What Is Schizophreniform?

Schizophreniform disorder is a recognized diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 5^th edition, text revision (DSM-5-TR).

It’s categorized under “schizophrenia spectrum disorders and other psychotic disorders” due to its classic presentation with symptoms of psychosis.

The DSM-5-TR indicates that schizophreniform disorder has the same symptomatic presentation as schizophrenia but is limited to a timeframe of more than 1 month but fewer than 6 months.

To receive a formal diagnosis of this condition under the DSM-5-TR, two or more of the following symptoms must be present for a significant amount of time during the 1-to-6-month period:

• delusions
• hallucinations
• disorganized speech (formal thought disorder)
• disorganized or catatonic behavior
• negative symptoms

Of symptoms present, one must be delusions, hallucinations, or thought disorder.

Your mental healthcare team will only make this diagnosis if all other conditions have been ruled out and no physiological effects of a substance are responsible for your symptoms.

The symptoms of schizophreniform disorder are identical to the symptoms of schizophrenia in the DSM-5-TR.

Symptoms are broken down into two primary categories:

• positive symptoms
• negative symptoms

Positive symptoms are those that add a feature to your existing function. They include:

• false sensory experiences, known as hallucinations
• unwavering, inaccurate beliefs known as delusions
• disorganized speech (formal thought disorder)
• disorganized behavior/motor function

Negative symptoms are those that indicate a diminished functional effect. They include experiences of:

• diminished emotional expression (flat affect)
• decreased self-initiated motivation (avolition)
• decreased speech output (alogia)
• reduced ability to experience pleasure (anhedonia)
• disinterest in socialization (asociality)

The DSM-5-TR states duration of symptoms is what differentiates schizophreniform disorder from schizophrenia.

Schizophreniform disorder symptoms last no longer than 6 months, while schizophrenia is a lifelong condition.

In many cases, a schizophreniform diagnosis is titled “provisional” because, without full recovery, it becomes classified as schizophrenia. Approximately two-thirds of people initially diagnosed with schizophreniform disorder will eventually receive a schizophrenia or schizoaffective disorder diagnosis.

Functionality can also vary slightly between these conditions. Unlike schizophrenia, schizophreniform disorder does not require a marked decline in function for diagnosis.

Brief psychotic disorder

Schizophrenia spectrum disorder symptoms that occur for fewer than 1 month may be diagnosed as brief psychotic disorder under DSM-5-TR criteria.

Unlike schizophreniform disorder and schizophrenia, negative symptoms are not listed as part of the possible diagnostic features of brief psychotic disorder.

Schizoaffective disorder

Schizoaffective disorder may share symptoms of psychosis with other schizophrenia spectrum disorders. However, it is characterized by an uninterrupted symptomatic period during which you will experience episodes of depression or mania.

Schizotypal disorder

Listed in the DSM-5-TR as a personality disorder, schizotypal disorder is also considered a part of the schizophrenia spectrum.

Schizotypal disorder, also identified as schizotypal personality disorder, presents with some symptoms of psychosis but also involves the impaired social and interpersonal behavior patterns that mark personality disorders.

Delusions are the most prominent type of psychosis symptom experienced in this condition, and hallucinations, if they occur, are typically related to present patterns of delusion thinking.

Schizotypal disorder is not the same as delusional disorder. Delusional disorder may also present with symptoms of delusions and related hallucinations. However, interpersonal function is not impacted as it is in a personality disorder.

No singular cause has been found at the root of schizophreniform disorder or schizophrenia. Many factors likely play a role, including:

• environmental exposures
• altered brain structure
• genetics
• neurotransmitter imbalance
• substance use
• life stress or trauma
• prenatal development abnormalities
• gonadal hormone imbalance

When symptoms of schizophreniform disorder appear, it’s unclear if you’re experiencing short-duration psychosis or the first episode of a chronic condition like schizophrenia.

For this reason, schizophreniform disorder is treated in the same way as first-episode schizophrenia, with a focus on the elimination of psychosis symptoms.

First-episode or acute schizophrenia is treated with antipsychotic medications, such as:

• olanzapine
• risperidone
• clozapine

Your healthcare team may keep you on this treatment course for up to 1 year.

During that time, you’ll be monitored for signs of functional impairment or persisting symptoms. Even if you can manage symptoms successfully with medication, you may benefit from other treatments utilized in schizophrenia spectrum disorders, such as:

• cognitive behavioral therapy
• behavioral skills training
• supported employment
• family education
• coordinated specialty care
• assertive community treatment
• treatment for substance misuse

Schizophreniform disorder is a mental health diagnosis that shares the same symptoms as schizophrenia but lasts fewer than 6 months.

In many cases, schizophreniform disorder is a precursor for schizophrenia. As many as two-thirds of people with schizophreniform disorder will eventually receive a schizophrenia diagnosis.

Because there is no way to know if you’re experiencing first-episode schizophrenia or schizophreniform disorder, both conditions are treated initially with antipsychotics.