
Schizophrenia: Diagnostic Criteria
Information from the Diagnostic and Statistical Manual of Mental Disorders, 4th. Ed.
- Characteristic symptoms:
Two (or more) of the following, each present for a
significant portion of time during a 1-month period (or less if successfully treated):
- delusions
- hallucinations
- disorganized speech (e.g., frequent derailment or incoherence)
- grossly disorganized or catatonic behavior
- negative symptoms, i.e., affective flattening, alogia, or avolition
Note: Only one Criterion A symptom is required if delusions are bizarre or
hallucinations consist of a voice keeping up a running commentary on the person's behavior
or thoughts, or two or more voices conversing with each other.
- Social/occupational dysfunction:
For a significant portion of the time since the
onset of the disturbance, one or more major areas of functioning such as work,
interpersonal relations, or self-care are markedly below the level achieved prior to the
onset (or when the onset is in childhood or adolescence, failure to achieve expected level
of interpersonal, academic, or occupational achievement).
- Duration:
Continuous signs of the disturbance persist for at least 6 months. This
6-month period must include at least 1 month of symptoms (or less if successfully treated)
that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal
or residual symptoms. During these prodromal or residual periods, the signs of the
disturbance may be manifested by only negative symptoms or two or more symptoms listed in
Criterion A present in an attenuated form (e.g., odd beliefs, unusual perceptual
experiences).
- Schizoaffective and Mood Disorder exclusion:
Schizoaffective Disorder and Mood
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) if mood episodes have occurred during active-phase symptoms, their total
duration has been brief relative to the duration of the active and residual periods.
- Substance/general medical condition exclusion:
The disturbance is not due to the
direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a
general medical condition.
- Relationship to a Pervasive Developmental Disorder:
If there is a history of
Autistic Disorder or another Pervasive Developmental Disorder, the additional diagnosis of
Schizophrenia is made only if prominent delusions or hallucinations are also present for
at least a month (or less if successfully treated).
Diagnostic Criteria of Schizophrenia Subtypes
Paranoid Type
A type of Schizophrenia in which the following criteria are met:
- Preoccupation with one or more delusions or frequent auditory hallucinations.
- None of the following is prominent: disorganized speech, disorganized or catatonic
behavior, or flat or inappropriate affect.
Catatonic Type
A type of Schizophrenia in which the clinical picture is dominated by at
least two of the following:
- motoric immobility as evidenced by catalepsy (including waxy flexibility) or stupor
- excessive motor activity (that is apparently purposeless and not influenced by external
stimuli)
- extreme negativism (an apparently motiveless resistance to all instructions or
maintenance of a rigid posture against attempts to be moved) or mutism
- peculiarities of voluntary movement as evidenced by posturing (voluntary assumption of
inappropriate or bizarre postures), stereotyped movements, prominent mannerisms, or
prominent grimacing
- echolalia (immediate and involuntary repetition
of words or phrases just spoken by others) or echopraxia
(involuntary imitation of movements made by another)
Disorganized Type
A type of Schizophrenia in which the following criteria are met:
- All of the following are prominent:
- disorganized speech
- disorganized behavior
- flat or inappropriate affect
- The criteria are not met for Catatonic Type.
Undifferentiated Type
A type of Schizophrenia in which symptoms that meet Criterion A are
present, but the criteria are not met for the Paranoid, Disorganized, or Catatonic Type.
Residual Type
A type of Schizophrenia in which the following criteria are met:
- Absence of prominent delusions, hallucinations, disorganized speech, and grossly
disorganized or catatonic behavior.
- There is continuing evidence of the disturbance, as indicated by the presence of
negative symptoms or two or more symptoms listed in Criterion A for Schizophrenia, present
in an attenuated form (e.g., odd beliefs, unusual perceptual experiences).