• The text revision of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) describes schizophreniform disorder as similar to schizophrenia, except that its symptoms last at least 1 month but less than 6 months.

• Schizophreniform disorder is an acute psychotic disorder that has a rapid onset and lacks a long prodromal phase

• By definition, patients with schizophreniform disorder return to their baseline state within 6 months

• Part of defining SFD involves examining possible biological influences on the development of the individual's psychotic symptoms.

• When the psychotic features result from a physical disease, a reaction to medication, or intoxication with drugs or alcohol, then these symptoms are not considered SFD.

• Also, if hallucinations, delusions or other psychotic symptoms are experienced solely during episodes of clinical depression or mania, then SFD is not diagnosed. Instead, a mood disorder diagnosis is given.

Signs and symptoms

• The initial symptom profile is the same as that of schizophrenia in that two or more psychotic symptoms must be present (hallucinations, delusions, disorganized speech and behavior, or negative symptoms)

• Emotional turmoil and confusion, (the presence of which may indicate a good prognosis).

• Although negative symptoms may be present, they are relatively uncommon in schizophreniform disorder and are considered poor prognostic features.

Course of the Disease• People with schizophreniform disorder recover within six

months. If the symptoms do not improve, the person likely has schizophrenia, which is a lifelong illness

• Most estimates of progression to schizophrenia range between 60 and 80 percent. What happens to the other 20 to 40 percent is currently not known.

• Some will have a second or third episode during which they will deteriorate into a more chronic condition of schizophrenia

• A few, however, may have only this single episode and then continue on with their lives, which is clearly the outcome desired by all clinicians and family members

• The psychotic symptoms can usually be treated by a 3- to 6-month course of

antipsychotic drugs (e.g., risperidone).

Co existing diseases

• Substance abuse is common in schizophreniform disorder. The lifetime prevalence of any drug abuse (other than tobacco) is often greater than 50 percent. For all drugs of abuse (other than tobacco), abuse is associated with poorer function

Diabetes Mellitus

• There is evidence that some antipsychotic medications cause diabetes through a direct mechanism. Since treatment is similar to that of Schizophrenia, Schizophreniform disorder is possibly also associated with an increased risk of type II diabetes mellitus, due to effects of medications used to manage the condition.

Cardiovascular Disease

• Many antipsychotic medications have direct effects on cardiac electrophysiology. In addition, obesity, increased rates of smoking, diabetes, hyperlipidemia, and a sedentary lifestyle all independently increase the risk of cardiovascular morbidity and mortality.

HIV

• Patients with schizophreniform disorder may have a risk of HIV. This association is thought to be due to increased risk behaviors, such as unprotected sex, multiple partners, and increased drug use.

Chronic Obstructive Pulmonary Disease

• The increased prevalence of smoking is an obvious contributor to this problem and may be the only cause.

Risk factors• A lifetime prevalence rate of 0.2 percent and a 1-year prevalence

rate of 0.1 percent have been reported.

AGE:• The disorder is most common in adolescents and young adults and

is less than half as common as schizophrenia. GENDER:• The prevalence of schizophreniform disorder is equally distributed

between Men and women, with peak onset between the ages of 18 and 24 for men and24 and 25 in women.

FAMILY HISTORY:• There is increased occurrence of mood disorders in the relatives of

patients with schizophreniform disorder

GENETICS Diathesis is a medical term meaning that some element of one's physiology

makes one particularly prone to develop an illness if exposed to the right conditions.

Diathesis is another way of saying there is a personal predisposition to develop a disorder; the predisposition is biologically based and is genetically acquired (inherited in the person's genes).

Temporary psychotic reactions may occur in persons who have the diathesis for psychosis, when the individual is placed under marked stress .

The stress may result from typical life transition experiences such as moving away from home the first time, being widowed or getting divorced.

CHEMICAL IMBALANCE• Excessive dopamine release in patients may be associated with

the severity of positive psychotic symptoms• Current hypotheses posit serotonin excess as a cause of both

positive and negative symptoms • Some patients may have a loss of GABAergic neurons in the

hippocampus. GABA has a regulatory effect on dopamine activity, and the loss of inhibitory GABAergic neurons could lead to the hyperactivity of dopaminergic neurons

• Glutamate has been implicated because ingestion of phencyclidine, a glutamate antagonist, produces an acute syndrome similar to schizophrenia

CULTURALLY DEFINED DISORDERS. 

• Many cultures have forms of mental disorder, unique to that culture, that would meet criteria for SFD.

• In culturally defined disorders, a consistent set of features and presumed causes of the syndrome are localized to that community. Such disorders are termed "culture-bound."

• Examples of culture-bound syndromes that might meet SFD criteria are amok (Malaysia), or locura (Latino Americans).

• Amok is a syndrome characterized by brooding, persecutory delusions and aggressive actions.

• Locura involves incoherence, agitation, social dysfunction, erratic behavior, and hallucinations.