According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), schizophrenia is characterized by a range of cognitive, behavioral, and emotional dysfunctions. In order for a diagnosis to be made, there must be a collection of symptoms present that are associated with impaired occupational as well as social functioning. However, individuals with the disorder will vary considerably in many features.
Diagnostic Criteria for Schizophrenia DSM-5 295.90 (F20.9)
The following criteria, as outlined by the DSM-5, must be met in order for schizophrenia to be accurately diagnosed:
- The individual experiences two or more of the following for a significant portion of time during a 1-month period. And at least one of these must be (1), (2), or (3):
- Disorganized speech (incoherence or derailment)
- Completely disorganized or catatonic behavior
- Negative symptoms, such as diminished emotional expression
- For a significant amount of time since the disturbance began, level of functioning in one or more major areas (e.g., work, interpersonal relations, or self-care) is clearly below the level achieved prior to onset.
- In children or adolescents, there is a failure to achieve the expected level of interpersonal, academic, or occupational functioning.
- Signs of the disturbance continue for 6 months or longer. This period must include at least 1 full month of symptoms that meet the first criteria and may include periods of residual symptoms. During these residual periods, the signs of the disturbance may be manifested only by negative symptoms or by two or more symptoms outlined in the first criteria, only in a lesser form.
- The disturbance cannot be better explained by schizoaffective disorder, depressive or bipolar disorder because either:
- No major depressive or manic episodes have occurred concurrently with the active-phase symptoms or…
- If mood episodes have occurred during active phase symptoms, it’s been for a minor amount of time.
- The disturbance cannot be attributed to the physiological effects of a substance (e.g., a drug of abuse or medication) or another medical condition.
- If the individual has a history of autism spectrum disorder or a communication disorder of childhood onset, the additional diagnosis of schizophrenia is only made if delusions or hallucinations as well as the other required symptoms of schizophrenia are present for a month or more.
There are a few specifications that should be made when it comes to diagnosing schizophrenia. This includes specifying the severity, if it is with catatonia, as well as categorizing it episodically:
- First episode, currently in partial remission: Partial remission refers to a period of time in which the individual has improved after a previous episode is maintained and the criteria are only partially met.
- First episode, currently in full remission: Full remission refers to a period of time after a previous episode during which no symptoms are present.
- Multiple episodes, currently in acute episode: Several episodes may be determined after a minimum of two.
- Multiple episodes currently in partial remission
- Multiple episodes, currently in full remission
- Continuous: Symptoms of the disorder remain for the majority of the illness.
Who Is at Risk of Developing Schizophrenia DSM-5 295.90 (F20.9)?
The features of schizophrenia typically develop in the late teens and the mid-30’s—rarely does onset occur before an individual has reached adolescence. The onset may be sudden and deceptive, but people typically report a slow and gradual development of the disorder. About half of these individuals also experience and combat depressive symptoms, in addition to the aforementioned symptoms.
There are a few factors that may put an individual at a greater risk of developing schizophrenia. These include:
- Season of birth, which has been linked to incidence of schizophrenia. This includes late winter and early spring in some locations and summer for the deficit form.
- Environment type, as schizophrenia and similar disorders are more prevalent among children growing up in an urban environment.
- Genetics, pregnancy and birth complications, and prenatal stress, have also all been associated with a higher risk of schizophrenia in the child.
Treatment for Schizophrenia DSM-5 295.90 (F20.9)
Even in cases where symptoms have lessened or subsided, schizophrenia requires lifelong treatment. Treatment may include therapy, medication, or a combination of the two—this is determined on a case-by-case basis.
- Medication: The most commonly prescribed drug for those suffering with schizophrenia is antipsychotic medication. Its goal is to lessen and manage the harmful symptoms that come with the disorder. Other medications such as antidepressants or ant-anxiety drugs may also be prescribed.
- Psychotherapy: Psychotherapy is used to help the affected individual develop healthier, more accurate thought patterns. Subcategories of psychotherapy include individual therapy, family therapy, and social skills training, which can all be effective in treating schizophrenia.
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