Schizo-What? Part 1

by Dr. Lorin Bradbury

Question: I was just looking at a list of mental disorders. Some sound alike. What is the difference among Schizoaffective Disorder, Schizoid Personality Disorder, Schizophrenia, Schizophreniform Disorder, and Schizotypal Personality Disorder?
Answer: Since I am limited as to how much space I can take up in the paper, I will attempt to answer your question and yet be brief. First, among the disorder listed, there are two distinct categories—Mental Illnesses and Personality Disorders.
This week, I will address the mental illnesses—Schizophreniform Disorder, Schizophrenia, and Schizoaffective Disorder. Next week, I will describe the personality disorders you have noted in your question.
Of these three major mental illnesses, Schizophrenia is probably the best known among the general public, unless you or a family member are afflicted with one of the other disorders. Before making a diagnosis of Schizophrenia you would want to rule out other mental and medical disorders that might produce symptoms similar to Schizophrenia.
To receive a diagnosis of Schizophrenia, the individual would have to present with two or more of the following symptoms, each present for a significant portion of time during a one-month period (or less if successfully treated): (1) delusions, (2) hallucinations, (3) disorganized speech, (4) grossly disorganized or catatonic behavior, or (5) negative symptoms (i.e., flattening of affect, alogia, or avolition).
For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care must be markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, failure to achieve expected level of interpersonal, academic, or occupational achievement). And the duration of the disturbance would have to have persisted for at least six months. This six-month period must include at least one month of active symptoms.
The essential features of Schizophreniform Disorder is identical to Schizophrenia, except for two differences—the total duration of the illness is at least one month, but less than six months, and impairment in social or occupational functioning may not be present in some or part of the illness. Generally, when the duration of the illness has lasted six months, there will be impairment in social or occupational functioning, and the diagnosis will be changed to Schizophrenia.
The essential features of Schizoaffective Disorder is an uninterrupted period of illness that meets the criteria for Schizophrenia, during which, at some time, there is either (1) a Major Depressive Episode, (2) a Manic Episode, or (3) a Mixed Episode (depression and mania) concurrent with symptoms of Schizophrenia.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in the Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to [email protected].