Diagnosing Schizophrenia: The Five Symptoms & Other Requirements

The Diagnostic Statistic Manual IV (DSM-IV) identifies five symptoms of schizophrenia: (1) delusions, (2) hallucinations, (3) incoherent, derailed, or disorganized speech, (4) catatonic or extremely disorganized behavior, or (5) negative symptoms (e.g., reduced speech or flat affect). Normally, the patient is required to experience at least two of these different symptoms before he or she can be diagnosed with schizophrenia. However, there are two exceptions. First, if a delusion is exceptionally strange, as in the patient reporting aliens had abducted him or her, he or she is not required to exhibit any of the other four characteristic symptoms of schizophrenia. Also, if the individual is experiencing extreme hallucinations, such as more than one voice holding a conversation or the patient is continuously bothered by a voice narrating his or her thoughts and behavior, that one symptom will suffice for a diagnosis of schizophrenia (Harvard Medical School, 2006; HealthyPlace, 2000; Mueser & McGurk, 2004; PsychNet-UK, n.d.c).

Additional Requirements

In addition to having the correct type and number of symptoms, a patient's symptoms must last a certain amount of time before he or she can be diagnosed with schizophrenia. First, a person suspected of suffering from schizophrenia must have serious dysfunctions in his or her affect, behavior, communication with others, perception, and thought for over six months before he or she can be diagnosed with this mental disorder (HealthyPlace, 2000; PsychNet-UK, n.d.c).

Furthermore, an individual cannot be said to have schizophrenia unless he or she experiences the qualifying number of symptoms for at least a month. The only exception is that he or she is currently receiving adequate treatment (HealthyPlace, 2000; PsychNet-UK, n.d.c).

Finally, the course of psychosis for schizophrenic patients cannot be established until a year or more after the onset of the disorder. Then, the psychiatrist can assign a one of the six specifiers to describe the pattern of the individual's illness: (1) continuous, (2) episodic with interepisode residual symptoms, (3) episodic with no interepisode residual symptoms, (4) single episode in partial remission, (5) single episode in full remission, or (6) other or unspecified pattern (HealthyPlace, 2000; PsychNet-UK, n.d.c).

Similar Disorders

It is important to realize, however, that there are a number of disorders that may have similar symptoms to Schizophrenia. These include such illnesses as substance-induced disorders (e.g., Substance-Induced Delirium, Substance-Induced Persisting Dementia, and Substance-Induced Psychotic Disorder), Bipolar Disorder, Schizoaffective Disorder, and Pervasive Developmental Disorders (e.g. Autistic Disorder) (PsychNet-UK, n.d.c). Because of this, further information must be gathered before the patient can be diagnosed with schizophrenia. For example, psychiatrists typically send for the patient's medical records and explore his or her family's medical history to see if there might be a medical condition responsible for the erratic behavior. Also, they often run tests and ask those around the patient to see if he or she is taking any medications and/or illegal drugs to determine that the patient is not having a bad reaction from such substances or developing a substance-induced disorder (PsychNet-UK, n.d.c). Moreover, psychiatrists must monitor the patient to determine how long this behavior lasts. If it occurs more in episodes with considerable time in between these episodes, Schizoaffective Disorder might be a more proper diagnosis than schizophrenia (PsychNet-UK, n.d.b). Lastly, it must also be clarified whether or not the patient is experiencing mood swings or severe bouts of depression. If so, this might indicate another disorder such as Bipolar Disorder, rather than schizophrenia (PsychNet-UK, n.d.a).

References:

Harvard Medical School. (2006, July). The negative symptoms of schizophrenia. Harvard Medical Health Letter, 23(1). Retrieved November 12, 2007, from Colorado Technical University Online, Virtual Campus, PSYC336-0704A-02: Abnormal Psychology, Instructor Files: https://campus.ctuonline.edu

HealthyPlace. (2000). Schizophrenia overview. Retrieved November 12, 2007, from http://www.healthyplace.com/Communities/Thought_Disorders/site/schizophrenia_overview.htm

Mueser, K. T., & McGurk, S. R. (2004, June 19). Schizophrenia. The Lancet, 363, 2063-2072. Retrieved November 12, 2007, from Colorado Technical University Online, Virtual Campus, PSYC336-0704A-02: Abnormal Psychology, Instructor Files: https://campus.ctuonline.edu

PsychNet-UK. (n.d.a). Disorder information sheet: Bipolar I & Bipolar II. Retrieved November 12, 2007, from http://www.psychnet-uk.com/dsm_iv/bipolar _disorder.htm

PsychNet-UK. (n.d.b). Disorder information sheet: Schizoaffective Disorder. Retrieved November 12, 2007, from http://www.psychnet-uk.com/dsm_iv/schizoaffective _disorder.htm

PsychNet-UK. (n.d.c). Disorder information sheet: Schizophrenia. Retrieved November 12, 2007, from http://www.psychnet-uk.com/dsm_iv/schizophrenia_disorder.htm