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Schizophreniform Disorder

Reviewed by Psychology Today Staff

Schizophreniform disorder is a short-term psychotic disorder diagnosed in someone who shows symptoms of schizophrenia for the better part of at least one month but for less than six months. If the symptoms persist for six months or more, the diagnosis is changed to schizophrenia or, in some cases, bipolar or schizoaffective disorders. Someone with schizophreniform disorder cannot differentiate between what is real and what is imagined to a degree that affects their thought process, behavior, emotional expression, and interpersonal relationships. To meet the criteria for schizophreniform disorder, the symptoms must not be due to medication or recreational drugs, or to another medical or mental problem. About one in a 1000 people develop this disorder, and two-thirds of cases develop schizophrenia or schizoaffective disorder.

Symptoms

According to the DSM-5 and the NIH, schizophreniform disorder can be diagnosed if at least two of the following symptoms appear, and one of the two symptoms is delusions, hallucinations, or disorganized speech.

  • Delusions, having false beliefs even when evidence is presented, imagining that people are talking about you or spying on you
  • Distorted thinking
  • Hallucinations (hearing or seeing things that don't exist)
  • Disorganized or nonsensical speech
  • Strange or bizarre behavior, catatonia, and in some cases, pacing or walking in circles
  • No or limited emotional expression
  • Some cases develop mood disorders such as depression
  • Lack of hygiene
  • Loss of interest in life and normal activities

People with schizophreniform disorder often withdraw from loved ones and avoid social activities. Schizophreniform disorder often results in a loss of normal living and social skills and significant problems at school or work.

Like schizophrenia, schizophreniform disorder affects men and women equally, but onset is generally earlier in men, often appearing between the ages of 18 and 24. In contrast, onset in women is more common between the ages of 24 and 35, and it can be rapid. It is important to seek diagnosis and treatment as soon as one or more key symptoms appear, as the prognosis for a full recovery is best with early intervention.

Is schizoaffective disorder the same as schizophreniform disorder?

No. These are different disorders. Schizoaffective disorder is a thought disorder with both psychotic features and mood symptoms. Mania or depression accompanies schizoaffective disorder.

Is schizophreniform disorder different from brief psychotic disorder?

Yes. The duration of psychosis is not the same. People with brief psychotic disorder experience the sudden onset of psychotic behavior, and this period lasts less than one month. After that, people with brief psychosis experience complete remission, though relapse is possible.

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Causes

The cause of schizophreniform disorder is unclear but may be linked to genetics, abnormal brain structure, or circuitry in areas that involve perception, and or an environment or situation that initiates symptoms in someone who is genetically inclined to develop the disorder.

Poor interpersonal relationships or severe stress may trigger symptoms of schizophreniform in those who are susceptible. Children with parents affected by schizophrenia spectrum disorders may be at a higher-than-average risk of developing the condition themselves.

Can drug and alcohol use cause schizophreniform disorder?

No. This disorder can co-occur with addictions, but addiction does not cause the disorder. Health professionals recommend that patients avoid all drug and alcohol use, which will only worsen symptoms and react badly with antipsychotic medications.

Treatment

There are no lab tests to diagnose schizophreniform disorder. However, blood tests, brain imaging, and medical history are utilized to rule out other medical illnesses and conditions. Psychotherapy and antipsychotic medications are the mainstay of treatment for schizophreniform disorder, and are critical to prevent the development of schizophrenia.

Cognitive-behavioral therapy is routinely used to help those on the schizophrenia spectrum; CBT helps the patient to understand the disorder and provide practical ways to cope while improving social and problem-solving skills. Other types of talk therapy that take a positive approach may be equally effective, at least in the short term. If violent or self-destructive symptoms appear, hospitalization may be necessary. Family therapy can also help relatives deal with the disorder and learn effective ways to help.

Can schizophreniform disorder be prevented?

While there are no useful preventions or methods to reduce the risk of schizophreniform disorder. Early diagnosis is the best defense against the disorder.

References
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition 
Understanding Mental Disorders. Schizophreniform Disorder. 2015; American Psychiatric Association.
Merck Manual. Schizophreniform Disorder.  Jones C, Hacker D, Cormac I, Meaden A, Irving CB. Cognitive behavioural therapy versus other psychosocial treatments for schizophrenia. Cochrane Database of Systematic Reviews. April 2012.
National Institutes of Health
Last updated: 07/16/2021