Fast Five Quiz: Schizophrenia Practice Essentials

Steve Soreff, MD

Disclosures

November 22, 2022

The specific DSM-5 criteria for schizophrenia are:

  • The presence of two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated), with at least one of them being (1), (2), or (3): (1) delusions, (2) hallucinations, (3) disorganized speech, (4) grossly disorganized or catatonic behavior, and (5) negative symptoms.

  • For a significant portion of the time since the onset of the disturbance, level of functioning in one or more major areas (eg, work, interpersonal relations, or self-care) is markedly below the level achieved before onset; when the onset is in childhood or adolescence, the expected level of interpersonal, academic, or occupational functioning is not achieved.

  • Continuous signs of the disturbance persist for a period of at least 6 months, which must include at least 1 month of symptoms (or less if successfully treated). Prodromal symptoms often precede the active phase, and residual symptoms may follow it, characterized by mild or subthreshold forms of hallucinations or delusions.

  • Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either (1) no major depressive, manic, or mixed episodes have occurred concurrently with the active-phase symptoms or (2) any mood episodes that have occurred during active-phase symptoms have been present for a minority of the total duration of the active and residual periods of the illness.

  • The disturbance is not attributable to the physiologic effects of a substance (eg, a drug of abuse or a medication) or another medical condition.

  • If the patient has a history of autism spectrum disorder or a communication disorder of childhood onset, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations, in addition to the other required symptoms or schizophrenia, are also present for at least 1 month (or less if successfully treated).

Learn more about schizophrenia workup.

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