Schizophreniform Disorder

What is schizophreniform disorder?

Schizophreniform disorder is a psychotic disorder with symptoms that are identical to schizophrenia. The key difference is that schizophreniform disorder only lasts one to six months, whereas schizophrenia is a lifelong disorder. ^[1]

The symptoms of this disorder generally revolve around a break from reality. Affected individuals may have hallucinations, where they see, hear, smell, taste, or feel things that aren’t really there. They may also experience delusions, which are inaccurate beliefs that remain inflexible even when someone presents them with conflicting evidence.

Other symptoms can include abnormal behavior, such as walking in circles or odd movements, and disorganized speech, such as nonsensical words or quickly changing between topics.

Symptoms of schizophreniform disorder

People with schizophreniform disorder might experience the following:

• Hallucinations, or sensing things that aren’t there
• Delusions or false beliefs that persist even with evidence to the contrary
• Disorganized behavior, such as agitation or “silliness”
• Catatonic behavior, such as lack of reactivity or abnormal movements
• Disorganized speech, including rapidly switching topics or incoherence
• Low energy and motivation
• Withdrawal from friends, family, and social events
• Poor hygiene
• Loss of interest in things they used to enjoy
• Flat affect, or limited emotional expression

Causes of schizophreniform disorder

The causes of schizophreniform disorder are not yet fully understood. However, genetics, brain chemistry, and environment are all believed to play a part.

Genetics

A family history of schizophrenia, schizophreniform disorder, or other psychotic disorders significantly increases the chance of developing schizophreniform disorder. ^[2][4]

Brain Chemistry

Like schizophrenia, individuals with schizophreniform disorder often have an imbalance of neurotransmitters in the brain, such as dopamine and glutamate. ^[2] This affects perception and reasoning. 

Environmental Factors

Environmental factors, such as stressful experiences or childhood trauma, may trigger schizophreniform disorder in those genetically predisposed.

Complications of schizophreniform disorder

If schizophreniform disorder is left untreated, several complications can occur. Symptoms can negatively impact the individual’s personal life. They are also more likely to develop other mental disorders.

On a personal level, due to the nature of the symptoms, individuals with schizophreniform disorder may experience difficulty with interpersonal relationships or problems maintaining a job.

If left untreated, those who suffer from schizophreniform disorder are more likely than the general population to develop other mental illnesses, including: ^[2]:

• Depression
• Problems with substance abuse
• Schizophrenia

Diagnosing schizophreniform disorder

Diagnosing schizophreniform disorder begins with a physical examination and medical history review to rule out physical conditions. From there, a mental health professional will interview the person and observe their behavior.

Using this data, the professional will determine whether the person meets the DSM-5’s criteria for schizophreniform disorder. They must meet at least two of the following criteria, with each present most of the time for at least one month. At least one of the two must be from the first three listed criteria ^[1]:

• Hallucinations
• Delusions
• Disorganized speech
• Disorganized or catatonic behavior
• Flat affect or lack of motivation

These symptoms cannot be attributable to drug use or another medical condition. An episode must last between one and six months. If a diagnosis is made before six months, it must be noted as “provisional” since there is still a possibility that the true diagnosis is schizophrenia. ^[1] 

Differential diagnoses that must be ruled out include schizophrenia, brief psychotic disorder, schizoaffective disorder, and depressive or bipolar disorder with psychotic features. Generally, the differences between schizophreniform disorder and these other mood disorders are ^[1]:

• Symptoms of schizophrenia lasts longer than six months
• Brief psychotic disorder lasts between one day and one month
• In schizoaffective disorder, psychotic episodes co-occur with a depressive or manic episode
• Similar to schizoaffective disorder, diagnoses of depressive or bipolar disorder with psychotic features also require symptoms to be concurrent with a mood episode

Prevention of schizophreniform disorder

There is no specific way to prevent this disorder, as the causes are not well-understood. However, early recognition and treatment are key to reducing the impact on an individual’s social and professional life and preventing further complications.

Treatment for schizophreniform disorder

Since the disorder resolves on its own within six months, the goal of treatment is to stabilize and reduce symptoms. The most common form of treatment is medication, but individual psychotherapy and family therapy may be used as well.

Medication

The primary treatment for schizophreniform disorder is antipsychotic medication, which helps with hallucinations, delusions, and disordered thinking. Atypical antipsychotics are preferred over typical antipsychotics, which are less effective and have a greater risk of side effects. ^[3]

Some commonly used atypical antipsychotics include ^[2]:

• Clozapine
• Risperidone
• Quetiapine
• Olanzapine
• Paliperidone

After symptoms improve, medication should be continued for 12 months. Healthcare providers will gradually decrease the dosage and monitor for the return of symptoms. ^[2]

Talk therapy

Talk therapy is often used in conjunction with medication. In addition, different modalities may be used based on the individual’s symptoms and level of awareness, such as cognitive-behavioral therapy and interpersonal psychotherapy. Generally, the goals of therapy are to provide education, learn coping skills, manage everyday problems related to the symptoms, and challenge irrational thoughts.

Family therapy

Family therapy is sometimes used to help the family better understand the disorder and how to support their loved one more effectively. This allows the family to better monitor their symptoms and keep them on track with treatment.

Self-care for schizophreniform disorder

As a complement to medication and therapy, practicing self-care can help improve overall well-being. People with schizophreniform disorder should educate themselves on the disorder and effective coping mechanisms. They should also seek support from loved ones. These individuals should avoid drugs and alcohol, as they can worsen symptoms.

Helping someone with schizophreniform disorder

You can help someone with schizophreniform disorder by educating yourself on the disorder and encouraging them to seek treatment. Most people with this disorder do not have a lot of insight into their problems, so patience and empathy are key. Once they begin treatment, you can help them stay on track by keeping up with their medication and therapy appointments. 

Attending family therapy can help you better understand what your loved one is going through and how you can support them. Seek immediate help if you think they pose a danger to themself or others.

FAQs about schizophreniform

How common is schizophreniform disorder?

The incidence of schizophreniform disorder is relatively rare. Research estimates anywhere between 0.04-1% of the population suffer from this disorder at some point in their lives. ^[4] It is less common than schizophrenia in developed countries, although it may be more common in less developed countries. ^[1] Schizophreniform disorder affects men and women equally, but men tend to experience it at an earlier age. ^[2]

What is the outlook for people with schizophreniform disorder?

While true schizophreniform disorder resolves within six months, about two-thirds of those diagnosed initially with provisional schizophreniform disorder will not recover. ^[1] These individuals will ultimately receive a diagnosis of schizophrenia.

Schizophreniform vs. schizophrenia – What is the difference?

While schizophreniform disorder and schizophrenia have identical primary symptoms, the duration of symptoms differs. Schizophrenia is a life-long disorder, but schizophreniform symptoms only last for one to six months. ^[1] Unlike with schizophrenia, the level of functioning is not always affected, and impairment is not required for a diagnosis. ^[1]