DSM diagnostic criteria for schizophrenia

2021-07-15 04:43 PM

It only takes one of the symptoms of bizarre delusions or hallucinations that comment on an individual's behavior or thoughts or hallucinations for two or more voices to converse with each other.

For a diagnosis of schizophrenia, the DSM-IV-TR (APA, 2000) recommends that at least 2 of the symptoms listed below be evident during the 1-month period:



Youth language is often mixed or irrelevant.

Outrageous or catatonic violent behavior.

Negative symptoms: emotional blunting, loss of will, language.

It only takes one of these symptoms when present: bizarre delusions or hallucinations that comment on an individual's behavior or thoughts, or hallucinations of two or more voices conversing with each other. The second criterion is that the symptoms cause significant harm. Schizophrenia is divided into 4 types according to the predominant symptoms:

Juvenile form: salient features are ludicrous language and behavior, inappropriate or blunt emotions.

Paranoid: This is the most common form of schizophrenia, characterized by persistent paranoid delusions. Acoustic hallucinations can also support paranoid beliefs. Emotional and language disorders. The symptoms of catatonic tension are unsustainable.

Dystonia: prominent with psychomotor disorders. The disease can manifest very differently, from agitation to stupor and waxing and sculpting, the individual being able to maintain a posture imposed by outsiders for several hours. In addition, the patient may also have automatic obedience, a state of sleep-like lethargy accompanied by vivid hallucinations. Currently, this form of disease is rare in industrialized countries.

Sequelae: typically, absent from delusions, hallucinations, adolescent language, adolescent behavior, or hypertonia. However, there are still some obvious negative symptoms.

Another view of the symptoms

The development of different diagnostic criteria begins with considering which symptoms go together to form groups and what mechanisms are behind the groups of symptoms. Factor analysis of the signs and symptoms of different types of schizophrenia revealed that there are three main groups of symptoms: juvenile, positive and negative (Liddle et al., 1994). Adolescent symptoms include youthful language and behavior, blunted and inappropriate emotions (or “thought disturbances”).

The group of positive symptoms includes hallucinations and delusions. Finally, negative symptoms refer to impaired functioning, including apathy, lack of motivation, and poor language. Each of these symptoms can have different biological and psychological causes.

Criticism of schizophrenia

The diagnostic criteria for schizophrenia according to the DSM-IV-TR are significantly different from those of the DSM-III (see chapter 1) and from the definition of schizophrenia by Liddle et al. (1994). The difficulty of accurately defining schizophrenia creates fundamental problems for clinicians and researchers when developing causal models or approaching treatment. The difficulty is so great that many scientists and clinicians have questioned whether schizophrenia exists in some independent form as defined by the DSM.

The fundamental problem with the DSM's view of schizophrenia is that the same individual but different physicians can make very different diagnoses and two different symptoms may be sufficient. This disproves the notion that with every disorder there is a mechanism behind it. In other words, if individuals suffer from the same disease, individuals must have the same set of symptoms. It is also worth noting that different people with schizophrenia respond differently to drugs such as neuroleptics, lithium, and benzodiazepines. There are also people who do not respond to a single drug. Likewise, the course of therapy is also very different. As Bentall (1993) points out: “We must inevitably come to the important conclusion that 'schizophrenia is a disease without distinct symptoms, does not have its own course and does not respond to a particular treatment.” On this basis, he suggested that the diagnosis was not valid enough to eliminate the notion of schizophrenia. Furthermore, to account for multiple syndromes, future efforts should focus on explaining specific behaviors or experiences: each symptom of “schizophrenia” needs to be viewed as a Distinctive disorder with a distinct course and treatment.

The next problem is that these phenomena are not unique to people diagnosed with schizophrenia, there are many people who do not go to a psychiatrist even though they still hear voices in their heads. So what is the difference between those who seek help and those who do not seek help to solve their problems; distinguish differences in individual responses and their ability to deal with those problems? Positive coping strategies include setting time limits for hearing voices and talking back and selectively listening to positive voices (Romme & Escher, 1989).

Attempts to unify the disparate phenomena under one name "schizophrenia" remain controversial. Subsequent sections of the chapter deal more with traditional trends and review studies based on the DSM or similar definitions of schizophrenia. Some might argue that such research is dead-end, as the search for causative factors is not inherently present. On a more positive level, it is possible to identify some of the factors that increase the risk or provide more effective treatment for all that is now under the label of “schizophrenia”. paralyzed". This also highlights some of the problems researchers face when trying to explain common factors that contribute to the different experiences of people diagnosed with schizophrenia. Because most studies have focused on people diagnosed with schizophrenia, the term is commonly used across the categories, although there are differing assessments of its validity.