Schizophrenia

Schizophrenia DSM 5 Diagnostic Criteria

Diagnosis

The DSM 5 outlines the following criterion to make a diagnosis of schizophrenia:

1.    Two or more of the following for at least a one-month (or longer) period of time, and at least one of them must be 1, 2, or 3:

·         Delusions

·         Hallucinations

·         Disorganized speech

·         Grossly disorganized or catatonic behavior

·         
Negative symptoms
, such as diminished emotional expression

1.    Impairment in one of the major areas of functioning for a significant period of time since the onset of the disturbance: Work, interpersonal relations, or self-care.

2.    Some signs of the disorder must last for a continuous period of at least 6 months. This six-month period must include at least one month of symptoms (or less if treated) that meet criterion A (active phase symptoms) and may include periods of residual symptoms. During residual periods, only negative symptoms may be present.

3.    Schizoaffective disorder and bipolar or depressive disorder with psychotic features have been ruled out:

·         No 
major depressive
 or manic episodes occurred concurrently with active phase symptoms

·         If mood episodes (depressive or manic) have occurred during active phase symptoms, they have been present for a minority of the total duration of the active and residual phases of the illness.

1.    The disturbance is not caused by the effects of a substance or another medical condition

2.    If there is a history of autism spectrum disorder or a communication disorder (childhood onset), the diagnosis of schizophrenia is only made if prominent delusions or hallucinations, along with other symptoms, are present for at least one month

Associated Features

There are a number of symptoms that contribute to a diagnosis of schizophrenia.

·         Inappropriate affect (laughing in the absence of a stimulus)

·         Disturbed sleep pattern

·         Dysphoric mood (can be depression, anxiety, or anger)

·         
Anxiety
 and phobias

·         Depersonalization (detachment or feeling of disconnect from self)

·         Derealization (a feeling that surrounding aren’t real)

·         Cognitive deficits impacting language, processing, executive function, and/or memory

·         Lack of insight into disorder

·         Social cognition deficits

·         Hostility and aggression

Cognitive impairments caused by the disorder may persist when other symptoms are in remission. This contributes to impairments in functioning in employment, interpersonal relationships, and the ability to engage in proper self-care.