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SCHIZOPHRENIFORM DISORDER
 


Psychiatric Interview With A Simulated Psychotic Individual


SYNOPSIS

Acute Schizophrenia-like Psychotic Disorder F23.2 - ICD10 Description, World Health Organization
An acute psychotic disorder in which the psychotic symptoms are comparatively stable and justify a diagnosis of schizophrenia, but have lasted for less than about one month; the polymorphic unstable features, as described in F23.0, are absent. If the schizophrenic symptoms persist the diagnosis should be changed to schizophrenia.

    F23.3 Other acute predominantly delusional psychotic disorders

    Acute psychotic disorders in which comparatively stable delusions or hallucinations are the main clinical features, but do not justify a diagnosis of schizophrenia (F20.-). If the delusions persist the diagnosis should be changed to persistent delusional disorder (F22.-).
Schizophreniform Disorder - Diagnostic Criteria, American Psychiatric Association

An individual diagnosed with schizophreniform disorder needs to meet all of the following criteria:

  • Active-Phase Symptoms: Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one of these symptoms must be delusions, hallucinations, or disorganized speech:

    • Delusions.

    • Hallucinations.

    • Disorganized speech (e.g. frequent derailment or incoherence).

    • Grossly disorganized or catatonic behavior.

    • Negative symptoms (i.e., diminished emotional expression or avolition).

  • An episode of the disorder lasts for at least 1 month but less than 6 months. When the diagnosis must be made without waiting for recovery, it should be qualified as "provisional."

  • Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either (1) no major depressive or manic episodes have occurred concurrently with the active-phase symptoms; or (2) if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness.

  • The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.

  • Specify if:

    • With good prognostic features: This specifier requires the presence of at least two of the following features:

      • onset of prominent psychotic symptoms within 4 weeks of the first noticeable change in usual behavior or functioning

      • confusion or perplexity

      • good premorbid social and occupational functioning

      • absence of blunted or flat affect

    • Without good prognostic features: This specifier is applied if two or more of the above features have not been present.

This mental disorder is diagnosed when the symptom criteria for schizophrenia are met, but the duration is too short and social and occupational functioning may not be impaired. An episode of the disorder (including prodromal, active, and residual phases) lasts at least 1 month but less than 6 months. If this disorder lasts 6 months or longer; the diagnosis is changed to schizophrenia. This disorder is not due to a drug, medication or general medical disorder. There appears to be two types of schizophreniform disorder: one with a good prognosis, and the other with a bad prognosis. The schizophreniform disorder with a good prognosis more often had an episodic, recurrent course, and a family history of mood disorders. The schizophreniform disorder with a bad prognosis lacked these features.

Effective Therapies

Antipsychotic medication usually prevents suicide, minimizes rehospitalization, and dramatically improves social functioning.


Excellent Very Honest Documentary On Bellevue Psychiatric Hospital


Ineffective Therapies

Cognitive behavioral therapy (CBT) was not effective in reducing symptoms in schizophrenia, or in preventing relapse in bipolar I disorder. Vitamins, dietary supplements, cognitive training and cognitive rehabilitation have all proven to be ineffective in the treatment of psychotic disorders.


Cannabis And Schizophrenia

Cannabis (pot) has been proven to nearly quadruple the risk of developing schizophrenia. In 1969-70, Swedish military conscripts (>97% of the country's male population aged 18-20) were followed for 35 years. At the start of this study, none of the conscripts had schizophrenia. Over 35 years, those who had used cannabis more than 50 times at the beginning of the study had 3.7 times the normal rate of developing schizophrenia. This association was not explained by use of other psychoactive drugs or personality traits. Schizophrenia normally occurs in 1% of the population. 86% of individuals with schizophrenia are disabled and unemployed. Thus, if cannabis was legalized, the prevalence of schizophrenia could more than triple. This would cause a massive increase in the national unemployment rate.

Legalizing Illicit Drugs

Some people argue that illicit drugs should be legalized to decrease the crime associated with these drugs. Historically, tobacco and alcohol were once illegal drugs. Tobacco smoking is now the leading cause of death in America, and alcoholism is the third leading cause of death. Thus legalizing illicit drugs does not make them any less medically and socially harmful. In fact the opposite is true; legalizing illicit drugs increases their use and the harm they cause. The Government of Finland is passing legislation that will gradually ban all tobacco use by 2040.

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