Schizophreniform Disorder

What is schizophreniform disorder?

Schizophreniform disorder shares many similarities with schizophrenia, and in some cases can lead to a diagnosis of schizophrenia in the future. Although it might seem daunting to receive a diagnosis of schizophreniform, once doctors have established the disorder it is much easier to receive proper treatment and find methods for coping with the symptoms.

Overview of schizophreniform disorder

Schizophreniform disorder causes psychosis, which is where individuals experience a loss of contact with reality and exhibit unusual personality changes and behaviors. It is similar to schizophrenia disorder, but according to the Diagnostic and Statistical Manual for Mental Disorders, there are two distinct differences between schizophrenia and schizophreniform.

The first difference is the duration of the condition. An individual who has shown symptoms of schizophrenia for longer than one month but less than six months is diagnosed with schizophreniform disorder. It is only when the symptoms persist for longer than six months that an individual is deemed to have schizophrenia.

The second difference is the way the symptoms impair an individual’s life. The psychosis experienced during schizophrenia tends to severely impair an individual’s occupation, social life, and academic abilities. With schizophreniform, this impairment may not exist and the individual may be able to continue functioning in these aspects of their life despite the psychosis.

Around two-thirds of individuals with schizophreniform disorder go on to develop schizophrenia. This is why it is important for doctors to wait and see how an individual’s symptoms develop, because many will only experience the symptoms of schizophrenia temporarily, while others may deal with recurrent episodes throughout their entire lives.

Around one in every thousand people will experience schizophreniform disorder in their lifetime. Men and women are just as likely to be affected by the condition, but men tend to experience it at a younger age than women do. Most men who develop schizophreniform are aged between 18 and 24, while most women are aged between 24 and 35.

Symptoms of schizophreniform disorder

Schizophreniform disorder shares the same symptoms as schizophrenia, but they may or may not be so severe that they cause significant impairment to an individual’s life. The primary symptom of schizophreniform and schizophrenia is psychosis, which includes the following symptoms:

Delusions

This is where an individual completely believes something to be true, even when there is compelling evidence against it. For example, they might believe they have special powers or abilities, or that someone is following them. Often these delusions can be very distressing and cause the sufferer to act in a very unusual way.

Hallucinations

When a person experiences something that others do not, it is known as a hallucination. Hallucinations can affect all senses, so individuals may report seeing, hearing, feeling, tasting or smelling things that aren’t really there. Sometimes, hallucinations will tie in with the delusions an individual experiences. For example, someone might believe that someone is following them because they are hallucinating the sound of footsteps or voices.

Disorganized thoughts

This symptom is often most noticeable to other people who, when talking to someone experiencing psychosis, will observe them jumping from one topic to the next with no real connection between the topics.

Individuals might feel that their thoughts are jumbled or that they can’t focus on a specific thing. They may also have trouble remembering information.

Disorganized behavior

Along similar lines to disorganized thoughts, an individual may struggle to organize their behavior, particularly when it comes to goal-oriented tasks. For example, something like going to the store to buy a loaf of bread, which is a relatively simple task but requires multiple steps – getting ready to leave the house, traveling to the store, choosing the bread, paying, and traveling home again – might be impossible.

They may become distracted along the way, struggle to gather their thoughts and stay focused on the task at hand. Individuals may also exhibit very unusual behavior, such as dressing for hot, sunny weather during a winter storm.

Abnormal motor behavior

Disorganized behavior tends to tie in with abnormal motor behavior, where an individual acts in unusual ways.

For example, they may appear very agitated and find themselves pacing up and down, or they might do the opposite and experience catatonia, where they are unable to move or even talk.

Negative symptoms

The symptoms mentioned above are all positive symptoms because they are added on to an individual’s normal behavior and personality.

Negative symptoms are things that an individual doesn’t do, or which is taken away from normal behavior.

Negative symptoms include:

  • Reduced range of emotions, known as ‘flat effect’, ‘reduced affect display’ or ’emotional blunting’
  • Inability to take pleasure in things, known as ‘anhedonia’
  • Lack of motivation, known as ‘avolition’
  • Decreased or impaired speech, known as ‘aphasia’
  • Lack of desire to interact socially or the preference to be alone, known as ‘asociality’

In order for a diagnosis of schizophreniform disorder to be made, an individual must have experienced the symptoms for the majority of the time for at least one month. If symptoms occurred for less than a month, it could be that the individual is suffering from another mental health condition which can cause psychosis, such as bipolar disorder, severe depression or postnatal psychosis or depression.

It’s also important to note that schizophreniform disorder, like schizophrenia, has three distinct phases which tend to occur in a sequence. Individuals with schizophrenia experience multiple cycles of these phases throughout their lifetime, but individuals with schizophreniform disorder may only have experienced one phase, since they may have only had symptoms for a short period of time.

The three phases of schizophreniform and schizophrenia are as follows:

Prodromal phase

Symptoms begin to occur and progress gradually. Individuals may start to lose interest in their usual activities and in socializing with others. They may become confused, restless, listless and have trouble concentrating.

Sometimes symptoms plateau and do not develop further, but usually, the prodromal phase progresses into an active phase.

Active phase

Symptoms become more marked and individuals are likely to experience hallucinations, delusions and significant disturbances in their usual behavior and thoughts.

Typically, an active phase is preceded by a prodromal phase, but sometimes it can occur suddenly with severe psychotic symptoms appearing as if from nowhere.

Residual phase

As the active phase passes, individuals may feel listless and be withdrawn, and experience much of the same symptoms experienced during the prodromal phase. If a prodromal phase didn’t occur, the individual may not experience any residual symptoms at all after having the active phase.

Eventually, symptoms will either diminish completely and the patient may feel normal, or the cycle may begin again with the prodromal phase.

Causes of schizophreniform

It’s not fully understood exactly what causes schizophrenia or schizophreniform disorder, but it’s understood that there are a variety of factors involved.

The first factor to consider is biological. It is believed that individuals with schizophreniform disorder have an excess of dopamine in the brain, which is a chemical which helps brain cells to communicate. The heightened levels of dopamine could be responsible for psychosis, and since dopamine can affect people in a range of different ways, this explains why each individual with schizophreniform disorder presents with different types and severity of symptoms.

There is also a genetic factor at play with schizophrenia and schizophreniform. Individuals who have siblings or parents with either of the conditions are more at risk of developing schizophreniform themselves. However, there is a possibility that there is a certain environmental factor involved too, which can make it more difficult to understand the genetic link.

Some research, for example, has found that living in an urban environment, such as in a city, increases the risk of schizophrenia. This might explain why multiple people within one family could be affected by schizophrenia or schizophreniform disorder – because they all live in the same household in a city.

Sometimes, stressful or traumatic life events can trigger schizophreniform disorder. This might include the death of a loved one, the loss of a job, or experiencing financial difficulty. Sometimes, emotional trauma such as emotional or physical abuse, bullying, and extreme loneliness can trigger schizophreniform. However, it is not clear if these events are enough to trigger the disorder in their own right, or if they are catalysts for individuals who are already at an increased risk of developing the condition.

Similarly, certain recreational drugs, such as amphetamines, cannabis, cocaine, and LSD, can trigger schizophreniform or schizophrenia. This can occur as a result of prolonged used, after a single instance of heavy use, or when attempting to withdraw from a particular drug.

Treatment for schizophreniform disorder

Antipsychotic drugs are typically the first treatment option for people with schizophreniform disorder. These help to lower dopamine levels in the brain and alleviate psychosis. Sometimes, mood stabilizers such as lithium may also be used to help minimize agitation and disorganized thinking. Anticonvulsants, which are usually used to help treat epileptic seizures, can also be helpful in stabilizing moods.

Psychotherapy is also a common treatment for schizophreniform disorder, but often it is a secondary line of treatment since the priority is in stabilizing the patient’s mood and reducing the severity of their psychosis in order to reduce the risk of them being a danger to themselves. Psychotherapy will usually focus on helping patients to identify their symptoms in order so they can recognize warning signs of new cycles, seek treatment early, and manage their behavior as successfully as possible.

With schizophreniform disorder, it is particularly vital that the patient is monitored on an ongoing basis in order to determine if the disorder has escalated into schizophrenia. Patients may be required to have regular appointments with their doctor, psychotherapist or other mental health worker, and may be required to complete a mood journal to recognize patterns in their mood and behavior which could indicate that a new cycle is possible.

Prevention of schizophrenic disorder

There is no way to prevent schizophreniform disorder or to prevent it from developing into schizophrenia. However, those who have been diagnosed with the disorder may be able to find methods to help minimize the severity of future episodes or better manage their symptoms.

Firstly, it’s important to note that after each active phase of schizophrenia or schizophreniform, the residual phase will become longer and with more symptoms. For this reason, it is vital to follow treatment plans successfully, take any medications which are prescribed in between active phases and to seek medical support during active phases as this might help to slow the progression of the disorder.

It is often helpful to tell close family and friends about a diagnosis of schizophreniform and to explain to them the symptoms and warning signs. During active phases, individuals may be less capable of seeking medical support, following treatment plans or keeping their appointments with doctors or psychotherapists. Having a network of trusted individuals around you may help you to get the necessary medical support you need when the disorder is at its worst.