Schizophrenia
American Description
Diagnostic Criteria
Characteristic symptoms: Two (or more) of the following, each present for a
significant portion of time during a 1-month period (or less if successfully
treated):
delusions
hallucinations
disorganized speech (e.g., frequent derailment or incoherence)
grossly disorganized or catatonic behavior
negative symptoms, i.e., affective flattening, alogia, or avolition
Note: Only one Criterion A symptom is required if delusions are bizarre or
hallucinations consist of a voice keeping up a running commentary on the
person's behavior or thoughts, or 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 (or when the onset is in childhood or adolescence, failure to
achieve expected level of interpersonal, academic, or occupational
achievement).
Duration: 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 two or more symptoms listed in Criterion A present in an
attenuated form (e.g., odd beliefs, unusual perceptual experiences).
Schizoaffective and Mood Disorder exclusion: Schizoaffective Disorder and Mood
Disorder With Psychotic Features have been ruled out because either (1) no Major
Depressive, Manic, or Mixed Episodes have occurred concurrently with the
active-phase symptoms; or (2) if mood episodes have occurred during active-phase
symptoms, their total duration has been brief relative to the duration of the
active and residual periods.
Substance/general medical condition exclusion: The disturbance is not due to the
direct physiological effects of a substance (e.g., a drug of abuse, a
medication) or a general medical condition.
Relationship to a Pervasive Developmental Disorder: If there is a history of
Autistic Disorder or another Pervasive Developmental Disorder, the additional
diagnosis of Schizophrenia is made only if prominent delusions or hallucinations
are also present for at least a month (or less if successfully treated).
Diagnostic Criteria of Schizophrenia Subtypes
Paranoid Type
A type of Schizophrenia in which the following criteria are met:
Preoccupation with one or more delusions or frequent auditory
hallucinations.
None of the following is prominent: disorganized speech, disorganized or
catatonic behavior, or flat or inappropriate affect.
Catatonic Type
A type of Schizophrenia in which the clinical picture is dominated by at least
two of the following:
motoric immobility as evidenced by catalepsy (including waxy flexibility) or
stupor
excessive motor activity (that is apparently purposeless and not influenced by
external stimuli)
extreme negativism (an apparently motiveless resistance to all instructions or
maintenance of a rigid posture against attempts to be moved) or mutism
peculiarities of voluntary movement as evidenced by posturing (voluntary
assumption of inappropriate or bizarre postures), stereotyped movements,
prominent mannerisms, or prominent grimacing
echolalia or echopraxia
Disorganized Type
A type of Schizophrenia in which the following criteria are met:
All of the following are prominent:
disorganized speech
disorganized behavior
flat or inappropriate affect
The criteria are not met for Catatonic Type.
Undifferentiated Type
A type of Schizophrenia in which symptoms that meet Criterion A are present, but
the criteria are not met for the Paranoid, Disorganized, or Catatonic
Type.
Residual Type
A type of Schizophrenia in which the following criteria are met:
Absence of prominent delusions, hallucinations, disorganized speech, and grossly
disorganized or catatonic behavior.
There is continuing evidence of the disturbance, as indicated by the presence of
negative symptoms or two or more symptoms listed in Criterion A for
Schizophrenia, present in an attenuated form (e.g., odd beliefs, unusual
perceptual experiences).
Associated Features
Learning Problem
Hypoactivity
Psychotic
Euphoric Mood
Depressed Mood
Somatic/Sexual Dysfunction
Hyperactivity
Guilt/Obsession
Sexually Deviant Behavior
Odd/Eccentric/Suspicious Personality
Anxious/Fearful/Dependent Personality
Dramatic/Erratic/Antisocial Personality
Differential Diagnosis
Psychotic Disorder Due to a General Medical Condition, delirium, or dementia;
Substance-Induced Psychotic Disorder; Substance-Induced Delirium;
Substance-Induced Persisting Dementia; Substance-Related Disorders; Mood
Disorder With Psychotic Features; Schizoaffective Disorder; Depressive Disorder
Not Otherwise Specified; Bipolar Disorder Not Otherwise Specified; Mood Disorder
With Catatonic Features; Schizophreniform Disorder; Brief Psychotic Disorder;
Delusional Disorder; Psychotic Disorder Not Otherwise Specified; Pervasive
Developmental Disorders (e.g., Autistic Disorder); childhood presentations
combining disorganized speech (from a Communication Disorder) and disorganized
behavior (from Attention-Deficit/ Hyperactivity Disorder); Schizotypal
Personality Disorder; Schizoid Personality Disorder; Paranoid Personality
Disorder.
Internet Mental Health (www.mentalhealth.com) copyright © 1995-2001 by Phillip
W. Long, M.D.
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BipolarConnection
2001 - 2008
