530 CHAPTER 12
Schizophreniform and Brief Psychotic Disorders
In some cases, an individual’s symptoms may meet most, but not all, of the criteria
for a diagnosis of schizophrenia. The individual clearly suffers from some psychotic
symptoms and has signifi cant diffi culty in functioning as a result of his or her psy-
chological problems. However, the impaired functioning hasn’t been present for the
minimum 6-month duration required for a diagnosis of schizophrenia. Two disorders
fall into this class, depending on the specifi cs of the symptoms and their duration.
Schizophreniform disorder is the diagnosis given when a person’s symptoms
meet all the criteria for schizophrenia exceptthat the symptoms have been present
for only 1–6 months (American Psychiatric Association, 2000). In addition, daily
functioning may or may not have declined over that period of time. If the symptoms
persist for more than 6 months (and daily functioning signifi cantly declines, if it
hasn’t already), the diagnosis shifts to schizophrenia.
In contrast, brief psychotic disorder refers to the sudden onset of psychotic symp-
toms (hallucinations and delusions), symptoms of disorganized speech or behavior, or
catatonic behavior, that last between a day and a month and are followed by a full
recovery (American Psychiatric Association, 2000). With this disorder, no negative
symptoms should be present during the episode. Rather, brief psychotic disorder is
marked by intense emotional episodes and confusion, during which the person may
be so disorganized that he or she can’t function safely and independently; he or she
also has a higher risk of suicide during the time of the episode. Once recovered, people
who had this disorder have a good prognosis for full recovery (Pillman et al., 2002).Schizoaffective Disorder
Schizoaffective disorder is characterized by the presence of both schizophrenia and a
depressive, manic, or mixed mood episode (see Chapter 6). Because schizoaffective
disorder involves mood episodes, negative symptoms such as fl at affect are not com-
mon, and the diagnosis is likely to be made solely on the basis of positive symptoms.
Because of their mood episodes, people with schizoaffective disorder are at greater
risk for committing suicide than are people with schizophrenia (Bhatia et al., 2006;
De Hert, McKenzie, & Peuskens, 2001). The prognosis for recovery from schizo-
affective disorder is better than that for recovery from schizophrenia, particularly
when stressors or events clearly contribute to the disorder (American Psychiatric
Association, 2000).Delusional Disorder
When a person’s sole symptom is that he or she adheres to nonbizarre but demon-
strably incorrect beliefs—those that are theoretically plausible, such as believing
that someone is following you—and those beliefs have persisted for more than
1 month, that person is diagnosed with delusional disorder. Note that the assessment
of the bizarreness of the beliefs distinguishes schizophrenia (bizarre) from delusional
disorder (nonbizarre). What is interpreted as being bizarre will vary across clini-
cians, depending on their experience with people from different subcultures, ethnic
groups, or countries; what may seem bizarre to a clinician, though, may be under-
standable given a particular patient’s background and experience (Mullen, 2003).
Cliniciansand researchers have identifi ed the following types of nonbizarre delusions
(American Psychiatric Association, 2000):- Erotomanic. The belief that another person is in love with the patient. This delu-
sion usually focuses on romantic or spiritual union rather than sexual attraction.
It is common for people with erotomania to try to contact the person who is the
object of their delusion. - Grandiose. The belief that the patient has a great (but unrecognized) ability,
talent, or achievement. - Persecutory. The belief that the patient is being spied on, drugged, harassed, or other-
wise conspired against. Small snubs or slights are magnifi ed in the patient’s eyes, and
he or she may seek legal action to redress these perceived insults. People with this de-
lusion sometimes become violent against those whom they perceive as harming them.
Schizophreniform disorder
The psychotic disorder characterized by
symptoms that meet all the criteria for
schizophrenia except that the symptoms have
been present for only 1–6 months and daily
functioning may or may not have declined
over that period of time.
Brief psychotic disorder
The psychotic disorder characterized by the
sudden onset of positive or disorganized
symptoms that last between a day and a
month and are followed by a full recovery.
Schizoaffective disorder
The psychotic disorder characterized by
the presence of both schizophrenia and a
depressive, manic, or mixed mood episode.
Delusional disorder
The psychotic disorder characterized by the
presence of nonbizarre but demonstrably
incorrect beliefs that have persisted for more
than 1 month.