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Schizophrenia Diagnosis

(Also Known As: Paranoid Schizophrenia Diagnosis, Schizophrenic Diagnosis, Delusional Diagnosis, Psychosis Diagnosis)

(Reviewed by: Paul Peterson, Licensed Therapist)

How is Schizophrenia Diagnosed?

The diagnosis of schizophrenia does not involve laboratory tests. The spectrum of symptoms of the condition are gauged mainly by mental status examinations and clinical examination based on the person’s emotional and family history, current symptoms and presence of other disorders which merits a differential diagnosis. 6

Ruling out the other possible conditions that manifest similar symptoms as schizophrenia also contributes in making an accurate diagnosis of the condition. Among the differential diagnosis to make include metabolic and seizure disorders, brain tumor, drug use and thyroid dysfunction. Schizophrenia is diagnosed based on the diagnostic criteria from DSM-IV:

  • The person should manifest two or more of the following characteristic symptoms: 7
    • Delusion
    • Catatonic manifestations
    • Hallucinations
    • Disorganized speech
    • Negative symptoms
  • Social and occupational dysfunction
  • Duration
    • The continuous signs of disturbance usually persist for at least 6 months with at least 1 month of symptoms that are seen from the criteria no. 1 and may include prodromal or residual symptoms. The signs of symptoms during the residual or prodromal periods are manifested as negative symptoms of two or more symptoms from the criterion no.1.
  • Schizoaffective and mood disorder exclusion
    • Schizoaffective disorder and mood disorder with psychotic features have been ruled out because either no major depression, mixed or manic episodes occurred with the active-phase symptoms. Their total duration has been brief during the duration of the active and residual symptoms.
  • Substance and general medical condition exclusion
    • The disturbance is not due to any direct physiological effect of a substance such as drug abuse and/or due to general medical condition.
  • Relationship to a pervasive developmental disorder
    • In the presence of a history of a pervasive developmental disorder or autism the diagnosis of schizophrenia is added if the prominent delusion or hallucinations are present for at least a month or less if it is successfully treated.

More often it is difficult to diagnose acute schizophrenia during its first episode. The clinician will need to wait in order to establish a chronic intensity of the negative symptoms to manifest. Hence in the early diagnosis of schizophrenia the main goal of the physician is to rule out the other conditions that may cause the patient’s symptoms such as the presence of psychotic disorder, drug related conditions and organic disorder. Making the differential diagnosis is the key to a more accurate diagnosis of schizophrenia since other disorders may also manifest the schizophrenic type of mood changes that include depression and mania, such as those seen in bipolar disorder. The diagnosis is further made difficult in its early stage because mood changes often manifest in the late phase of schizophrenia.

Schizoaffective disorder usually features depression and mania with the schizophrenic symptoms. The following are the diagnostic criteria for schizoaffective disorder seen in schizophrenia:

  • Changes in mood must be present for a significant time during the period of psychosis.
  • Changes in mood corresponds to the active phase symptoms
  • Delusion and hallucinations must be present within 2 weeks without mood changes.

Could You Have Schizophrenia?

Schizophrenia Topics

Related Conditions

Bipolar Disorder – Psychosis, Hallucinations, Delusions, Suicide, Hypomania, Hypermania
Borderline Personality Disorder – Mood Variations/Changes, Unstable Interpersonal Relationships, Dissociation
Schizotypal Personality Disorder – Social Isolation, Odd Behavior, Unconventional Beliefs, Paranoia, Social Anxiety