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DSM-5 criteria for schizophrenia

Schizophrenia is a severe and chronic mental disorder characterized by disturbances in thought, perception, and behavior. Schizophrenia involves a variety of cognitive, behavioral, and emotional symptoms, and it is often difficult to diagnose.

According to the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM 5), schizophrenia has a lifetime prevalence ranging from between 0.3 and 0.7 percent. The psychotic features of the disorder generally emerge between the mid-teens and mid-thirties, with the height age of the first psychotic episode in the early to mid-twenties for men and late twenties for women.

Diagnosis of Schizophrenia

Two or more of the subsequent for a minimum of a one-month (or longer) period of your time, and a minimum of one among them must be 1, 2, or 3:

  • Delusions

  • Hallucinations

  • Disorganized speech

  • Grossly disorganized or catatonic behavior

  • Negative symptoms, like the diminished emotional expression

  • Impairment is among the main areas of functioning for an extended period of your time since the onset of the disturbance, including work, interpersonal relations, or self-care.

  • Some symptoms of the disorder must last for a continuous period of a minimum of 6 months. During residual periods, only negative symptoms could also be present.

Schizoaffective disorder and bipolar or clinical depression with psychotic features are ruled out:

  • If mood episodes, whether depressive or manic, have occurred during active phase symptoms, they need to be present for a minority of the duration of the active and residual phases of the illness.

  • If there is a history of autism spectrum disorder (ASD) or a communication disorder, the onset for which began in childhood, the diagnosis of schizophrenia is made if prominent delusions or hallucinations, in conjunction with other symptoms, are present for a minimum of one month.

  • Associated Features

  • The disturbance isn't caused by the consequences of a substance or another medical condition.

  • There are a variety of symptoms that contribute to a diagnosis of schizophrenia.

  • Inappropriate affect (laughing within the absence of a stimulus)

  • Anxiety and phobias

  • Disturbed sleep pattern

  • Lack of insight into the disorder

  • Dysphoric mood, including anger, depression, or anxiety

  • Depersonalization or feeling detached disconnected from self

  • Derealization (a belief that surrounding aren't real)

  • Social cognition deficits

  • Aggression and Hostility

  • Cognitive impairments caused by the disorder can persist when other symptoms are arrested. It contributes to impairments in functioning employed, interpersonal relationships, and, therefore, the ability to interact in proper self-care.

Suicide Risk

Approximately five to six individuals with schizophrenia die by suicide, about 20% make suicide attempts on quite one occasion, and many more have significant suicidal thoughts. Suicidal behavior is often in response to hallucinations, and suicide risk remains high over the lifespan of people with schizophrenia.

Functional Consequences

  • Schizophrenia is related to occupational and social dysfunction, as well. Completing education and maintaining employment are negatively impacted by symptoms of the disorder. Most people diagnosed with schizophrenia are employed at a lower level than their peers, friends, or parents. Many people with schizophrenia have few or limited social relationships outside of their immediate family.

  • Only one Criterion a logo is required if delusions are bizarre or hallucinations contains a voice maintaining a running commentary on the individual's behavior or thoughts, or two or more voices conversing with one another.

  • Social or occupational dysfunction: For a significant portion of the time since the onset of the disturbance, one or more significant areas of functioning like work, interpersonal relations, or self-care are markedly below the extent achieved before the emergence (or when the onset is in childhood or adolescence, failure to realize expected level of interpersonal, academic, or occupational achievement).

New Catatonic Disorders and Catatonic specifiers:

  • As mentioned above, the catatonic subtype has been removed, while a catatonic specifier has been added and should be used with depressive, bipolar, and psychotic disorders. This alteration recognizes that catatonia occurs across several categories of disorders, without necessarily indicating psychosis. Additionally, there are two new catatonic disorders: Catatonic Disorder, according to Another Medical Condition, and Other Specified Catatonic Disorder. Almost like the rationale for the catatonic specifier, the Catatonic Disorder, thanks to Another Medical Condition, recognizes that catatonia occurs within the context of several medical conditions.

  • The opposite Specified Catatonic Disorder could also be used when the clinician isn't yet certain of the underlying condition related to catatonia. In other words, mental health professionals are uncertain whether catatonia is associated with depression, bipolar disorder, psychotic, or other medical conditions. The DSM-5 requires 3 out of 12 catatonic symptoms for all four conditions (depression, bipolar disorder, psychotic, and medical condition).

  • According to the DSM-IV, psychotic and mood disorders required only 2 out of 5 symptom sets, while medical conditions only required only 1 out of 5 symptom sets.

Criteria changes in symptoms:

Schizophrenia: Criterion A lists the five key symptoms of psychotic disorders, including

1) delusions,

2) hallucinations,

3) disorganized speech,

4) disorganized or catatonic behavior, and

5) negative symptoms.

As per the DSM-IV, 2 of the above-mentioned five symptoms were required. However, just one of the five symptoms was required if delusions were bizarre or if hallucinations included a running commentary on an individual's thoughts or behavior, and/or two or more voices were heard conversing. This exception has been eliminated for the lack of specificity and poor reliability, and this alteration makes intuitive sense. The notion of what constitutes ‘bizarre’ is quite vague, and its removal reduces cultural bias. In DSM-5, two of those five symptoms are required, and a minimum of one symptom must be among the primary three- delusions, hallucinations, and disorganized speech.


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