Schizophrenia diagnostic criteria: Difference between revisions

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Latest revision as of 15:01, 4 September 2018

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2], Vindhya BellamKonda, M.B.B.S [3], Irfan Dotani

Diagnostic Criteria

DSM-V Diagnostic Criteria for Schizophrenia

“

A. Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated):^[1]

Delusions
Hallucinations
Disorganized speech (e.g., frequent derailment or incoherence)
Grossly disorganized or catatonic behavior
Negative symptoms (i.e., diminished emotional expression or avolition)

AND

B. For a significant portion of the time since the onset of the disturbance, level of functioning in one or more major areas, such as work, interpersonal relations, or self-care, is markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, there is failure to achieve expected level of interpersonal, academic, or occupational functioning).

AND

C. Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or by two or more symptoms listed in Criterion A present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences).

AND

D. Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either 1) no major depressive or manic episodes have occurred concurrently with the active-phase symptoms, or 2) if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness.

AND

E. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.

AND

F. If there is a history of autism spectrum disorder or a communication disorder of childhood onset, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations, in addition to the other required symptoms of schizophrenia, are also present for at least 1 month (or less if successfully treated).

Specify if:

The following course specifiers are only to be used after a 1-year duration of the disorder and if they are not in contradiction to the diagnostic course criteria.

First episode, currently in acute episode: First manifestation of the disorder meeting the defining diagnostic symptom and time criteria. An acute episode is a time period in which the symptom criteria are fulfilled.

First episode, currently in partial remission: Partial remission is a period of time during which an improvement after a previous episode is maintained and in which the defining criteria of the disorder are only partially fulfilled.

First episode, currently in full remission: Full remission is a period of time after a previous episode during which no disorder-specific symptoms are present.

Multiple episodes, currently in acute episode: Multiple episodes may be determined after a minimum of two episodes (i.e., after a first episode, a remission and a minimum of one relapse).

Multiple episodes, currently in partial remission

Multiple episodes, currently in full remission Continuous: Symptoms fulfilling the diagnostic symptom criteria of the disorder are remaining for the majority of the illness course, with subthreshold symptom periods being very brief relative to the overall course.

Unspecified

Specify if:

With catatonia

Specify current severity:

Severity is rated by a quantitative assessment of the primary symptoms of psychosis, including delusions, hallucinations, disorganized speech, abnormal psychomotor behavior, and negative symptoms. Each of these symptoms may be rated for its current severity (most severe in the last 7 days) on a 5-point scale ranging from 0 (not present) to 4 (present and severe). Note: Diagnosis of schizophrenia can be made without using this severity specifier.

”

Note: Diagnosis of schizophrenia can be made without using this severity specifier.

References

↑ Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association. 2013. ISBN 0890425558.

[DSMV-1] Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association. 2013. ISBN 0890425558.

[1]

@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Schizophrenia}}
-{{CMG}}
+{{CMG}}; {{AE}} {{JH}}, {{Vbe}}, {{I.D.}}
-==Diagnosis==
+==Diagnostic Criteria==
-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.
+===DSM-V Diagnostic Criteria for Schizophrenia===
+{{cquote|
+* A. Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated):<ref name=DSMV>{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558 }}</ref>
-==DSM IV Criteria==
+# [[Delusion]]s
-To be diagnosed with schizophrenia, a person must display:<ref name="DSM-IV-TR" />
+# [[Hallucination]]s
+# [[Disorganized speech]] (e.g., frequent derailment or incoherence)
+# Grossly disorganized or catatonic behavior
+# Negative symptoms (i.e., [[diminished emotional expression]] or [[avolition]])
-*'''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)
+'''''AND'''''
-** [[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.
+* B. For a significant portion of the time since the onset of the disturbance, level of functioning in one or more major areas, such as work, interpersonal relations, or self-care, is markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, there is failure to achieve expected level of interpersonal, academic, or occupational functioning).
-*'''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.
+'''''AND'''''
-*'''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).
+* C. Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or by two or more symptoms listed in Criterion A present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences).
-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.
+'''''AND'''''
+* D. [[Schizoaffective disorder]] and depressive or [[bipolar disorder]] with psychotic features have been ruled out because either 1) no major depressive or manic episodes have occurred concurrently with the active-phase symptoms, or 2) if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness.
+'''''AND'''''
+* E. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
+'''''AND'''''
+* F. If there is a history of [[autism spectrum disorder]] or a [[communication disorder]] of childhood onset, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations, in addition to the other required symptoms of schizophrenia, are also present for at least 1 month (or less if successfully treated).
+''Specify if:''
+The following course specifiers are only to be used after a 1-year duration of the disorder and if they are not in contradiction to the diagnostic course criteria.
+'''First episode, currently in acute episode:''' First manifestation of the disorder meeting the defining diagnostic symptom and time criteria. An acute episode is a time period in which the symptom criteria are fulfilled.
+'''First episode, currently in partial remission:''' Partial remission is a period of time during which an improvement after a previous episode is maintained and in which the defining criteria of the disorder are only partially fulfilled.
+'''First episode, currently in full remission:''' Full remission is a period of time after a previous episode during which no disorder-specific symptoms are present.
+'''Multiple episodes, currently in acute episode:''' Multiple episodes may be determined after a minimum of two episodes (i.e., after a first episode, a remission and a minimum of one relapse).
+'''Multiple episodes, currently in partial remission'''
+'''Multiple episodes, currently in full remission''' Continuous: Symptoms fulfilling the diagnostic symptom criteria of the disorder are remaining for the majority of the illness course, with subthreshold symptom periods being very brief relative to the overall course.
+'''Unspecified'''
+''Specify if:''
+'''With catatonia'''
+''Specify current severity:''
+Severity is rated by a quantitative assessment of the primary symptoms of psychosis, including delusions, hallucinations, disorganized speech, abnormal psychomotor behavior, and negative symptoms. Each of these symptoms may be rated for its current severity (most severe in the last 7 days) on a 5-point scale ranging from 0 (not present) to 4 (present and severe).
+Note: Diagnosis of schizophrenia can be made without using this severity specifier.
+}}
+<SMALL>''Note: Diagnosis of schizophrenia can be made without using this severity specifier.''</SMALL>
 ==References==
-{{Reflist|2}}
+{{reflist|2}}
-[[Category:Disease]]
+[[Category:DSM-V Diagnostic Criteria]]
+[[Category:Psychiatric Disease]]
 [[Category:Psychiatry]]
-[[Category:Mature chapter]]
-[[Category:Primary care]]
-[[Category:Needs overview]]
-{{WH}}
-{{WS}}

Schizophrenia diagnostic criteria: Difference between revisions

Latest revision as of 15:01, 4 September 2018

Diagnostic Criteria

DSM-V Diagnostic Criteria for Schizophrenia

References

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