Genetic and physiological. Relatives of individuals with schizophreniform disorder have an increased risk for schizophrenia.
At least 2
of the following, each present for a significant portion of time during a 1
-month period (or less if successfully treated). At least one of these must be (1), (2), or (3):
An episode of the disorder lasts at least 1
month but less than 6
months. When the diagnosis must be made without waiting for recovery, it should be qualified as “provisional.”
Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either:
The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
Specify if:
Specify if: Severity is rated by a quantitative assessment of the primary symptoms of psychosis, including delusions, hallucinations, disorganized speech, abnormal psychomotor behaviour, and negative symptoms. Each of these symptoms may be rated for its current severity (most severe in the last 7 days) on a 5-point scale ranging from 0 (not present) to 4 (present and severe). (See Clinician-Rated Dimensions of Psychosis Symptom Severity in the chapter “Assessment Measures.”)
The term psychosis has been defined in various ways in the medical literature over time. The narrowest and current definition of psychosis is hallucinations and delusions, with the lack of reality testing or insight. A broader definition of psychosis would also include disorganized thought, emotions, and behaviour. This loose definition was more common in the past, and schizophrenia was often overdiagnosed as a result.
Type | Onset | Length | Psychotic Symptoms | Mood Symptoms | Functional Decline? |
---|---|---|---|---|---|
Brief psychotic disorder | Sudden | 1 day to 1 month | At least 1 of: • Delusions • Hallucinations • Disorganized speech • Grossly disorganized or catatonic behaviour | No | Full resolution of symptoms |
Schizophreniform disorder | Can be prodromal | 1 month to 6 months | At least 2 of: • Delusions • Hallucinations • Disorganized speech • Grossly disorganized or catatonic behaviour • Negative symptoms | No | Not required |
Schizophrenia | Can be prodromal | > 6 months | At least 2 of: • Delusions • Hallucinations • Disorganized speech • Grossly disorganized or catatonic behaviour • Negative symptoms | No | Required |
Schizoaffective disorder | Can be prodromal | Major mood episode + 2 weeks of isolated psychotic symptoms + predominantly mood symptoms over course of illness | • Delusions or hallucinations for 2 or more weeks, which must be in absence of a major mood episode (depressive or manic) during the lifetime duration of the illness | Required | Not required |
Delusional disorder | Can be prodromal | > 1 month | • One or more delusions, with no other psychotic symptoms. | No | Normal function aside from impact of delusions |