OBJECTIVE: The author examined the validity of schizophreniform disorder
as defined in DSM-III and DSM-III-R by critically reviewing the current
literature. METHOD: Thirty publications that met specific inclusion
criteria were identified and reviewed. To organize information relevant to
the question of validity, the data were divided into three general classes
of validators: antecedent, concurrent, and predictive. When possible,
meta-analyses of specific validators were performed according to the
summary odds ratio method of Mantel- Haenszel. RESULTS: The findings of
this review failed to provide support for the validity of schizophreniform
disorder, as it is currently defined, as a distinct diagnostic entity. In
addition, the review did not provide strong support for schizophreniform
disorder as representing a subtype of schizophrenia or affective illness.
Instead, the data suggest that the current diagnostic criteria for
schizophreniform disorder identify a heterogeneous group of patients with
new-onset schizophrenia, schizoaffective disorder, and atypical affective
disorder and a small subgroup with a remitting nonaffective psychosis.
CONCLUSIONS: This review suggests that the diagnosis of schizophreniform
disorder has limited clinical utility. Patients meeting criteria for
schizophreniform disorder should instead be diagnosed as having psychotic
disorder not otherwise specified until additional clinical information
(e.g., course of illness) becomes available. Future research will require
prospective longitudinal follow- up of patients with new-onset affective
and nonaffective psychoses to identify the subgroup with "true"
schizophreniform disorder, i.e., a remitting nonaffective psychosis.