Making a schizophreniform disorder diagnosis can be tricky because its characteristics are identical to those of schizophrenia, considering it is a short-term type of schizophrenia. However, the key to distinguishing the two is looking at the very duration of the episodes. Schizophreniform episodes last for at least 1 month but less than 6 months. The rest of the diagnostic criteria is outlined below.
Diagnostic Criteria for Schizophreniform Disorder DSM-5 295.40 (F20.81)
- At least two of the following are present for a significant amount of time during a 1-month window:
- Delusions
- Hallucinations
- Disorganized speech
- Disorganized behavior
- Negative symptoms (such as lack of emotional expression)
- An episode lasts at least 1 month but not longer than 6 months. If a diagnosis needs to be made without waiting for recovery, it should be classified as “provisional”.
- Similar disorders, such as schizoaffective disorder, bipolar disorder, and depressive disorder with psychotic features cannot be attributed to the disease due to one of two reasons:
- Major depressive or manic episodes have not occurred concurrently with the active-phase symptoms.
- Any mood episodes that have occurred during active-phase symptoms were only present for a minority of the total time of the active and residual periods of the illness.
- The disturbance is not attributable to the physiological effects of a substance, such as a medication or abusive drug, or another medical condition.
It should be specified if:
- With good prognostic features: This calls for the presence of at least two of the following qualities:
- Onset of prominent psychotic symptoms within 4 weeks of the first sign of unusual behavior
- Confusion or perplexity
- Satisfactory premorbid social and occupational functions
- Absence of blunted or flat affect
- Without good prognostic features: This applies to cases where two or more of the previously mentioned features are not present.
Furthermore, the severity of the illness should also be specified as well as if the disorder exists with catatonia.
Who Is at Risk of Developing Schizophreniform Disorder DSM-5 295.40 (F20.81)?
The prevalence of schizophreniform is very low across all sociocultural settings. However, it may be slightly more prevalent in developing countries, especially for the specifier “with good prognostic features”, versus developed countries. Aside from a sociocultural context, not any one individual or group is at a higher risk of developing schizophreniform disorder. However, individuals with relatives affected by schizophreniform disorder do have an increased risk of developing schizophrenia.
Treatment for Schizophreniform Disorder
Individuals with schizophreniform disorder can seek a few treatment options, which aim to stabilize the patient and relieve symptoms:
- Psychotherapy: The therapist will help the patient learn about the illness, come up with goals, and manage difficulties that come with the disorder. Psychotherapy can also help affected individuals manage feelings of distress. Family therapy may also be explored, as it can help family members deal more effectively with the individual who has schizophreniform disorder, as well as use them to reach an even better outcome with the patient.
- Medication: The primary medications used to treat individuals with schizophreniform disorder directly treat the psychotic symptoms. This anti-psychotics, as they’re called, include risperidone, clozapine, quetiapine, ziprasidone, and many others.
- Note: When the individual’s symptoms do improve, treatment should not be deserted; instead, he or she should continue the treatment for at least a full year. However, the dosage of medication can be slowly reduced as can the frequency of the therapy sessions. Signs of relapse should also be carefully monitored.
Functional Consequences
Most individuals with schizophreniform disorder have difficulty functioning normally in multiple areas of daily functioning: at work, at school, in interpersonal relationships, and with self-care. They also are likely to receive an eventual diagnosis of schizophrenia or schizoaffective disorder, and consequently experience functional difficulties from those as well.
Differential Diagnosis
Other possible causes of these symptoms or this disturbance should be carefully considered:
- Other mental disorders and medical conditions: A multitude of mental and medical conditions can cause psychotic symptoms to surface, and therefore must be considered during assessment of a possibly schizophreniform disorder. These may include delirium or major neurocognitive disorder; substance or medication-induced psychotic disorder; depressive or bipolar disorder with psychotic features; schizoaffective disorder; schizophrenia; delusional disorder; paranoid personality disorder; and many others.
- Brief psychotic disorder: Brief psychotic disorder lasts less than 1 month, while schizophreniform disorder lasts been 1 and 6 months.
