Schizophreniform Disorder

Essentially, this is schizophrenia that fails to last for 6 months and does not involve social withdrawal.

Epidemiology

The validity of this diagnosis is under question. Outcome studies of this disorder indicate that most patients may go on to develop full-blown schizophrenia, whereas others appear to develop a mood disorder. The diagnosis of schizophreniform disorder may, however, help to avoid premature diagnosis of patients with schizophrenia before some other disorder, such as bipolar disorder, manifests itself.

Etiology

At this time, the etiology is unknown. At least one study found similarities in brain structure abnormalities between schizophrenics and those with schizophreniform disorder.

Clinical Manifestations

History and Mental Status Examination Schizophreniform disorder is essentially short-course schizophrenia without the requirement of social withdrawal. Patients with this disorder have what appears to be a "full-blown" episode of schizophrenia, including delusions, hallucinations, disorganized speech, or negative symptoms, but the duration of illness including prodromal, active, and residual phases, is from 1 to 6 months. The diagnosis changes to schizophrenia once the symptoms have extended past 6 months, even if only residual symptoms are left.

Differential Diagnosis

Care must be taken to distinguish schizophreniform disorder from a manic or depressive episode with psychotic features. Other causes of an acute psychosis must be ruled out (substance-induced or due to a general medical condition).

Management

The disorder is by definition self-limited. When symptoms cause severe impairment, treatment is similar to that for the acute treatment of psychosis in schizophrenia. KEY POINTS 1. Schizophreniform disorder resembles schizophrenia. 2. It resolves completely in less than 6 months. 3. It most often results in either schizophrenia or bipolar disorder. 4. It is self-limited.