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Sometimes, we encounter people complaining of 'losing touch with reality after experiencing a major life event or a trauma. This feeling usually accompanies auditory/visual hallucinations, delusions, and unregulated mood changes. The following article helps us understand whether these changes are temporary or permanent and their impact on one's day-to-day functioning.
What Is Schizophreniform Disorder?
Schizophreniform is a disorder characterized by schizophrenia-like symptoms for a short period of time. It can be grouped under the schizophrenia spectrum of mental health disorders. An affected person will likely exhibit disorganized behavior and psychotic symptoms such as hallucinations, delusions, and disorganized speech. Any substantial mood swings should be transient and unrelated to substance usage or adverse medical effects. Between 0.4 and 1% of people in the general population have primary schizophreniform illnesses. Research indicates that it affects both men and women equally, between the ages of 18 and 24. However, it frequently affects men at an earlier age. It most commonly affects women between the ages of 24 and 35.
Schizophreniform disorder is frequently used as a preliminary diagnosis until a more definite diagnosis is established through long-term follow-up. About 2/3 of patients initially diagnosed with the schizophreniform disorder will go on to be diagnosed with schizophrenia or schizoaffective disorder. Alternatively, the rate of first-episode psychosis patients retaining a diagnosis of schizophreniform disorder over time is only 29%.
Schizophrenia vs. Schizophreniform disorder
Three illnesses that cause identical symptoms have been found by researchers: brief psychotic episodes, schizophreniform disorder & schizophrenia. A clinician's diagnosis is based on how long the symptoms persist. The brief psychotic episode lasts for less than a month and is usually brought on by a specific precipitating factor.
Severity & Duration of symptoms
The symptoms of schizophrenia and schizophreniform disorder are mostly identical as they share many of the same features, with their main differentiating factor being the time duration of symptoms & degree of impairment. The main feature of both conditions is a loss of the ability to tell the difference between what is real and what is not. In terms of Duration, a schizophrenic person would exhibit symptoms for at least six months before being diagnosed, after which the symptoms would continue to worsen. On the other hand, these symptoms are, by definition, present for 1–6 months in schizophreniform disorder. When schizophrenia is identified, there is typically considerable functional impairment (academic, occupational, or social); these challenges may not be present when schizophreniform illness is identified. Additionally, compared to schizophrenia, its onset can be very quick.
Causes of the Disorder
Schizophreniform, like the other disorders in the schizophrenia spectrum, is a serious & incapacitating mental illness with positive and negative symptoms and behavioral abnormalities. Patients with this illness have generalized alterations in brain structure and cognitive impairment noticeable on neuropsychological tests, which stands as evidence of genetic susceptibility, and Dopamine & serotonin neurotransmission abnormalities are demonstrated. Patients with schizophreniform disorder also have increased interhemispheric disparities and MRI evidence of cerebral cortical dysfunction (inability to pay attention, disorientation, difficulty thinking coherently, etc.). The environment in which a person is reared also impacts how this disorder manifests itself, in addition to genetic and biological factors. Evidence suggests that situations like unsatisfactory social interactions or a very stressful occurrence could help someone develop schizophreniform symptoms.
Signs & Symptoms
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines the following four basic components for diagnosing the schizophreniform disorder.
- The onset of psychotic symptoms (delusions, hallucinations, or disorganized speech) within four weeks of the first noticeable change in behavior or functioning.
- The absence of manic, depressive, or mixed manic-depressive episodes during these symptoms and any mood disturbance must have been present only a minority of this time. This excludes schizoaffective disorder or bipolar disorder with psychotic features.
- The symptoms must last for more than a month but less than six months.
- Associated symptoms include limited emotional expression (blunted affect), lack of energy, poor hygiene, grooming habits, loss of interest or pleasure in life (anhedonia), low motivation, changes in speech, depression-like symptoms & withdrawal from family, friends, and social activities.
Treatment & Management
Treatment options for schizophreniform disorder and schizophrenia include both pharmacological & psychosocial therapy. The approach will vary according to the individual's age and the progression of the symptoms.
A significant portion of treatment involves the use of antipsychotic medicines. Typically, they were prescribed by psychiatrists together with antidepressants or antimanic medications for 12 months after the symptoms subsided. The treatment plan aims to find the lowest dose of an atypical antipsychotic neuroleptic (risperidone, quetiapine, olanzapine, and ziprasidone) that is still effective while minimizing any negative side effects. Second-generation neuroleptics are often used to treat resistant symptoms, though they may also be treated with lithium, SSRIs, mood-stabilizing anticonvulsants, newer antipsychotic medications, or newer antipsychotic medications. In certain cases, electroconvulsive therapy works to address symptoms that are resistant to other treatments. Supportive psychotherapy plays a significant role in ensuring that the benefits of drug therapy are long-lasting and that the patient can function properly. These include cognitive behavioral therapy, family-focused therapy, and group therapy. Social and vocational rehabilitation may also be required in some circumstances. The patient can gain from this type of therapy by developing social skills, allies, and an enhanced ability to handle daily chores.
The consequences of schizophrenia can be severe. It can change a person's behavior, lead them to think irregularly, speak too quickly, express their emotions inconsistently, change their relationships with others, and modify how they perceive reality. It might be frightening to experience, but thankfully, some specialists and treatments may be able to assist control and treating symptoms.
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