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Schizophreniform Disorder

Schizophreniform Disorder is characterized by the presence of the symptoms of schizophrenia, including delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, and negative symptoms. The disorder, including its prodromal, active, and residual phases, lasts longer than 1 month but less than 6 months.

For a material part of at least one month (or less, if effectively treated) the patient has had 2 or more of:
Delusions (only one symptom is required if a delusion is bizarre, such as being abducted in a space ship from the sun).
Hallucinations (only one symptom is required if hallucinations are of at least two voices talking to one another or of a voice that keeps up a running commentary on the patient's thoughts or actions).

Speech that shows incoherence, derailment or other disorganization.

Severely disorganized or catatonic behavior.
Any negative symptom such as flat affect, muteness, lack of volition.
This disorder is not the direct physiological result of a general medical condition or the use of substances, including prescription medications.

A statement of prognosis should be added to the diagnosis: With Good Prognostic Features (2 or more of the following):

Actual psychotic features begin within 4 weeks of the first noticeable change in the patient's functioning or behavior.

The patient is confused or perplexed when most psychotic.

Premorbid social and job functioning are good.

Affect is neither blunt nor flattened.

Associated Features:

Differential Diagnosis:

Some disorders have similar or even the same symptom. The clinician, therefore, in his diagnostic attempt has to differentiate against the following disorders which he needs to rule out to establish a precise diagnosis.


Schizophreniform disorder appears to be related to abnormalities in the structure and chemistry of the brain, and appears to have strong genetic links; but its course and severity can be altered by social factors such as stress or a lack of support within the family. The cause of schizoaffective disorder is less clear cut, but biological factors are also suspected


Medication is the most important part of treatment as it can reduce and sometimes eliminate the psychotic symptoms. Case management is often needed to assist with daily living skills, financial matters, and housing, and therapy can help the individual learn better coping skills and improve social and occupational skills.

Counseling and Psychotherapy [ See Therapy Section ]:

Cognitive, behavior, and psychoanalytic therapies are used to treat individuals with Schizophrenoform Disorder.

Pharmacotherapy [ See Psychopharmacology Section ] :


Special Antipsychotic Adverse Reactions:
Neuroleptic Malignant Syndrome. May occur at any point during the course of treatment. Includes symptoms of autonomic instability, altered mental status, which may progress to hyperthermia, stupor, and muscle hypertonicity. Death may occur. Cause: Neuroleptics (phenothiazines, etc.) Characteristics. Same symptoms as malignant hyperthermia (see below) but generally develops over days instead of minutes. Treatment: As per malignant hyperthermia.

Malignant Hyperthermia. Cause. 1:20,000 in response to a muscle-relaxing agent (such as succinylcholine) or an inhaled anesthetic (such as halothane). Is hereditary. May also be secondary to physical or emotional stress. Characteristics. Hyperthermia, muscle rigidity, tachycardia, acidosis, shock, coma, rhabdomyolysis. Treatment includes IV dantrolene 1 to 10 mg/kg IV titrated to effect, management of acidosis and shock, peripheral cooling (see management of heat stroke below).

Tardive Dyskinesia. Involuntary movements of the tongue, face, mouth, or jaw associated with long-term administration of antipsychotics. Elderly females at highest risk. May be irreversible.
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