Schizophreniform Disorder: Symptoms, Diagnosis, And Treatment

Find out:

  • What is schizophreniform disorder;
  • symptoms (DSM), diagnosis and prognosis;
  • relationship between schizophreniform disorder and schizophrenia;
  • “Schizophreniform disorder can be

Schizophreniform disorder  is a mental disorder diagnosed when the symptoms of schizophrenia are present for a significant part of the time within a period of one month , but the signs of disturbance are not present during the full six months required for the diagnosis of schizophrenia.

The symptoms of both disorders can include  delusions, hallucinations, disorganized speech, disorganized or catatonic behavior and social withdrawal . Although impairment in social, occupational or academic functioning is necessary for the diagnosis of schizophrenia, in schizophreniform disorder the level of functioning of an individual may or may not be affected. Although the onset of schizophrenia is often gradual over several months or years, the onset of schizophreniform disorder can be relatively rapid.

Like schizophrenia, schizophreniform disorder is often treated with antipsychotic drugs, especially  atypical ones , along with a variety of social supports (such as individual psychotherapy, family therapy, occupational therapy, etc.) designed to reduce the social and emotional impact of the disease. The prognosis varies depending on the nature, severity and duration of the symptoms, but about two thirds of individuals diagnosed with schizophreniform disorder develop schizophrenia. [1]

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Content

  • 1 Symptoms and diagnosis
  • 1 Prognosis
  • 2 Prevalence
  • 3 Treatment
  • 4 References

Symptoms and diagnosis of schizophreniform disorder

Schizophreniform disorder is a type of mental illness that is characterized by psychosis and is closely related to schizophrenia. Both schizophrenia and schizophreniform disorder, as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM), have the same essential symptoms and characteristics, except for two differences: the level of functional impairment and the duration of symptoms.

Impairment in occupational, social or academic functioning is usually present in schizophrenia, particularly around the time of the first diagnosis, but this impairment may or may not be present in schizophreniform disorder. In schizophreniform disorder, symptoms (including prodromal, active and residual phases) should last at least 1 month, but not more than 6 months, while in schizophrenia the symptoms must be present for a minimum of 6 months. [2]

If symptoms persist for at least a month, a provisional diagnosis of schizophreniform disorder can be made while waiting to see if recovery occurs. If symptoms resolve within 6 months of onset, the provisional qualifier is removed from the diagnosis. However, if symptoms persist for 6 months or more, the diagnosis of schizophreniform disorder should be reviewed. The diagnosis of brief psychotic disorder can be considered when the duration of symptoms is less than one month.

Differences between brief psychotic disorder, schizophreniform disorder and schizophrenia over time:

  • brief psychotic disorder: less than 1 month
  • schizophreniform disorder: from 1 to 6 months
  • schizophrenia: more than 6 months

The list of the main symptoms of schizophreniform disorder and schizophrenia can include: [1]

  • delusions ,
  • hallucinations,
  • disorganized speech resulting from formal thinking disorder,
  • disorganized or catatonic behavior, and
  • negative symptoms such as:
  • inability to feel a variety of emotions (flat affect),
  • inability to feel pleasure (anhedonia ),
  • impaired or impaired speech ( aphasia ),
  • lack of desire to form relationships (associations) and
  • lack of motivation (avolition).

Prognosis

The following specifiers for schizophreniform disorder can be used to indicate the presence or absence of characteristics that may be associated with a better prognosis:

  • With good prognosis characteristics , used if at least two of the following resources are present:
  • Onset of prominent psychotic symptoms within 4 weeks of the first noticeable change in normal behavior or functioning
  • Confusion or perplexity at the height of the psychotic episode
  • Good pre-morbid social and occupational functioning
  • Absence of blunt or flat affection
  • No good prognostic characteristics , used if two or more of the above resources are not present.

The presence of negative symptoms and poor eye contact seem to be predictive of a poor result. [3] Many of the anatomical and functional changes seen in the brains of patients with schizophrenia also occur in patients with schizophreniform disorder. However, there is currently no consensus among scientists as to whether ventricular enlargement, which is a poor prognostic factor in schizophrenia, has any prognostic value in patients with schizophreniform disorder. [1] According to the American Psychiatric Association, approximately two-thirds of patients diagnosed with “provisional” schizophreniform disorder are later diagnosed with schizophrenia; the rest maintain a diagnosis of schizophreniform disorder. [1]

Is Schizophreniform Disorder Cure?

Most estimates indicate that schizophreniform disorder progresses to schizophrenia in 60 to 80% of cases, and does not know what happens to the other 20 to 40%. Some will have other episodes of the disease during which they will deteriorate to schizophrenia, and few will have only a single episode during their lifetime. Most cases of schizofreiniform disorder progress to schizophrenia, despite treatment. [4]

Causes of schizophrenia

It is generally accepted that schizophrenia is caused by a combination of factors, rather than a single one.

Dopamine

Dopamine is one of the chemicals that carries messages between brain cells. There is evidence that a lot of dopamine may be involved in the development of schizophrenia, but it is still unclear how, or if everyone diagnosed with schizophrenia has too much dopamine. Neuroleptic (antipsychotic) drugs, which are sometimes used to treat schizophrenia, target the dopamine system.

Stressful life events

Highly stressful or life-changing events can trigger schizophrenia. These include:

  • Social isolation
  • be out of work
  • live in poverty
  • be homeless
  • lose someone close
  • be physically or verbally abused or harassed.

Drug abuse

Some people may develop symptoms of schizophrenia as a result of using cannabis or other street drugs, such as cocaine and amphetamines. If you already have schizophrenia, using street drugs can make your symptoms worse. Drinking alcohol and smoking can also limit the effectiveness with which drugs treat the symptoms of schizophrenia.

Genetic inheritance

Some families seem prone to schizophrenia, which suggests a genetic link. Instead of having a specific gene for schizophrenia, it is believed that certain genes can make some people more vulnerable to the disease.

Prevalence

Schizophreniform disorder is equally prevalent among men and women. The most common ages of onset are 18–24 for men and 18–35 for women. Although the symptoms of schizophrenia develop gradually over a period of years, the diagnostic criteria for schizophreniform disorder require a much faster onset. [1]

Available evidence suggests variations in incidence in socio-cultural contexts. In the United States and other developed countries the incidence is low, possibly five times less than that of schizophrenia. In developing countries, the incidence is substantially higher, especially for the subtype “With good prognostic characteristics”. In some of these environments, schizophreniform disorder can be as common as schizophrenia.

Treatment of  schizophreniform disorder

Various treatment modalities, including pharmacotherapy, psychotherapy and several other psychosocial and educational interventions, are used in the treatment of schizophreniform disorder. Pharmacotherapy is the most commonly used treatment modality, as psychiatric drugs can act quickly to reduce the severity of symptoms and shorten their duration. The drugs used are basically the same ones used to treat schizophrenia, with an atypical antipsychotic as the usual drug of choice. Patients who do not respond to the initial atypical antipsychotic may benefit from switching to another atypical antipsychotic, adding a mood stabilizer, such as lithium or an anticonvulsant, or transferring to a typical antipsychotic. [1]

The treatment of schizophreniform disorder can occur in hospital, outpatient and partial hospital settings. In selecting the treatment scenario, the main objectives are to minimize the psychosocial consequences for the patient and maintain the safety of the patient and others. Although the need to quickly stabilize the patient’s symptoms almost always exists, consideration of the severity of the patient’s symptoms, family support, and the perception of the likelihood of compliance with outpatient treatment can help determine whether stabilization can occur in the outpatient setting. . Patients receiving inpatient treatment can benefit from a structured intermediate environment, such as a subacute unit, an abandonment unit, a partial hospital or a day hospital, during the initial stages of returning to the community. [1]

As improvement progresses during treatment, it helps with coping skills, problem solving techniques, psychoeducational approaches and, eventually, occupational therapy and vocational assessments are often very useful for patients and their families. Virtually all types of individual psychotherapy are used to treat schizophreniform disorder, except for insight-oriented therapies, as patients often have limited vision as a symptom of their illness. [1]

Because schizophreniform disorder has such a rapid onset of severe symptoms, patients sometimes deny their disease, which would also limit the effectiveness of insight-oriented therapies. Forms of supportive psychotherapy, such as interpersonal psychotherapy, supportive psychotherapy and cognitive behavioral therapy, are particularly suitable for the treatment of the disorder. Group psychotherapy is generally not indicated for patients with schizophreniform disorder, because they may be distressed by the symptoms of patients with more advanced psychotic disorders. [1]

ECT (electroconvulsive therapy) may be indicated for some patients with schizophreniform disorder, especially those with marked catatonic or depressive symptoms

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