Schizophreniform Disorder: Symptoms, Causes, and Treatment

Schizophrenia is a widely known mental disorder, considered to be the most representative of all psychotic disorders.

However, among these we find other disorders more or less similar, such as schizoaffective disorder, chronic delusional disorder or the disorder that concerns us in this article: schizophreniform disorder.

The latter is a psychological disorder difficult to define and with unclear limits, because its differences with other disorders of the psychotic type are more quantitative than qualitative, as we will see.

    What is a schizophreniform disorder?

    The diagnosis of schizophreniform disorder is made in all cases in which at least hallucinations, delusions and / or impaired speech appear. and disorganized for more than a month but less than six. However, in some cases it is not known whether it is a schizophreniform disorder or any other type of mental disorder on the psychotic spectrum.

    The lines of demarcation between these concepts are blurred and can provoke debate; primarily, these definitions serve as a reference for guidance in the clinical field. For this reason, some researchers have criticized the concept of schizophreniform disorder for being raised in a similar fashion to a “tailor’s drawer” category, that is, one in which to include cases that are difficult to classify and do not have large. – something in common.

    In contrast, as with all psychological disorders and psychiatric syndromes, the diagnosis of schizophreniform disorder can only be made by mental health professionals with the appropriate training and accreditation.

    symptoms

    Symptoms of schizophreniform disorder are variedEspecially since the way the disconnection from reality is presented changes the way the person reacts a lot.

    However, the symptoms are not as long lasting as with schizophrenia, and over time they may go away completely or almost completely. This is why its development can give the feeling that there are emotional ups and downs and unforeseen problems.

    It is not uncommon for people with schizophreniform disorder to exhibit increased activity and impulsivity., Acting chaotically, and a varying level of disconnection from reality. You may also have catatonia or negative symptoms such as abulia or bradypsychia. The onset of these symptoms tends to be sudden and acute, as does their subsequent disappearance.

    Differences from schizophrenia

    This brief definition may remind us of schizophrenia, which differs primarily in the time window in which it appears (from one to six months, requiring the diagnosis of schizophrenia at least six and acute psychotic disorder of less than one month) and because ‘they usually leave after-effects or produce deterioration (unless this leads to another disorder). That’s why it usually has a much better prognosis than this one.

    It is common that when the diagnosis is made, if the problem is not already resolved, the schizophreniform disorder is considered a provisional diagnosis until it is determined whether it ceases before six months or if it can. be considered schizophrenia. In fact, at the time, some authors proposed that this diagnostic label actually encompassed subjects with successfully resolved and treated schizophrenia.

    One-third of patients achieve full recovery, with no other symptoms or sequelae., Even often without treatment (although that doesn’t mean you don’t need to seek professional help, plus it is essential that you do). However, in the remaining two-thirds, schizophreniform disorder may eventually progress to schizophrenia or schizoaffective disorder, especially if left untreated (although it should be noted that the phenomenon explained in the previous paragraph also influences this).). It can also develop into a schizotypal personality disorder.

    Causes of this disorder

    The etiology (causes) of this disorder is not fully known, mixing in this regard different hypotheses which largely coincide with those of other psychotic disorders such as schizophrenia.

    By default, it is assumed that the roots of schizophreniform disorder are not in one cause, but in many, And some of them have not so much to do with the biological characteristics of the patient, but with the context in which he lives and the way he is used to interacting with his physical and social environment.

    Correlations have been observed to suggest that at least some subjects with this disorder have inherited genetic disorders, and it is common for a parent to suffer from mood disorders or schizophrenia. Experiencing traumatic situations by a person with a genetic vulnerability can trigger the onset of the disorder as well as the use of substances. For example, drugs as common as cannabis are known to dramatically increase the chances of developing psychotic-type disorders, and schizophreniform disorder is one of them.

    At the cerebral level, we observe, as in schizophrenia, that alterations may occur in the dopaminergic pathways, particularly in the mesolimbic and mesocortical pathways. In the first of these, there would be dopaminergic hyperexcitation which would cause positive symptoms such as hallucinations, and mesocortical hypoactivation 1 due to a lack of sufficient levels of this hormone which would generate abulia and other negative symptoms. However, although schizophrenia has a generally chronic course into schizophreniform disorder, symptoms eventually subside with treatment or even in some cases on their own, so the change in the aforementioned systems could be a storm.

    Good prognosis factors

    Various studies on schizophreniform disorder highlight the existence of certain factors that tend to be related to a good prognosis.

    Among them, there was a good premorbid adjustment (i.e. the subject did not present any difficulties before the epidemic and was well integrated in socio-work), that there were feelings of confusion or strangeness between symptoms, that the positive psychotic symptoms begin within the first four weeks of the onset of the first changes and no emotional jam or other negative symptoms appear.

    This does not mean that those who do not have these characteristics will necessarily have a worse outcome, but that those who do will have a harder time controlling the disorder.

    treatment

    The treatment for schizophreniform disorder is almost identical to that for schizophrenia. What has been shown to be most effective in the fight against this disorder is the combined use of pharmacological and psychological therapy, with a better prognosis from the start of the mixed treatment.

    Below, we review some of the most common and scientifically proven methods for treating schizophreniform disorder.

    1. Pharmacological

    At the pharmacological level, the administration of neuroleptics is prescribed in order to fight against the positive symptoms.It is generally recommended to use an atypical product because of its lesser side effects.

    This treatment is carried out both to stabilize the patient initially in the acute phase and subsequently thereafter. A lower maintenance dose is usually needed than in schizophrenia, as well as less time for it. If there is a risk of injury or self-harm, hospitalization may be necessary until the patient stabilizes.

    However, administering drugs (always under medical indication) and trusting them is not a good idea; it is necessary to constantly monitor its effects and assess its side effects in patients.

    2. Psychological

    At the psychological level, the treatment will be carried out once the patient is stabilized. Therapies such that problem solving and coping skills training, as well as psychosocial support, are helpful.

    The presence of hallucinations and delusions can be treated with focusing therapy (if you can hear voices) and techniques such as cognitive restructuring. In addition, behavior therapy can help to dissociate the onset of hallucinations with the function that has adopted this phenomenon given the patient’s context (eg, as a response mechanism to stressful situations).

    It should be noted that after experiencing a psychotic flare, over-stimulation can be harmful initially., With which it is advisable that the reincorporation into daily life is gradual. In any case, social and community strengthening is very useful in improving the patient’s condition, and it is essential to conduct psychoeducation both with those affected and their environment.

    Thanks to the psycho-educational process, the patient and his family are informed of the implications of this disorder and of the lifestyle habits to adopt to offer the best possible well-being.

    Finally, it should be borne in mind that regular monitoring of each case must be carried out in order to avoid a possible development towards another psychological or psychiatric disorder. This involves scheduling visits to the therapist’s consultation on a regular basis but without weekly frequency, unlike the intervention phase to treat symptoms.

    Bibliographical references:

    • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.
    • Gutierrez, MI; Sanchez, M .; Trujillo, A .; Sanchez, L. (2012). Cognitive-behavioral therapy in acute psychosis. Rev. Asoc.Esp.Neuropsi. 31 (114); 225-245.
    • Kendler, KS, Walsh, D. (1995). Schizophreniform Disorder, Delusional Disorder, and Psychotic Disorder Not Elsewhere Specified: Clinical Features, Outcomes, and Familial Psychopathology. Acta Psychiatr Scand, 91 (6): pages 370-378.
    • Pérez-Egea, R .; Escartí, JA; Ramos-Quirga, I .; Corripio-Collado, J .; Pérez-Blanco, V .; Pérez-Sola, V. and Álvarez-Martínez, I. (2006). Schizophreniform disorder. Prospective study with 5 years of follow-up. Psiq. Biol. 13 (1); 1-7.
    • Sants, JL; Garcia, LI; Calderon, MA; Sanz, LJ; of rivers, P .; Left, S .; Román, P .; Hernangómez, L .; Navas, E .; Lladre, A and Álvarez-Cienfuegos, L. (2012). Clinical Psychology. CEDE PIR preparation manual, 02. CEDE. Madrid.
    • Strakowski, SM (1994). Diagnostic validity of schizophreniform disorder. American Journal of Psychiatry, 151 (6): pages 815-824.
    • Troisi, A., Pasini, A., Bersani G., Di Mauro M., Ciani N. (1991). Negative symptoms and visual behavior in the DSM-III-R prognostic subtypes of schizophreniform disorder. ”Acta Psychiatr Scand. 83 (5): 391-4.

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