Schizophrenia Cluster Notes

Schizophrenia Cluster Notes 1. Schizophrenia Diagnostic Criteria a. Two or more of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one must be (1), (2), or (3): 1. Delusions 2. Hallucinations 3. Disor...

Schizophrenia Cluster Notes 1. Schizophrenia Diagnostic Criteria a. Two or more of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one must be (1), (2), or (3): 1. Delusions 2. Hallucinations 3. Disorganized speech 4. Grossly disorganized or catatonic behavior 5. Negative symptoms (e.g., diminished emotional expression or avolition) b. For a significant time since onset, functioning in major life areas (work, relationships, self- care) is markedly impaired. c. Continuous signs of disturbance last at least 6 months. This must include ≥1 month of active- phase symptoms (Criterion a) and may include prodromal/residual symptoms. d. Schizoaffective disorder, depressive disorder, or bipolar disorder with psychotic features have been ruled out (i.e., no major mood episodes concurrent with active-phase symptoms, or mood symptoms present for a minority of total illness duration). e. Not due to the physiological effects of a substance or another medical condition. f. If there is a history of autism spectrum disorder or childhood communication disorder, schizophrenia is diagnosed only if prominent delusions or hallucinations are also present for ≥1 month. Differential Diagnosis (with specifiers) 1. Major depressive or bipolar disorder with psychotic or catatonic features - Specifier relevance: If psychotic symptoms occur exclusively during mood episodes, diagnose a mood disorder with psychotic features instead. - Mood-congruent/incongruent specifier: Use if psychosis is tied to mood themes. 2. Schizoaffective disorder - Requires a major mood episode (depressive or manic) concurrent with psychotic symptoms AND ≥2 weeks of psychotic symptoms without mood symptoms. 3. Schizophreniform disorder - Time specifier: Total duration of illness is at least 1 month but less than 6 months.  4. Brief psychotic disorder - Time specifier: Symptoms last more than 1 day but less than 1 month, followed by full return to premorbid functioning. 5. Delusional disorder - Presence of one or more delusions for ≥1 month, but no other prominent psychotic symptoms. - Specifier: With bizarre content (if delusions are implausible or not understandable). 6. Substance/medication-induced psychotic disorder - Psychotic symptoms develop during or shortly after substance use. - Specifiers: - With onset during intoxication - With onset during withdrawal - With onset after medication use 7. Psychotic disorder due to another medical condition - Rule out medical causes via history, physical, and lab data. - Specifiers: - With delusions - With hallucinations 8. Autism spectrum or communication disorders - Schizophrenia is diagnosed only when hallucinations or delusions are prominent for ≥1 month. 2. Schizophreniform Disorder Diagnostic Criteria a. Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one must be (1), (2), or (3): 1. Delusions 2. Hallucinations 3. Disorganized speech 4. Grossly disorganized or catatonic behavior 5. Negative symptoms b. An episode of the disorder lasts at least 1 month but less than 6 months. c. Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out. d. The disturbance is not attributable to the physiological effects of a substance or another medical condition. Specifiers:  With good prognostic features (requires ≥2: onset within 4 weeks, confusion/perplexity, good premorbid functioning, no flat/blunted affect)  Without good prognostic features  With catatonia (use additional code F06.1)  Severity (0–4 scale rating on 8 core symptom dimensions) Differential Diagnosis 1. Brief psychotic disorder – Symptoms last