What Is Schizophreniform Disorder Versus Schizophrenia?

Schizophrenia spectrum disorder and other psychotic disorders is a new category introduced in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Within this category are conditions like schizoaffective disorder and schizophreniform disorder. Although these disorders share a similar name to schizophrenia, they have some differences. Understanding schizophreniform disorder, the diagnostic criteria, and standard treatment options is one way to better manage daily life and build independence. 

Schizophreniform disorder can be manageable with treatment

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What is schizophreniform disorder? A short-term mental health condition that causes psychosis 

The DSM-5, published by the American Psychiatric Association, classifies schizophreniform disorder as a schizophrenia spectrum disorder. Other conditions in this category include schizophrenia, schizotypal personality disorder, and schizoaffective disorder. 

While they are similar, schizophreniform disorder’s symptoms are milder than schizophrenia or schizoaffective disorder. All schizophrenia spectrum disorders can have a significant impact on an individual’s daily functioning, including at work, school, and in interpersonal relationships. 

Causes of schizophreniform disorder vs schizophrenia

Experts are unsure of schizophreniform disorder’s direct cause. Studies are few, but researchers may gain insight into possible causes through studies of schizophrenia. A combination of risk factors could lead to its development, including but not necessarily limited to the following.

Genetics linked to schizophrenia spectrum disorders

Data gathered from recent research suggests there are several genes linked to schizophrenia and, by association, schizophreniform disorder. Heritability rates for schizophrenia are estimated to be approximately 80%.

Brain function

Abnormal brain functioning is another potential causality for schizophrenia and schizophreniform disorder. Some research has revealed a connection between dopaminergic dysfunction in the brain and psychotic symptoms, and studies also suggest a link between differences in structure within gray and white matter between people who have schizophrenia and those who don’t.

Further, the COVID-19 pandemic prompted research on a potential connection between schizophrenia and the virus’s impact on the brain. Prenatal stress and malnourishment during the first three months of pregnancy may also play a part in developing the disease later in life.  

Environmental factors

There may be a bi-directional relationship between schizophreniform disorder and substance use. In one study, 30% to 70% of individuals with a substance use disorder experienced schizophrenic symptoms. Cannabis use has also been hypothesized to increase the risk of schizophrenic symptoms.

Childhood trauma may be a risk factor for developing schizophrenia spectrum disorders, including severely adverse social experiences early in life. To illustrate, a study published in the Journal of Psychological Medicine surveyed 332 patients with psychosis and found they were approximately twice as likely to have experienced the loss of a parent and three times as likely to have experienced long-term separation from a parent in childhood.

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources.

Symptoms and diagnostic criteria

Schizophreniform disorder symptoms often emerge differently between individuals, varying in length, severity, and type. They may arise during the late teens or early adulthood and are generally episodic in nature, featuring three phases: 

• Prodromal: Individuals may display depressive or anxious symptoms during the prodromal phase before more severe symptoms emerge. 
• Active: The active phase features psychosis symptoms like hallucinations, delusions, and disorganized speech.
• Residual: Although this phase isn’t officially included in the DSM-5 criteria for schizophreniform disorder, it’s often recognized by clinicians. It features symptoms similar to the prodromal stage. 

Positive symptoms include delusions, hallucinations and disorganized speech

Positive symptoms of schizophreniform disorder refer to those that emerge outwardly and can be observed in a person’s behaviors and speech, including the following: 

• Delusions: People with delusions may have paranoid thoughts and beliefs, like someone is stalking or trying to kill them. Delusional individuals might believe outside influences are controlling them or that they possess extraordinary abilities. These beliefs are often difficult to change, despite evidence to the contrary. 
• Hallucinations: Hallucinations may include auditory hallucinations (hearing voices) or visual, olfactory, tactile, or gustatory sensations that don’t exist. 
• Disorganized thoughts, behaviors, and speech: Individuals with schizophreniform disorder may display unpredictable behaviors and speech. For example, they may have extreme agitation or catatonia (lack of movement and response to outside stimuli). Catatonia can sometimes look like jerky, unusual, or purposeless movements alongside a lack of response to one’s environment. 

Negative symptoms of a short-term mental health condition that causes psychosis

Negative symptoms refer to those that may not be obvious to others or present in the general population. They’re often associated with affect, motivation, and mood. Negative schizophreniform and schizophrenia symptoms include:

• Flat affect: Diminished ability to feel and express emotions verbally or physically
• Emotional blunting: Includes anhedonia (an inability to experience pleasure) and indifference
• Avolition: The absence of motivation—people with avolition are often unable or reluctant to engage in tasks and fulfill responsibilities.  
• Social withdrawal: The absence of a desire for relationships and social interaction—people experiencing asociality may display an active aversion toward interacting with others.
• Alogia: Referred to as poverty of speech, alogia describes a disruption in quantity and quality of speech.

Diagnosis of schizophreniform disorder vs schizophrenia or bipolar disorder

For an accurate diagnosis, individuals with schizophreniform disorder participate in a comprehensive assessment by a mental health professional qualified to identify and treat schizophrenia spectrum disorders. Early diagnosis can be helpful to successfully manage the condition’s symptoms and prevent long-term impairment. Early diagnosis may also be beneficial when looking to identify possible comorbidities.

According to the DSM-5, the following criteria must be met to diagnose schizophreniform disorder:

• Two or more characteristic symptoms must be present for at least one month. In cases when symptoms persist for six months or longer, the diagnosis must be reassessed to consider the possibility of schizophrenia.
• Schizoaffective and mood disorders must be ruled out because there are either no manic, depressive, or mixed episodes, or their total duration is brief relative to the length of active and residual periods.
• Schizophrenic episodes must not be the result of substance use, medication, injury, or medical conditions. 

Treatment and management

Treatment for schizophreniform disorder is the same or similar to those used for schizophrenia and other psychotic disorders. Treatment aims to neutralize the symptoms, help the individual learn to cope with symptoms when they arise, improve daily functioning, and achieve quality of life. 

Treatment for schizophreniform disorder often involves a combination of methods, including antipsychotic medications, psychotherapy, and psychosocial support from mental health professionals, peers, family, and friends. 

Medications

Antipsychotic medications may be one of the first treatments for psychotic disorders like schizophreniform disorder. They may help individuals manage positive symptoms, including delusions, hallucinations, and disorganized thinking and speech. In addition, they may reduce negative symptoms like emotional blunting, flat affect, and asociality. 

Mood stabilizers and antidepressants are also sometimes prescribed to treat some of the challenging mood symptoms of schizophreniform disorder and to manage symptoms of common comorbidities like depression and anxiety.

Consult a medical doctor before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis.

Cognitive-behavioral therapy (CBT)

In cognitive-behavioral therapy, the client and clinician work together to identify the underlying thought patterns contributing to emotional dysfunction and maladaptive behaviors. Once these thoughts are isolated, their impact on the individual’s relationships and functioning is examined, and the patterns are reframed into more positive, productive thoughts. Once thought patterns are changed, the individual may better manage their symptoms, behaviors, and emotional responses to everyday challenges.

Cognitive remediation therapy (CRT)

In some cases, individuals may engage in a combination of CBT and CRT. Sometimes referred to as cognitive enhancement therapy, CRT focuses on improving memory, attention, and mental functioning. It also aims to help individuals better identify the social cues and environmental conditions that can trigger schizophreniform disorder’s symptoms.

Family therapy

Mental health professionals often include family members in the therapeutic process for support. Family therapy can improve communication, strengthen conflict management, facilitate a better understanding of the disorder, cultivate empathy, and reduce stress within the family.

Psychoeducational programs

Often, learning about schizophreniform disorder and how to manage it can be a core part of treatment. Psychoeducation may improve insight, reduce stigma, and promote treatment adherence.

Electroconvulsive therapy (ECT)

If other clinical treatment methods aren’t successful, a psychiatrist may recommend ECT. This treatment applies electrical current to the individual’s scalp to stimulate specific parts of the brain, potentially improving symptoms like severe depression and agitation.

Hospitalization

If the symptoms are severe or the individual is at risk of harming oneself or others, inpatient treatment in a hospital might be recommended or implemented to stabilize symptoms and keep the person safe. 

Other treatment options for schizophreniform disorder, bipolar disorder, or other mental health conditions

Depending on the nature of the individual’s symptoms, psychologists may recommend additional treatment to psychotherapy and medication. These complementary treatment methods may help individuals cope with challenges, recover from episodes quickly, and learn skills that support independence and productivity. While they may be helpful, it may be best if these strategies are used as a supplement to more traditional, evidence-based treatments. Below are several options: 

• Social support: Staying connected with friends, family, and community can provide encouragement and practical assistance for individuals with schizophreniform disorder. 
• Group therapy: Group therapy can be peer-led by a trained individual diagnosed with a similar disorder or therapist-led by a counselor trained in treating schizophrenia spectrum disorders. Group therapy can help individuals know they aren’t alone in struggling with their symptoms and become inspired by others’ successes. 
• Vocational rehabilitation: These programs may help individuals develop the skills to find and retain meaningful employment, improving self-esteem and functioning in daily life. 

Self-care

Individuals with schizophreniform disorder can benefit from healthy lifestyle habits like maintaining proper nutrition, physical activity, and quality sleep. Additionally, some may benefit from self-care activities like engaging in a hobby, yoga, mindfulness practice, or creative expression. 

Schizophreniform disorder can be manageable with treatment

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Alternative therapies for schizophreniform disorder 

Schizophreniform disorder is one of several in the schizophrenia spectrum category. It can be challenging for those who have it and their loved ones to cope with. However, with education, support, and the proper treatment, it is possible to manage the condition and live productively. 

Because of its neurological connection, psychiatric intervention from a medical doctor is often beneficial to determine if the individual can benefit from medications to treat schizophreniform disorder and others on the schizophrenia disorder spectrum. However, medications are only one part of a treatment plan, which can also include individual and family therapy. Although it may not be a viable option in every case, some individuals choose to speak to a therapist online because of its convenience and availability.  

Because they eliminate geographical barriers, online therapy platforms like BetterHelp often provide a connection to a broader pool of mental health professionals trained in treating various mental health conditions, including schizophreniform disorder. Virtual therapy allows individuals to speak with a mental health professional from the comfort of home on a schedule that fits their needs. 

Some people prefer at-home therapy to traditional treatment because they are uncomfortable encountering others in an office setting. In addition, it may eliminate the need to commute to and from appointments. Online therapy is often less expensive than conventional therapy without insurance, and a growing body of research suggests it’s as effective.

Takeaway 

If you or someone you love is struggling with symptoms of schizophreniform disorders, help is available. Reach out to a trained mental health professional to begin finding support tailored to your unique situation.