Schizophrenia (DSM IV)

Diagnosis of Schizophrenia:

Patient displays at least 2 of the following for 6 months or more…

1. delusions: think they are god or a famous person (grandeur), think they have committed something terrible (guilt), think they have disease, think that spouses or partners have been unfaithful (jealous), think they are being controlled by outside powers i.e. aliens, radio waves, etc. (passivity), think people blame them for things (persecution), even though they may have a job and money in the bank they feel they are poverty stricken or destined for destitution, feel that people are talking behind their backs (reference), they may also believe that others are putting thoughts into their heads (thought control).

2. hallucinations: false sensory perception that occurs in the absence of a related sensory stimulus. These can affect all five senses but most commonly affect visual and auditory senses.

3. disorganized behavior: physical actions that do not appear to be goal oriented (i.e. taking off clothes in public, strange gestures or postures, etc.), or otherwise bizarre physical activities.

4. disorganized speech: mental associations are governed not by logic but by rhymes, puns, and other rules not apparent to the observer, or by no clear rules at all. Generally the speech is understandable but sometimes may be difficult to understand.

5. negative symptoms: reduced range of expression of emotion, obvious reduced fluency of speech, loss of will to do things (avolition). It seems that something has been taken away from the patient, such as the textural richness of their personality.


5 subtypes of Schizophrenia

1. Paranoid: these patients have persecutory delusions and auditory hallucinations, but no negative symptoms, disorganized speech, or catatonic behavior.

2. Disorganized: delusions and hallucinations are less prominent than negative symptoms and disorganized speech and behavior.

3. Catatonic: excessively retarded or excessively excited behavior that is very bizarre.

4. Undifferentiated: some of all the basic types of psychotic symptoms, not one particularly dominates.

5. Residual: after an acute psychosis the patient is markedly improved, although they still seem somewhat unusual, odd, or peculiar.


Schizophrenia-like disorders

Schizophreniform: patients who display the proper signs and symptoms for diagnosis but have only been affected for under 6 months.

Schizoaffective disorder: for at least one month the patient has had symptoms of schizophrenia, at the same time they have prominent symptoms of mania and/or depression.

Brief Psychotic disorder: at least one of the psychotic symptoms for under one month.


Other Psychotic Disorders

Psychotic Disorder due to a General Medical Condition: a wide variety of medical and neurological conditions can produce psychotic symptoms that may not meet criteria for the conditions above.

Substance-Induced Psychotic Disorders: Alcohol or other substances (intoxication or withdrawal) can cause psychotic symptoms that may not meet criteria fore any of the conditions above.

Psychotic Disorder not otherwise Specified: this is usually patients with postpartum psychosis or other symptoms that do not seem to fit any of the categories above.

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