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Schizophrenia in DSM-5 requires the presence of at least three specified symptoms for at least one month.
Schizophrenia in DSM-5 requires the presence of at least three specified symptoms for at least one month.
False (B)
One of the required symptoms for diagnosing schizophrenia in DSM-5 can be disorganized speech.
One of the required symptoms for diagnosing schizophrenia in DSM-5 can be disorganized speech.
True (A)
Impaired functioning in social and occupational domains is required for the diagnosis of schizophrenia in DSM-5.
Impaired functioning in social and occupational domains is required for the diagnosis of schizophrenia in DSM-5.
True (A)
The 6-month period of disturbance in DSM-5 includes intermittent symptoms that meet Criterion A.
The 6-month period of disturbance in DSM-5 includes intermittent symptoms that meet Criterion A.
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ICD-10 includes 'Hebephrenic' as a sub-type of schizophrenia.
ICD-10 includes 'Hebephrenic' as a sub-type of schizophrenia.
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In DSM-5, if there is a history of autism spectrum disorder, schizophrenia is diagnosed only if there are delusions or hallucinations for at least 1 month.
In DSM-5, if there is a history of autism spectrum disorder, schizophrenia is diagnosed only if there are delusions or hallucinations for at least 1 month.
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DSM-5 includes 'Brief psychotic disorder' under schizophrenia-like disorders.
DSM-5 includes 'Brief psychotic disorder' under schizophrenia-like disorders.
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ICD-10 classifies schizotypal disorder as a separate condition from the spectrum of schizophrenic disorders.
ICD-10 classifies schizotypal disorder as a separate condition from the spectrum of schizophrenic disorders.
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DSM-5 does not divide schizophrenia into classical subtypes like ICD-10.
DSM-5 does not divide schizophrenia into classical subtypes like ICD-10.
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ICD-10 includes 'Substance/medication-induced psychotic disorder' as a classification.
ICD-10 includes 'Substance/medication-induced psychotic disorder' as a classification.
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ICD-10 and DSM-5 both classify 'Schizoaffective disorder'.
ICD-10 and DSM-5 both classify 'Schizoaffective disorder'.
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DSM-5 includes conditions such as schizophrenia-like disorders secondary to substance use within the schizophrenia chapter.
DSM-5 includes conditions such as schizophrenia-like disorders secondary to substance use within the schizophrenia chapter.
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ICD-10 includes 'Schizophreniform disorder' under its classification of schizophrenia-like disorders.
ICD-10 includes 'Schizophreniform disorder' under its classification of schizophrenia-like disorders.
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DSM-5 categorizes 'Postschizophrenic depression' as a type of schizophrenia.
DSM-5 categorizes 'Postschizophrenic depression' as a type of schizophrenia.
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DSM-5 and ICD-10 both classify 'Induced delusional disorder'.
DSM-5 and ICD-10 both classify 'Induced delusional disorder'.
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A similarity between ICD-10 and DSM-5 is that both include 'Unspecified schizophrenia spectrum and other psychotic disorder'.
A similarity between ICD-10 and DSM-5 is that both include 'Unspecified schizophrenia spectrum and other psychotic disorder'.
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Schizophrenia was once believed to be a part of a single mental disorder entity called Einheitpsychose.
Schizophrenia was once believed to be a part of a single mental disorder entity called Einheitpsychose.
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In the 1960s, US psychiatrists typically identified schizophrenia using Schneider's first-rank symptoms.
In the 1960s, US psychiatrists typically identified schizophrenia using Schneider's first-rank symptoms.
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Emil Kraepelin described schizophrenia as occurring in clear consciousness and consisting of a series of states.
Emil Kraepelin described schizophrenia as occurring in clear consciousness and consisting of a series of states.
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The discrepancies in schizophrenia diagnosis between the USA and UK led to the development of ICD-10 and DSM-5 criteria for schizophrenia.
The discrepancies in schizophrenia diagnosis between the USA and UK led to the development of ICD-10 and DSM-5 criteria for schizophrenia.
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Kahlbaum described catatonia in the year 1852.
Kahlbaum described catatonia in the year 1852.
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First-admission rates for schizophrenia were higher in the UK than in the USA during the 1960s.
First-admission rates for schizophrenia were higher in the UK than in the USA during the 1960s.
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Morel's classification of mental disorders was based on cause, symptoms, and outcome.
Morel's classification of mental disorders was based on cause, symptoms, and outcome.
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Hecker’s account of a condition called hebephrenia was written after Kahlbaum described catatonia.
Hecker’s account of a condition called hebephrenia was written after Kahlbaum described catatonia.
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Eugen Bleuler was mainly concerned with prognosis rather than the mechanisms of symptom formation.
Eugen Bleuler was mainly concerned with prognosis rather than the mechanisms of symptom formation.
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The term 'schizophrenia' was used by Eugen Bleuler to denote a 'splitting' of psychic functions.
The term 'schizophrenia' was used by Eugen Bleuler to denote a 'splitting' of psychic functions.
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Bleuler viewed hallucinations and delusions as primary symptoms of schizophrenia.
Bleuler viewed hallucinations and delusions as primary symptoms of schizophrenia.
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Bleuler believed there was a possible neuropathological cause for schizophrenia.
Bleuler believed there was a possible neuropathological cause for schizophrenia.
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Kleist used Bleuler's diagnostic framework in his study on associations between brain pathology and subtypes of psychotic illness.
Kleist used Bleuler's diagnostic framework in his study on associations between brain pathology and subtypes of psychotic illness.
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Leonhard classified schizophrenia into progressive and systematic groups.
Leonhard classified schizophrenia into progressive and systematic groups.
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Schizophrasia is characterized by grossly disordered speech.
Schizophrasia is characterized by grossly disordered speech.
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Langfeldt proposed a distinction between true schizophrenia and schizophreniform states, with the latter having a good prognosis.
Langfeldt proposed a distinction between true schizophrenia and schizophreniform states, with the latter having a good prognosis.
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Psychogenic psychosis is classified as a mood disorder in modern diagnostic schemes.
Psychogenic psychosis is classified as a mood disorder in modern diagnostic schemes.
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There is a debate on whether schizophrenia should be abolished and replaced with the term 'psychosis spectrum syndrome'.
There is a debate on whether schizophrenia should be abolished and replaced with the term 'psychosis spectrum syndrome'.
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Steroids and dopamine agonists are known to cause florid psychotic states.
Steroids and dopamine agonists are known to cause florid psychotic states.
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Alcohol misuse is never considered in the presentation of schizophrenia-like psychoses.
Alcohol misuse is never considered in the presentation of schizophrenia-like psychoses.
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Urine or hair testing has no role in the diagnosis of drug-induced psychosis.
Urine or hair testing has no role in the diagnosis of drug-induced psychosis.
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A clear distinction between drug-induced psychosis and schizophrenia is always possible.
A clear distinction between drug-induced psychosis and schizophrenia is always possible.
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The degree and persistence of the mood disorder is irrelevant in distinguishing schizophrenia from affective psychosis.
The degree and persistence of the mood disorder is irrelevant in distinguishing schizophrenia from affective psychosis.
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A family history of mood disorder can sometimes help clarify the diagnosis of affective psychosis.
A family history of mood disorder can sometimes help clarify the diagnosis of affective psychosis.
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In delusional disorders, many areas of the mental state are unremarkable besides the chronic, systematized paranoid delusions.
In delusional disorders, many areas of the mental state are unremarkable besides the chronic, systematized paranoid delusions.
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Borderline personality disorder patients always exhibit permanent psychotic symptoms.
Borderline personality disorder patients always exhibit permanent psychotic symptoms.
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For a diagnosis of schizophrenia according to ICD-10, symptoms must be present for a period of 1 month or more.
For a diagnosis of schizophrenia according to ICD-10, symptoms must be present for a period of 1 month or more.
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DSM-5 recognizes traditional subtypes of schizophrenia.
DSM-5 recognizes traditional subtypes of schizophrenia.
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ICD-10 places weight on Schneider’s first-rank symptoms for diagnosing schizophrenia.
ICD-10 places weight on Schneider’s first-rank symptoms for diagnosing schizophrenia.
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ICD-10 requires a duration of illness of 6 months for diagnosing schizophrenia.
ICD-10 requires a duration of illness of 6 months for diagnosing schizophrenia.
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Schizotypal disorder is categorized as a personality disorder in ICD-10.
Schizotypal disorder is categorized as a personality disorder in ICD-10.
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For a diagnosis of brief psychotic disorder in DSM-5, the syndrome must last for at least 1 month.
For a diagnosis of brief psychotic disorder in DSM-5, the syndrome must last for at least 1 month.
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Persistent hallucinations in any modality, even without delusions or overvalued ideas, are sufficient for a diagnosis of schizophrenia in ICD-10.
Persistent hallucinations in any modality, even without delusions or overvalued ideas, are sufficient for a diagnosis of schizophrenia in ICD-10.
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According to ICD-10, negative symptoms such as marked apathy must not be due to depression or neuroleptic medication for a diagnosis of schizophrenia.
According to ICD-10, negative symptoms such as marked apathy must not be due to depression or neuroleptic medication for a diagnosis of schizophrenia.
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DSM-5 uses the term schizophreniform disorder for syndromes lasting more than 1 month but less than 3 months.
DSM-5 uses the term schizophreniform disorder for syndromes lasting more than 1 month but less than 3 months.
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ICD-10 recognizes delusional disorders as a form of schizophrenia-like disorders.
ICD-10 recognizes delusional disorders as a form of schizophrenia-like disorders.
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Schizoaffective disorder is classified under schizoaffective disorder in both DSM-5 and ICD-10.
Schizoaffective disorder is classified under schizoaffective disorder in both DSM-5 and ICD-10.
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According to DSM-5, schizoaffective disorder requires an uninterrupted period of illness during which there is a minor depressive or manic episode concurrent with symptoms that meet criterion A for schizophrenia.
According to DSM-5, schizoaffective disorder requires an uninterrupted period of illness during which there is a minor depressive or manic episode concurrent with symptoms that meet criterion A for schizophrenia.
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Kasanin used the term schizoaffective disorder for the first time to describe a small group of young patients with severe mental disorders characterized by sudden onset and emotional turmoil.
Kasanin used the term schizoaffective disorder for the first time to describe a small group of young patients with severe mental disorders characterized by sudden onset and emotional turmoil.
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ICD-10 classifies schizoaffective disorder according to whether the mood disturbance is obsessive, compulsive, or mixed.
ICD-10 classifies schizoaffective disorder according to whether the mood disturbance is obsessive, compulsive, or mixed.
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The current definitions of schizoaffective disorder specify that the diagnosis should only be made when there are definite schizophrenic and affective symptoms equally prominent and present simultaneously, or within a few days of each other.
The current definitions of schizoaffective disorder specify that the diagnosis should only be made when there are definite schizophrenic and affective symptoms equally prominent and present simultaneously, or within a few days of each other.
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DSM-5 specifies schizoaffective disorder as bipolar type only.
DSM-5 specifies schizoaffective disorder as bipolar type only.
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Postschizophrenic depression is classified in ICD-10 when prominent depressive symptoms have been present for at least 2 weeks while some symptoms of schizophrenia still remain.
Postschizophrenic depression is classified in ICD-10 when prominent depressive symptoms have been present for at least 2 weeks while some symptoms of schizophrenia still remain.
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The outcome of schizoaffective disorder is generally thought to be worse than that for schizophrenia.
The outcome of schizoaffective disorder is generally thought to be worse than that for schizophrenia.
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People who have shown full clinical symptoms of schizophrenia in the past but no longer meet all criteria are classified as having transient schizophrenia in ICD-10.
People who have shown full clinical symptoms of schizophrenia in the past but no longer meet all criteria are classified as having transient schizophrenia in ICD-10.
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Schizotypal personality disorder according to DSM-5 is considered part of the schizophrenia spectrum.
Schizotypal personality disorder according to DSM-5 is considered part of the schizophrenia spectrum.
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Schizotypal disorder meets all criteria for schizophrenia.
Schizotypal disorder meets all criteria for schizophrenia.
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Bipolar disorder is categorized under cases with affective and psychotic symptoms in differential diagnosis of schizophrenia.
Bipolar disorder is categorized under cases with affective and psychotic symptoms in differential diagnosis of schizophrenia.
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Visual, olfactory, and gustatory hallucinations suggest an organic aetiology.
Visual, olfactory, and gustatory hallucinations suggest an organic aetiology.
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Obsessive-compulsive disorder is categorized under schizophrenia-like disorders attributable to a specific cause.
Obsessive-compulsive disorder is categorized under schizophrenia-like disorders attributable to a specific cause.
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Temporal lobe epilepsy can be a cause of organic schizophrenia-like disorders.
Temporal lobe epilepsy can be a cause of organic schizophrenia-like disorders.
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The distinction between schizophrenia and organic schizophrenia-like disorders is clear and well-defined.
The distinction between schizophrenia and organic schizophrenia-like disorders is clear and well-defined.
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In London, the study mentioned found that 3.7% of 'first-episode schizophrenia' cases had an organic cause other than substance misuse.
In London, the study mentioned found that 3.7% of 'first-episode schizophrenia' cases had an organic cause other than substance misuse.
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Delusional disorder is considered a variant of schizophrenia.
Delusional disorder is considered a variant of schizophrenia.
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General paralysis of the insane is an example of a primary cause of schizophrenia.
General paralysis of the insane is an example of a primary cause of schizophrenia.
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Psychotic depression falls under the category of schizophrenia-like disorders attributable to a specific cause.
Psychotic depression falls under the category of schizophrenia-like disorders attributable to a specific cause.
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Study Notes
Classification of Schizophrenia and Schizophrenia-Like Disorders
ICD-10 Classification
- Schizophrenia:
- Paranoid
- Hebephrenic
- Catatonic
- Undifferentiated
- Residual
- Simple schizophrenia
- Postschizophrenic depression
- Other schizophrenia
- Unspecified schizophrenia
- Schizoaffective disorder
- Persistent delusional disorders:
- Delusional disorder
- Other persistent delusional disorders
- Acute and transient psychotic disorder:
- Acute schizophrenia-like psychotic disorder
- Acute polymorphic psychotic disorder
- Other acute psychotic disorders
- Induced delusional disorder
- Other non-organic psychotic disorders
- Unspecified non-organic psychosis
- Schizotypal disorder
DSM-5 Classification
- Schizophrenia
- Schizoaffective disorder
- Delusional disorder
- Brief psychotic disorder
- Schizophreniform disorder
- Other specified schizophrenia spectrum and other psychotic disorder
- Unspecified schizophrenia spectrum and other psychotic disorder
- Substance/medication-induced psychotic disorder
- Psychotic disorder due to another medical condition
Criteria for Schizophrenia in DSM-5
- Two or more symptoms present for at least 1 month (or less if successfully treated):
- Delusions
- Hallucinations
- Disorganized speech
- Grossly disorganized or catatonic behavior
- Negative symptoms (i.e., diminished emotional expression or avolition)
- Impaired level of functioning in one or more domains (e.g., work, relationships) for a significant portion of the time since onset
- Continuous signs of the disturbance persist for at least 6 months
- The patient does not meet criteria for schizoaffective disorder, or a mood disorder with psychotic features
- The disturbance is not attributable to the psychological effects of a substance or another medical condition
- If there is a history of autism spectrum disorder, the additional diagnosis of schizophrenia is made only if there are prominent delusions or hallucinations present for at least 1 month
DSM-5 vs ICD-10
- ICD-10 places more emphasis on specific types of psychotic symptoms, including first-rank symptoms
- DSM-5 does not divide schizophrenia into classical subtypes such as paranoid, hebephrenic, or catatonic
- ICD-10 considers schizotypal disorder among the spectrum of schizophrenic disorders, whereas in DSM-5 it is classified as a personality disorder
- ICD-10 includes a group of acute and transient psychotic disorders that have an acute onset and complete recovery within 2-3 months
Historical Development of Ideas about Schizophrenia
- The concept of schizophrenia has undergone significant changes over time
- Different views and traditions have influenced the diagnosis and classification of schizophrenia
- The development of standardized diagnostic criteria has improved consistency and reliability in diagnosis
Consensus on Diagnostic Criteria
- Cross-national studies of diagnostic practice (e.g., US-UK Diagnostic Project and International Pilot Study of Schizophrenia) led to a consensus on diagnostic criteria
- Standardized methods for defining and identifying diagnostic criteria have improved consistency and reliability in diagnosis
Schizophrenia-Like Disorders
- Cases that resemble schizophrenia but do not meet the criteria for diagnosis can be considered schizophrenia-like disorders
- Examples include brief psychotic disorder, schizophreniform disorder, and psychotic disorder accompanied by prominent affective symptoms
- Delusional disorders are a type of schizophrenia-like disorder characterized by chronic, systematized paranoid delusions without other symptoms of schizophrenia### Differential Diagnosis of Schizophrenia
- Brief psychotic disorder, delusional disorder, and schizotypal disorder are cases that meet some but not all criteria for schizophrenia
Affective and Psychotic Symptoms
- Schizoaffective disorder, psychotic depression, and bipolar disorder are cases with affective and psychotic symptoms that must be differentiated from schizophrenia
Schizophrenia-like Disorders Due to Specific Causes
- Schizophrenia-like disorder due to psychoactive substance use and organic schizophrenia-like disorder are cases attributable to a specific cause that must be differentiated from schizophrenia
Other Disorders
- Autism and related disorders, obsessive-compulsive disorder, body dysmorphic disorder, schizoid personality disorder, and paranoid personality disorder are other disorders that must be differentiated from schizophrenia
Challenges in Differential Diagnosis
- The boundary between schizophrenia and schizophrenia-like disorders is blurred and arbitrary
- The distinction between disorders considered variants of schizophrenia and those in its differential diagnosis is unclear
- The distinction between schizophrenia and organic schizophrenia-like disorders is also becoming increasingly blurred
- The classification of schizophrenia is limited by the unknown validity of the syndrome(s) and the lack of empirically validated markers
Organic Syndromes
- Acute schizophrenia can be mistaken for delirium, especially if there is pronounced thought disorder and a rapidly fluctuating affect and mental state
- Careful observation is needed to distinguish between the two, looking for features such as clouding of consciousness, disorientation, and other features of delirium
- Schizophrenia-like disorders can occur in clear consciousness in a range of neurological and medical disorders, such as temporal lobe epilepsy, general paralysis of the insane, and metachromatic leukodystrophy
- Visual, olfactory, and gustatory hallucinations are suggestive of an organic aetiology
- A careful medical history and physical examination (and investigations, if indicated) are essential in all patients to rule out organic causes
- One study found that 10 out of 268 cases (3.7%) of 'first-episode schizophrenia' had an organic cause other than substance misuse
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Description
This quiz covers the classification of schizophrenia and schizophrenia-like disorders according to the ICD-10 and DSM-5 systems, including subtypes and related conditions.
