Distinguishing between first-admission schizophreniform disorder and schizophrenia.
BACKGROUND
The validity of schizophreniform disorder remains controversial. Past research suggests that cases of schizophreniform disorder may be: (1). atypical cases of affective disorders, (2). cases of schizophrenia in early course, or (3). a heterogeneous group of disorders including a subgroup with benign course and outcome which maintains this diagnosis in the long term.


METHODS
We tested the validity of the schizophreniform disorder diagnosis by comparing the socio-demographic and baseline clinical characteristics, 24-month course and outcome, and 6- and 24-month research diagnoses of 34 cases initially diagnosed with schizophreniform disorder, and 128 cases with schizophrenia, drawn from a cohort of 628 first-admission patients in the Suffolk County Mental Health Project.


RESULTS
Compared to patients with schizophrenia, those with schizophreniform disorder were more likely to remit fully by 6 months and retain this status by 24 months. Only about half of the patients with schizophreniform disorder were re-diagnosed with schizophrenia or schizoaffective disorder at 24-month follow-up, 13% were re-diagnosed with affective disorders and 19% retained the diagnosis of schizophreniform disorder. In contrast, 92% of cases with a baseline diagnosis of schizophrenia retained this diagnosis at 24-month follow-up. The findings were similar in comparisons with schizophrenia patients having onset of symptoms within 6 months of hospitalization.


CONCLUSIONS
Schizophreniform disorder is a heterogeneous category, which includes a small group with benign psychotic disorders who maintain this diagnosis over at least 24 months. Better delineation of this subgroup has important treatment implications.
Naz
Bushra
B
Department of Psychiatry, State University of New York at Stony Brook, Stony Brook, NY 11794-8790, USA.
Bromet
Evelyn J
EJ
Mojtabai
Ramin
R
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D010343:Patient Admission; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000145:classification / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000145:classification / Q000175:diagnosis* / Q000628:therapy; D012565:Schizophrenic Psychology