Schizophreniform Disorder

The primary symptoms of schizophreniform disorder fall into two categories—positive symptoms that emerge outwardly and are easily observable, and negative symptoms marked by a diminishment in affect and socialization that may not be immediately apparent to others.  

Typical symptoms of schizophreniform disorder include:

Positive symptoms of schizophreniform disorder

(The term positive in this context refers to symptoms that emerge outwardly and are easily observable.)

• Hallucinations. An individual may have sensory perceptions that don't exist, manifesting as auditory hallucinations (perceiving voices) or visual, tactile, gustatory, or olfactory sensations that lack corresponding external stimuli.
• Delusions. A person may have beliefs that lack correspondence with objective reality. Their beliefs may involve eccentric or improbable characteristics, such as the belief that they possess extraordinary abilities or the perception of being subject to external influences. Some may also experience paranoia symptoms, such as the belief that someone is tapping the phone or stalking them. 
• Disorganized thoughts, speech, and behavior. An individual may display agitated or unpredictable behaviors and speech that lack coherence. Some people with schizophreniform disorder may display catatonia (a lack of response or movement).

Negative symptoms of schizophreniform disorder

(Negative in this context refers to symptoms marked by a diminishment in affect and socialization that may not be immediately apparent to others.)

• Alogia, or impaired or decreased quantity and quality of speech
• Flat affect, a reduced ability to feel and express a range of emotions through behavior, tone of voice, or facial expressions
• Anhedonia, an inability to experience pleasure
• Avolition, a generalized lack of motivation and reluctance or inability to complete daily tasks 
• Asociality, a lack of desire for relationships or an aversion to participation in social interactions

Individuals can experience schizophreniform disorder differently, and each person's presentation of symptoms can be unique. Early intervention and diagnosis may significantly improve the ability to manage symptoms. Diagnosing schizophreniform disorder typically involves a comprehensive psychiatric assessment by a mental health professional, as schizophreniform disorder and schizophrenia spectrum mental disorders can look similar. 

If two or more symptoms last for a minimum of one month and are not attributable to side effects of medications, substance use, or brain injury/infection, it may be possible to establish a preliminary diagnosis of schizophreniform disease. However, in cases when the symptoms remain for six months or more, it usually becomes necessary to reassess the diagnosis and consider the possibility of schizophrenia.

A direct cause of schizophreniform disorder is not yet established, but it is believed to result from a combination of factors, such as genetics, disruptions in brain chemistry and communication, and environmental conditions. 

Genetics

Although specific studies on schizophreniform disorder are minimal, its similarity to schizophrenia allows researchers to study potential causality for both. A growing body of research suggests that genetics plays a large part in the development of schizophrenia, and presumably schizophreniform disorder, with a 10% risk of inheritance from a first-degree relative. 

Research on heritability between twins provides further evidence of a connection. For example, a study from the University of Copenhagen, Denmark, found that out of 30,000 pairs of twins with schizophrenia spectrum disorders, an estimated 73% were affected by heritability.  

Neurophysiology

Causes and symptoms of schizophreniform disorder may be traced to abnormal activity in brain function, with evidence pointing to abnormalities in neurotransmitters, including serotonin, dopamine, and glutamate. Researchers have also found a connection between differences in structure within gray and white matter and other brain networks that may explain the development of schizophreniform disorder. 

Also, dysfunction in prenatal brain development due to factors like severe stress, malnourishment, and substance use may also play a role in developing the disease later in life. 

Environmental factors

It is hypothesized that the genetic risks for schizophrenia may cause a tendency toward substance use. There may be a bi-directional relationship between schizophreniform disorder, with substance use disorder as an environmental factor of causality. Other research has found that cannabis use is associated with an increased risk of psychosis.

Trauma in childhood due to abuse, neglect, the death of a parent or caregiver, and severe bullying may pose a risk for schizophrenia spectrum disorders. Severely adverse social experiences are linked to an increased risk of psychosis. For example, an English study found that out of 332 patients with psychosis, individuals were roughly twice as likely to have lost a parent and approximately three times more likely to have experienced a long-term separation from a parent before 17 years old.

The treatments for schizophreniform disorder are like those used for schizophrenia and other psychotic disorders. The goal of treatment is typically to manage symptoms, improve functioning in daily life, and achieve an overall better quality of life. 

Treatment for schizophreniform disorder usually involves a combination of antipsychotic medications, psychotherapy, and support from mental health professionals, family, and friends. Early intervention from an experienced mental health professional may prevent long-term impairment and help a person manage symptoms more effectively.

Medication

Medications are often combined with psychotherapy to treat individuals with schizophrenia spectrum disorders. Antipsychotic medications, also known as neuroleptics, are sometimes the first-line treatment for schizophreniform disorder—helping to manage symptoms such as hallucinations, delusions, and disorganized thinking. Both typical (first-generation) and atypical (second-generation) antipsychotics may be prescribed, depending on individual response and side effects.

Mood stabilizers and antidepressants are sometimes prescribed to aid in alleviating the sometimes difficult mood symptoms of schizophreniform disorder. Do not start, stop, or change a medication without consulting with your physician or other qualified health professional.

Other treatment options

In addition to psychotherapy and medication, psychologists may recommend other forms of treatment to help individuals cope with symptoms and learn productivity skills.

• Social support. Building a solid social support network can contribute to an individual's recovery. Friends, family, support groups, and community resources can provide encouragement and practical assistance.
• Coping skills training. This typically involves teaching practical skills to manage stress, anxiety, and daily challenges related to symptoms.
• Vocational rehabilitation. Helping individuals develop skills and find meaningful employment can improve their self-esteem and overall functioning.
• Hospitalization. In some cases, if symptoms are severe or there is a risk of harm to oneself or others, short-term hospitalization may be necessary for stabilization and safety.

Self-care

Addressing physical health needs, such as ensuring proper nutrition, exercise, and sleep, can help with overall well-being and symptom management. Some individuals may also benefit from complementary and alternative therapies like yoga, mindfulness practice, and creative arts therapy. While they may be helpful, these strategies should be used in conjunction with evidence-based treatments.

Therapeutic intervention is often essential for those with schizophreniform disorder, and the quality of treatment for these individuals and their families can significantly impact successful recovery and/or symptom management. For those who cannot attend traditional in-person therapy, it may be helpful to connect with a therapy through an online therapy platform, which typically allows for sessions via audio, video, or live chat. 

There are many resources available to help individuals and their families find specialized treatment, learn more about the disorder, and support patients in all areas of well-being:

• The National Alliance on Mental Illness (NAMI)
• The Substance Abuse and Mental Health Services Administration (SAMHSA) Early Serious Mental Illness Treatment Locator
• Centers for Disease Control and Prevention tools and resources page
• Schizophrenia & Psychosis Action Alliance

For those experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7. Please also see our Get Help Now page for more immediate resources.

Research on schizophreniform disorder and other schizophrenia spectrum disorders provides clinicians with valuable insight into potential treatments and etiological markers. Much of this arrives via exploration of the disorder's relationship to neurological function, genetics, and environmental factors. 

A recent study conducted by researchers at Research Triangle Institute (RTI) International has revealed that schizophrenia spectrum disorders may be much more common than initially thought, leading to questions about diagnostic accuracy, treatment needs, and societal effects. 

Researchers in the study found that an estimated 1.8% of U.S. adults aged 18-65 have had schizophrenia spectrum illnesses at some point in their lives. This prevalence rate is two to three times higher than statistics in previous investigations. 

It's relevant to note that while the findings may suggest that more individuals have access to treatment than in the past, the research also points to disparities in treatment for individuals with generalized anxiety disorder and major depressive disorder—both common comorbidities with schizophreniform disorder. 

In other research, investigators from Vanderbilt University identified a protein in the central nervous system called mGlu1, which may provide a treatment target for people with schizophrenia and schizophreniform disorder. 

While antipsychotics are generally effective for treating positive symptoms such as hallucinations and delusions, they don't typically help treat negative symptoms. Data from the study indicates that manipulating this protein may pave the way for specialized treatments of negative symptoms such as apathy, flat affect, and social withdrawal in people with schizophrenia. 

Further research is needed to evaluate longitudinal efficacy, potential side effects, and its effects on other symptoms of schizophrenia, but the study results provide a significant foundation for possible solutions.

Here are some key statistics on schizophreniform disorder:

• Schizophreniform disorder affects between 0.4% and 1% of people in the general population.
• Studies estimate that 2.48% of individuals identified as homeless are affected by schizophreniform disorder. 
• About 65% of individuals diagnosed with schizophreniform disorder go on to receive a diagnosis of schizophrenia in four years.
• While symptoms of schizophreniform disorder typically subside within six months, individuals often continue treatment for comorbidities, such as anxiety and depression. One review including 17 studies showed that online therapy for depression was “at least as effective” as traditional in-person therapy.