Understanding Schizophreniform Disorder : Symptoms, Differences from Schizophrenia, and Treatment

Schizophrenia is a form of mental health condition that affects how a person thinks, feels, or acts. If the symptoms of schizophrenia last for less than six months, it is often referred to as schizophreniform disorder. Schizophreniform disorder is a condition that causes symptoms like delusions, hallucinations, as well as disorganized thoughts. Remember that schizophrenia and other similar disorders are clubbed under schizophrenia spectrum disorders that all present with symptoms of altered reality or psychosis. It is the number, duration, and major types of symptoms that a person experiences that help determine their exact diagnosis. Read on to find out more about what is schizophreniform and how it is different from schizophrenia.

Schizophreniform disorder is best described as a short-duration schizophrenia spectrum disorder. It is a recognized disorder under the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR).⁽¹⁾ Schizophreniform is a psychotic condition that impacts the manner in which a person thinks, acts, expresses emotions, relates to others, and perceives reality. While schizophrenia is a long-term condition, schizophreniform tends to last for one to six months only rather than the rest of your life. Even though it lasts for a shorter duration, it is still a serious psychotic disorder that might be caused by a variety of factors like genetics, environmental factors, or even brain chemistry.^(2,3,4)

Schizophreniform is categorized as schizophrenia spectrum disorders and other psychotic disorders as it presents with many classic symptoms of psychosis. The timeframe of this disorder is at least one month, but less than six months. According to DSM-5-TR, the symptoms need to be present for at least one month but less than six months for a diagnosis of schizophreniform disorder.

To be diagnosed with schizophreniform under the DSM-5-TR, you need to present with two or more of the symptoms of the condition. The symptoms need to be present for a substantial amount of time in the one to six-month period. The symptoms of schizophreniform include:^(5,6)

• Hallucinations
• Delusions
• Disorganized speech, also known as formal thought disorder
• Negative symptoms of schizophrenia
• Disorganized or catatonic behavior

Out of all the symptoms that are present, one of the symptoms that a doctor looks for should be hallucinations, delusions, or thought disorder. Your therapist or doctor will only arrive at the diagnosis of schizophreniform after ruling out all other conditions and ensuring that no physiological effects of a substance are causing the symptoms.

It is important to note that the symptoms of the schizophreniform disorder are identical to the symptoms of schizophrenia. The symptoms of schizophreniform are primarily segregated into two broad categories, which include positive symptoms and negative symptoms.

Positive symptoms are those symptoms that add a feature to the existing function, and may include:^(7,8)

• Experiencing false sensory experiences known as hallucinations
• Having disorganized speech, or formal thought disorder
• Having inaccurate and unwavering beliefs known as delusions
• Experiencing disorganized motor function or behavior

Negative symptoms of schizophreniform refer to those that show there is a reduced functional effect. These include experiencing the following:^(9,10)

• Reduced emotional expression known as flat affect
• Reduced self-initiated motivation known as avolition
• Reduced speech output known as alogia
• Disinterest in socializing known as asociality
• Decreased ability to experience pleasure known as anhedonia

Based on the DSM-5-TR, one of the primary distinctions between schizophrenia and schizophreniform disorder is the duration of symptoms. Schizophreniform disorder is characterized by symptoms that last no longer than six months, whereas the symptoms of schizophrenia persist for the duration of the individual’s life. As a result, a diagnosis of schizophreniform disorder is often considered provisional, as individuals who do not experience full recovery within six months are subsequently diagnosed with schizophrenia. In fact, nearly two-thirds of those initially diagnosed with schizophreniform disorder eventually receive a diagnosis of schizophrenia or schizoaffective disorder after six months.⁽¹¹⁾

While schizoaffective disorder also shares symptoms of psychosis with other disorders on the schizophrenia spectrum, it is typically characterized by uninterrupted symptomatic periods during which the patient experiences episodes of either mania or depression.^(12,13) In contrast, schizophreniform disorder does not require a marked decline in functioning for diagnosis, unlike schizophrenia.⁽¹⁴⁾

Before diagnosing an individual with schizophreniform disorder, healthcare professionals will exclude other potential causes of similar symptoms, including mood disorders such as bipolar disorder, substance abuse, and delusional disorder.

There is no one cause or risk factor that has been found to be at the root of schizophreniform disorder or for that matter, schizophrenia. Some of the risk factors that are believed to play a role include:⁽¹⁵⁾

• Environmental factors
• Genetics
• Altered brain structure
• Substance abuse
• Neurotransmitter imbalance
• Life stress
• Major trauma in life
• Prenatal abnormalities
• Gonadal hormone imbalance

Once the symptoms of schizophreniform disorder start to appear, it is still unclear about whether you are only experiencing short-term psychosis or if it is the first episode of a chronic mental health condition like schizophrenia. Due to this reason, the treatment of schizophreniform disorder is the same as the treatment for the first episode of schizophrenia. The focus of treatment remains on eliminating the psychosis symptoms.

The treatment of the first episode of acute schizophrenia involves antipsychotic medications like clozapine, olanzapine, or risperidone. Your doctor is likely to keep you on this course of treatment for at least one year.^(16,17)

During this one-year period, you will be monitored closely to look for signs of persisting symptoms or functional impairment. Even if the symptoms are managed successfully with medications, it might be determined that you may benefit further from other treatments in combination with the medications including:

• Cognitive behavioral therapy
• Behavioral skill straining
• Family education
• Coordinated specialty care
• Supported employment
• Treatment or rehabilitation for substance abuse
• Assertive community treatment

Schizophreniform disorder is a type of mental health disorder that has identical symptoms as schizophrenia, but it lasts only for six months or less. In many of cases, the schizophreniform disorder is usually a precursor for schizophrenia. nearly two-thirds of people with schizophreniform disorder will go on to receive a schizophrenia diagnosis. Since there is no way of determining whether a person is experiencing a first episode of schizophrenia or schizophreniform disorder, both conditions are usually treated in the same manner in the initial stages, most commonly with antipsychotics.

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