Diagnosis

The Diagnostic and Statistical Manual

When it comes to diagnosing any disease within the realm of psychiatry, health care providers in the United States use the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM is "the standard classification of mental disorders [...] and contains a listing of diagnostic criteria for every psychiatric disorder recognized by the U.S. healthcare system."1 Over the years of psychiatric medicine the DSM has been revised and republished several times by the American Psychiatric Association (APA). The most recent publication, the DSM-5, was released in May of 2013, after over a decade of revisions and meetings. However, with the arrival of the newest edition came a lot of worry about what it would mean for those who may have been misdiagnosed according to the DSM-5. Many worry that it will only make the problems we have here in the USA surrounding mental health worse. Either way, the DSM-5 is here to stay, and the group in the video below have come up with a fun jingle about the APA's newest diagnostic criteria manual.

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Diagnostic Criteria for Schizophrenia

Schizophrenia has a variety of different symptoms that when discovered in a person come together to form the diagnosis of this illness (next week I will be discussing the symptoms of schizophrenia in depth, so here I will only mention which symptoms a person diagnosed with the disease will experience).

Tandon, et al. published an article in 2014 comparing the DSM-4 to the DSM-5. The article does an excellent job highlighting and explaining the major differences between the two diagnostic manuals when it comes specifically to the diagnostic criteria for schizophrenia. Here are the six criteria that a person must meet in order to be diagnosed with schizophrenia: 3

Criterion A: Characteristic Symptoms
The person must have two or more of these symptoms for a significant amount of time, and one of the symptoms must be one of the first three listed:

• delusions

• hallucinations

• disorganized speech

• grossly disorganized or catatonic behavior

• negative symptoms

Criterion B: Social/Occupational Dysfunction
The person must experience some form of dysfunction whether it be with self care, work, personal relationships, etc that is clearly worse than prior to onset.

Criterion C: Duration of Six Months
The person must have ongoing symptoms for at least six months with at least one month with active symptoms from criterion A.

Criterion D: Schizoaffective and Mood Disorder Exclusion
Schizoaffective disorder must have been ruled out along with any mood disorders (major depressive disorder, bipolar disorder) with psychotic features.

Criterion E: Substance/General Mood Condition Exclusion
The illness cannot have been caused by any substance use, such as amphetamines, or by any medical condition, such as a brain tumor.

Criterion F: Relationship to Global Developmental Delay or Autism Spectrum Disorder
If a person has a childhood diagnoses of Autism Spectrum Disorder, or any other childhood communication disorder, an additional diagnosis of schizophrenia will only occur if delusions and hallucinations are present for at least a month.


References:

1: American Psychiatric Association DSM-5 Development. (n.d.). Retrieved January 31, 2015, from http://www.dsm5.org/about/Pages/Default.aspx

2: Neipsychopharm. (2014, March 18). DSM-5! [Video file]. Retrieved from https://www.youtube.com/watch?v=0rm5p3DTyE8

3: Tandon, R., Gaebel, W., Barch, D. M., Bustillo, J., Gur, R. E., Heckers, S., & ... Carpenter, W. (2013). Definition and description of schizophrenia in the DSM-5. Schizophrenia Research, 150(1), 3-10. doi:10.1016/j.schres.2013.05.028