WHAT IS IT?
Schizophreniform disorder is a mental disturbance with serious abnormalities in sensory perceptions, thought, speech, attention, mood, behavior, will, interpretation of everyday life events, and/or the capacity to enjoy life. A person with this disorder appears similar to those with schizophrenia. But, schizophreniform disorder is a more acute illness lasting for less than six months. Another difference is that serious impairment in social and occupational functioning may or may not have occurred (a diagnosis of schizophrenia requires functional impairment and at least six months of illness). The disorder is not due to drug or alcohol abuse. It is diagnosed after ruling out schizoaffective disorder or a mood disorder with psychotic features such as
bipolar disorder (manic-depression).
Symptoms of this disorder are described as positive or negative. Positive symptoms are an excess of normal functions, such as abnormalities of thinking (delusions), sensory perceptions (hallucinations), language (disorganized speech), or behavior (grossly disorganized or catatonic behavior). Negative symptoms show a reduction or loss of normal functions, such as a restriction and flattening of emotions, severely reduced speech or thought, and lack of interest in any goal-directed activities.
HOW IS IT DIAGNOSED?
History includes at least two of the following: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, or diminished emotions/thoughts/will to pursue any goal. These must have been present for at least one month, but less than six months.
Physical exam does not contribute to this diagnosis. Observation of the individual's orientation, dress, mannerisms, behavior and content of speech provide essential signs to diagnose the illness.
Tests: Psychological tests may be used but do not prove the diagnosis.
HOW IS IT TREATED?
Initial treatment is hospitalization to establish diagnosis and begin treatment with medication. Hospitalization may also be necessary for patient safety, to address the risk of suicide or homicide, and take care of basic needs. Antipsychotic drug therapy is helpful for hallucinations and delusions and to prevent a relapse into psychosis; anticonvulsants and lithium can also be helpful. Outpatient treatment includes crisis intervention, individual and group psychotherapy, family therapy, and development of social supports. Vocational rehabilitation may be needed to provide assistance upon returning to work when the individual has recovered sufficiently from the acute psychotic episode.
WHAT MIGHT COMPLICATE IT?
Injuries, accidents, suicide, or homicide can occur.
Alcohol and drug abuse is common. Major mood disorders may appear.
PREDICTED OUTCOME
Approximately one-third of the individuals with this diagnosis will recover within six months. Two- thirds will not recover and will become chronically ill. At that time, the diagnosis will change to schizophrenia or schizoaffective disorder.
ALTERNATIVES
It may be schizophrenia, schizoaffective disorder, brief psychotic disorder, or mood disorder with psychotic features. It could also be substance abuse, one of the most common causes of abrupt onset of psychotic symptoms. Medical causes include metabolic and endocrine disorders, and brain tumor.
APPROPRIATE SPECIALISTS
Psychiatrist, psychologist, and other mental health professionals.
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