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.