Psychosis

Schizophrenia Diagnosis

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Schizophrenia Diagnosis

  • See Also
  1. Schizophrenia
  2. Psychosis
  3. Psychosis Symptoms
  4. Psychosis Exam
  5. Psychosis Types
  6. Psychosis Differential Diagnosis
  7. Drug Induced Psychosis
  8. Psychosis Diagnostic Testing
  9. Delirium
  • Symptoms
  • Positive
  1. Delusions (often bizarre)
  2. Hallucinations (not fantasy)
  3. Disorganized Speech
    1. Frequent derailment or incoherence
    2. Conceptional disorganization
  4. Bizarre disorganized or Catatonic behavior
    1. Delusions
    2. Excitement
    3. Grandiosity
    4. Suspiciousness or persecution
    5. Hostility
  • Symptoms
  • Negative (Lack of normal function)
  1. See Negative Symptoms in Psychosis
  2. Diminished emotional expression or avolition
  3. Blunted affect
  4. Alogia (fewer words spoken)
  5. Avolition (decreased motivation, decreased goal directed activity)
  6. Asocial
  7. Anhedonia
  • Diagnosis
  • Criteria
  1. Symptoms (active phase)
    1. Two symptoms or more from list above
      1. At least one positive symptom (Delusions, Hallucinations or Disorganized Speech) AND
      2. At least one negative symptom OR grossly disorganized or Catatonic behavior
      3. In DSM IV, one symptom was sufficient if significant, bizarre Delusion or Hallucination (e.g. 2 voices conversing)
    2. Each symptom present for a significant amount of time during a one month period
      1. Symptoms may be less prominent during the month if treated
  2. Severe for at least one month (or less if receiving clinical treatment)
  3. Impaired social or occupational function
  4. Continuous signs and symptoms for at least 6 months
  5. Not due to secondary cause
    1. Not due to schizoaffective disorder
    2. Not due to Bipolar Disorder (minimal or no concurrent mania or Major Depression during active phase)
    3. Not due to Mood Disorder
    4. Not due to Substance Abuse
    5. Not due to underlying medical illness
    6. Not due to pervasive Developmental Disorder
    7. Not due to Autism, unless Delusions or Hallucinations are prominent
  • References
  1. (2000) DSM IV, American Psychiatric Association, p. 297-343
  2. (2013) DSM V, American Psychiatric Association, p. 99
  3. Crawford (2022) Am Fam Physician 106(4): 388-96 [PubMed]
  4. Freedman (2003) N Engl J Med 349:1738-49 [PubMed]
  5. Holder (1014) Am Fam Physician 90(11): 775-82 [PubMed]
  6. Schultz (2007) Am Fam Physician 75:1821-9 [PubMed]