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nonaffective

Schizophreniform disorder

Schizophreniform disorder is characterized by the presence of criterion A symptoms of schizophrenia. These include: delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, and negative symptoms. The disorder - including its prodromal, active, and residual phases - lasts longer than 1 month but less than 6 months.

Diagnostic Features

Schizophreniform disorder is a serious mental illness related to schizophrenia. It is a psychiatric disorder, as defined by the DSM-IV-TR.

The essential features of schizophreniform disorder are identical to those of schizophrenia except for two differences: the total duration of the illness (including prodromal, active, and residual phases) is at least 1 month but less than 6 months and impaired social or occupational functioning during some part of the illness is not required (although it may occur).

About half of those diagnosed with schizophreniform disorder are later diagnosed with schizophrenia. This disorder is more likely to occur in people if they have family members with schizophrenia or bipolar disorder (also called manic depression). The exact cause of the disorder is unknown.

The main criteria are the same as for schizophrenia. The main difference is the time course of the illness. Symptoms should be present for greater than one month but less than six months. This is opposed to schizophrenia where the illness has to have occurred for greater than six months. A brief psychotic disorder lasts for less than one month.

Treatment is similar to schizophrenia.

A full recovery from the disorder is probable. Medication and psychotherapy are used to treat schizophreniform disorder. In extreme cases, a patient may need to be hospitalized. It occurs equally in males and females.

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.

Specifiers

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

With Good Prognostic Features. This specifier is used if at least two of the following features are present: onset of prominent psychotic symptoms within 4 weeks of the first noticeable change in usual behavior or functioning, confusion or perplexity at the height of the psychotic episode, good premorbid social and occupational functioning, and absence of blunted or flat affect.

Without Good Prognostic Features. This specifier is used if two or more of the above features have not been present.

Prevalence

Available evidence suggests variations in incidence across sociocultural settings. In the United States and other developed countries, the incidence is low, possibly fivefold less than that of schizophrenia. In developing countries, the incidence is substantially higher, especially for the subtype "With Good Prognostic Features"; in some of these settings schizophreniform disorder may be as common as schizophrenia.

Familial Pattern

Few family studies have focused on schizophreniform disorder. Available evidence suggests that relatives of individuals with schizophreniform disorder have an increased risk for schizophrenia.

Differential Diagnosis

Because the diagnostic criteria for schizophrenia and schizophreniform disorder differ primarily in terms of duration of illness, the discussion of the differential diagnosis of schizophrenia also applies to schizophreniform disorder. Schizophreniform disorder differs from brief psychotic disorder, which has a duration of less than 1 month.

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.

Summary of time course of select psychotic disorders

  • Less than one month: Brief psychotic disorder
  • >1 month, <6 months: Schizophreniform disorder
  • Greater than six months: Schizophrenia

Sources

External links

Bibliography

  • Compton MT: Barriers to initial outpatient treatment engagement following first hospitalization for a first episode of nonaffective psychosis: a descriptive case series. J Psychiatr Pract 2005 Jan; 11(1): 62-9 [Medline].
  • Coryell W, Tsuang MT: Outcome after 40 years in DSM-III schizophreniform disorder. Arch Gen Psychiatry 1986 Apr; 43(4): 324-8 [Medline].
  • Strakowski SM: Diagnostic validity of schizophreniform disorder. Am J Psychiatry 1994 Jun; 151(6): 815-24 [Medline].
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