Schizophrenia diagnostic criteria: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
Diagnosis is based on the self-reported experiences of the person as well as abnormalities in behavior reported by family members, friends or co-workers, followed by secondary signs observed by a [[psychiatrist]], [[social worker]], [[clinical psychologist]] or other clinician in a clinical assessment. There is a list of criteria that must be met for someone to be so diagnosed. These depend on both the presence and duration of certain signs and symptoms. The most widely used criteria for diagnosing schizophrenia are from the [[American Psychiatric Association|American Psychiatric Association's]] [[Diagnostic and Statistical Manual of Mental Disorders]], the current version being DSM-IV-TR, and the [[World Health Organization|World Health Organization's]] [[ICD|International Statistical Classification of Diseases and Related Health Problems]], currently the ICD-10. The latter criteria are typically used in European countries while the DSM criteria are used in the USA or the rest of the world, as well as prevailing in research studies. The ICD-10 criteria put more emphasis on Schneiderian [[Kurt Schneider#First rank symptoms|first rank symptoms]] although, in practice, agreement between the two systems is high.<ref name="Jakobsen_et_al_2005">Jakobsen KD, Frederiksen JN, Hansen T, Jansson LB, Parnas J, Werge T (2005) Reliability of clinical ICD-10 schizophrenia diagnoses. ''Nordic Journal of Psychiatry'', 59 (3), 209-12. PMID 16195122</ref> The [[World Health Organization|WHO]] has developed the tool ''[[SCAN]] (Schedules for Clinical Assessment in Neuropsychiatry)'' which can be used for diagnosing a number of psychiatric conditions, including schizophrenia. | Diagnosis is based on the self-reported experiences of the person as well as abnormalities in behavior reported by family members, friends or co-workers, followed by secondary signs observed by a [[psychiatrist]], [[social worker]], [[clinical psychologist]] or other clinician in a clinical assessment. There is a list of criteria that must be met for someone to be so diagnosed. These depend on both the presence and duration of certain signs and symptoms. The most widely used criteria for diagnosing schizophrenia are from the [[American Psychiatric Association|American Psychiatric Association's]] [[Diagnostic and Statistical Manual of Mental Disorders]], the current version being DSM-IV-TR, and the [[World Health Organization|World Health Organization's]] [[ICD|International Statistical Classification of Diseases and Related Health Problems]], currently the ICD-10. The latter criteria are typically used in European countries while the DSM criteria are used in the USA or the rest of the world, as well as prevailing in research studies. The ICD-10 criteria put more emphasis on Schneiderian [[Kurt Schneider#First rank symptoms|first rank symptoms]] although, in practice, agreement between the two systems is high.<ref name="Jakobsen_et_al_2005">Jakobsen KD, Frederiksen JN, Hansen T, Jansson LB, Parnas J, Werge T (2005) Reliability of clinical ICD-10 schizophrenia diagnoses. ''Nordic Journal of Psychiatry'', 59 (3), 209-12. PMID 16195122</ref> The [[World Health Organization|WHO]] has developed the tool ''[[SCAN]] (Schedules for Clinical Assessment in Neuropsychiatry)'' which can be used for diagnosing a number of psychiatric conditions, including schizophrenia. | ||
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*'''Characteristic symptoms''': Two or more of the following, each present for a significant portion of time during a one-month period (or less, if successfully treated) | *'''Characteristic symptoms''': Two or more of the following, each present for a significant portion of time during a one-month period (or less, if successfully treated) | ||
** [[ | ** [[Delusion]]s | ||
** [[ | ** [[Hallucination]]s | ||
** | ** Disorganized speech (e.g., frequent derailment or incoherence; speaking in abstracts). See [[thought disorder]]. | ||
** | ** Grossly disorganized behavior (e.g. dressing inappropriately, crying frequently) or [[Catatonia|catatonic]] behavior | ||
** | ** Negative symptoms, i.e., [[affective flattening]] (lack or decline in emotional response), [[alogia]] (lack or decline in speech), or [[avolition]] (lack or decline in motivation). | ||
:Note: Only one of these symptoms is required if delusions are bizarre or hallucinations consist of hearing one voice participating in a running commentary of the patient's actions or of hearing two or more voices conversing with each other. | :Note: Only one of these symptoms is required if delusions are bizarre or hallucinations consist of hearing one voice participating in a running commentary of the patient's actions or of hearing two or more voices conversing with each other. | ||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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[[Category:Psychiatry]] | [[Category:Psychiatry]] | ||
[[Category:Mature chapter]] | [[Category:Mature chapter]] | ||
[[Category:Primary care]] | |||
[[Category:Needs overview]] | |||
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{{WS}} | |||
Revision as of 18:59, 19 March 2013
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Schizophrenia Microchapters |
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Schizophrenia diagnostic criteria On the Web |
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Risk calculators and risk factors for Schizophrenia diagnostic criteria |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Diagnosis
Diagnosis is based on the self-reported experiences of the person as well as abnormalities in behavior reported by family members, friends or co-workers, followed by secondary signs observed by a psychiatrist, social worker, clinical psychologist or other clinician in a clinical assessment. There is a list of criteria that must be met for someone to be so diagnosed. These depend on both the presence and duration of certain signs and symptoms. The most widely used criteria for diagnosing schizophrenia are from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, the current version being DSM-IV-TR, and the World Health Organization's International Statistical Classification of Diseases and Related Health Problems, currently the ICD-10. The latter criteria are typically used in European countries while the DSM criteria are used in the USA or the rest of the world, as well as prevailing in research studies. The ICD-10 criteria put more emphasis on Schneiderian first rank symptoms although, in practice, agreement between the two systems is high.[1] The WHO has developed the tool SCAN (Schedules for Clinical Assessment in Neuropsychiatry) which can be used for diagnosing a number of psychiatric conditions, including schizophrenia.
DSM IV Criteria
To be diagnosed with schizophrenia, a person must display:[2]
- Characteristic symptoms: Two or more of the following, each present for a significant portion of time during a one-month period (or less, if successfully treated)
- Delusions
- Hallucinations
- Disorganized speech (e.g., frequent derailment or incoherence; speaking in abstracts). See thought disorder.
- Grossly disorganized behavior (e.g. dressing inappropriately, crying frequently) or catatonic behavior
- Negative symptoms, i.e., affective flattening (lack or decline in emotional response), alogia (lack or decline in speech), or avolition (lack or decline in motivation).
- Note: Only one of these symptoms is required if delusions are bizarre or hallucinations consist of hearing one voice participating in a running commentary of the patient's actions or of hearing two or more voices conversing with each other.
- Social/occupational dysfunction: 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, are markedly below the level achieved prior to the onset.
- Duration: Continuous signs of the disturbance persist for at least six months. This six-month period must include at least one month of symptoms (or less, if successfully treated).
Additional criteria are also given that exclude the diagnosis; thus schizophrenia cannot be diagnosed if symptoms of mood disorder or pervasive developmental disorder are present, or the symptoms are the direct result of a substance (e.g., abuse of a drug, medication) or a general medical condition.