Schizophreniform Disorder Symptoms, Causes, Treatment

The schizophreniform disorder is a psychopathological condition in which symptoms of schizophrenia are experienced for a few months, remitting due to treatment or for unknown reasons.

The symptoms of this disorder are identical to those of schizophrenia, although they last at least 1 month and less than 6 months. It is not caused by medication, substances, or other mental disorders.

Article index

• 1 Main symptoms
• 2 Causes
  • 2.1 Genetics
  • 2.2 Brain chemistry
  • 2.3 Environment
• 3 Diagnosis
  • 3.1 Diagnostic criteria according to DSM-IV
• 4 Treatment
  • 4.1 -Drugs / medication
• 5 Consequences for mental health
• 6 References

Main symptoms

There are five main symptoms given by the DSM-V:

• Hallucinations: hearing, seeing, smelling or feeling things that are not real.
• Delusions: having false beliefs, strange to other people.
• Disorganized thinking: thoughts that make the person stop speaking suddenly or use nonsense words. 
• Disorganized behavior: Behaving strangely in public, accumulating objects, catatonia (from unbridled agitation to immobility), waxy flexibility (keeping the body and limbs in the position in which someone places them).
• Negative symptoms: apathy, alogia, anhedonia, flat affectivity.

Causes

Although the exact causes of schizophreniform disorder are not known, it is believed to be due to genetic, chemical, and environmental factors..

Genetic

It is more likely to occur in people who have family members with schizophrenia or bipolar disorder. Some people have a multifactorial genetic vulnerability that is triggered by environmental factors.

Brain chemistry

People with this disorder may have a disturbance in the functioning of the brain circuits that regulate perception or thinking..

Atmosphere

Some environmental factors, such as stressful events or poor social interactions, can trigger the disorder in people who have inherited the tendency to develop it..

Diagnosis

It is important to distinguish this disorder from other medical and psychiatric conditions. They can be considered:

• Toxicological evaluation.
• Medical evaluation.
• Evaluation of the psychological state.

Diagnostic criteria according to DSM-IV

A) Criteria A, D and E are met for schizophrenia.

B) An episode of the disorder (including the phrases prodromal, active, and residual) lasts at least 1 month but less than 6 months. (When the diagnosis must be made without waiting for remission, it will be classified as provisional).

Specify if: No good prognosis characteristics.

With good prognosis characteristics: indicated by two or more of the following items:

1. Onset of marked psychotic symptoms within the first 4 weeks of the first major change in behavior or habitual activity.
2. Confusion or perplexity throughout the psychotic episode.
3. Good premorbid social and work activity.
4. Absence of affective flattening or blunting.

The following disorders can be considered as an alternative diagnosis:

• Schizophrenia.
• Brief psychotic disorder.
• Bipolar disorder.
• Depression.
• Substance Abuse-Induced Psychotic Disorder.
• Depression.
• Delusional disorder.
• Post-traumatic stress disorder.
• Brain injury.

Treatment

Drug therapy, psychotherapy, and other educational interventions are considered for the treatment of schizophreniform disorder..

-Drugs / medication

Drugs are the most common treatment, because they can reduce the severity of symptoms in a short period of time..

The same drugs are usually used as in schizophrenia. If one drug has no effect, others are often tried, adding mood stabilizers such as lithium or anticonvulsants, or switching to conventional antipsychotics.

Atypical antipsychotics

These second-generation drugs are generally preferred because they have a lower risk of developing side effects than conventional antipsychotics..

In general, the goal of antipsychotic treatment is to effectively control symptoms with the lowest possible dose..

They include:

• Aripiprazole.
• Asenapine.
• Clozapine.
• Iloperidone.
• Lurasidone.
• Olanzapine.
• Paliperidone.
• Quetiapine.
• Risperidone.
• Ziprasidone.

Atypical antipsychotics can have side effects such as:

• Loss of motivation.
• Drowsiness.
• Nervousness.
• Weight gain.
• Sexual dysfunctions.

Conventional antipsychotics

This first generation of antipsychotic drugs have frequent side effects, including the possibility of developing dyskinesia (abnormal and voluntary movements).

They include:

• Chlorpromazine.
• Fluphenazine
• Haloperidol.
• Perphenazine.

Treatment can occur in hospitalized, outpatient, or semi-hospitalized patients. The main thing is to minimize the psychosocial consequences of the disorder on the patient and maintain their safety and that of others.

To consider whether hospitalization is necessary, the severity of the symptoms should be taken into account, if there is family support and if the patient is willing to comply with the treatment..

As treatment progresses, training in coping strategies, problem solving, psychoeducation, and occupational therapy have good effects..

Because people with this disorder have a rapid onset of symptoms, they tend to deny their disease, which makes the use of insight-oriented therapies difficult.

Therapies such as interpersonal psychotherapy or cognitive behavioral therapy are more suitable for treatment in conjunction with medication.

Group therapy is not recommended because people with this disorder may feel stress or anxiety when observing people with more severe symptoms..

Consequences for mental health

This disorder can have the following mental health consequences:

• Social functioning: If left untreated, you can develop schizoid or paranoid symptoms that interfere with functioning in society.
• Employment and economyMany people with this disorder are unemployed and lack goals or purposes. They often sleep excessively and don't follow a routine.
• Schizophrenia: If left untreated, it can develop into schizophrenia.
• Confidence: If left untreated, some people can become paranoid.
• Social isolation- some people may withdraw and stop participating in family and social activities.
• Independence: If left untreated, some people may have a hard time living alone or taking care of themselves.
• Cognitive abilities: They may have difficulty concentrating, remembering things, solving problems, motivating themselves, or enjoying themselves. This makes it more difficult to maintain jobs, establish personal relationships or control daily life..

References

1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, (4th ed., Text revision). Washington, DC: American Psychiatric Association.
2. Troisi A, Pasini A, Bersani G, Di Mauro M, Ciani N (May 1991). "Negative symptoms and visual behavior in DSM-III-R prognostic subtypes of schizophreniform disorder". Acta Psychiatr Scand 83 (5): 391-4.