to develop the disease. These factors can be poor social interactions or a highly stressful event.
What are the complications?
According to the American Psychiatric Association, approximately two-thirds of people with the schizophreniform disorder develop schizophrenia. In some cases, they also have symptoms of depression, which increases the risk of suicide.
When is a schizophreniform disorder not schizophrenia?
If symptoms of schizophrenia disorder persist beyond six months, the schizophreniform disease is and always was true schizophrenia. On the other hand, the diagnosis disappears if another condition causes the symptoms. Examples include some temporary symptoms of bipolar disorder or substance use disorder.
And sometimes, the symptoms go away. Occasionally we see people who look like schizophrenia, and the symptoms go away; it may have been a reaction to extreme stress or drugs. In many cases, we never know.
One myth surrounding schizophreniform disorder is that it can be caused by substance abuse; this is not true, as drug or alcohol abuse can cause symptoms that resemble schizophreniform disease. The two conditions can also exist together, but they are not the same.
Diagnosis of schizophreniform disorder
A doctor can use various tests, such as brain imaging (MRI) or blood tests, to rule out a non-psychiatric medical problem if someone has symptoms.
If the doctor does not find a physical reason for the symptoms, they may refer the person to a psychiatrist or psychologist or mental health professionals who are trained to diagnose and treat mental illness. They use specially designed interview and assessment tools to see if someone has a psychotic disorder; for a diagnosis of schizophreniform disease, the symptoms may only have lasted less than six months.
Which is the treatment?
Medication and psychotherapy (a type of counseling) are used. People with severe symptoms or at risk of hurting themselves or others may need to be hospitalized to control their condition.
Antipsychotic medications are the main ones that doctors use to treat the psychotic symptoms of schizophreniform disorder, such as delusions, hallucinations, and disordered thinking.
The goal of psychotherapy is to help the person recognize and learn about the disease and its treatment, set goals, and manage the everyday problems related to the condition; it can also help the person manage the feelings of distress related to the symptoms. Family therapy can help families cope more effectively with a loved one who has a schizophreniform disorder.
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