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DSM-IV-TR Diagnostic Criteria for Schizophrenia

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  1. 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):

    1. delusions

    1. hallucinations

    1. disorganized speech (e.g., frequent derailment or incoherence)

    1. grossly disorganized or catatonic behavior

    1. negative symptoms, i.e., affective flattening, alogia, or avolition

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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.

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  1. 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).

  2. 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).

  3. 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.

  4. 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.

  5. 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).

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(Adapted, with permission, from Diagnostic and Statistical Manual of Mental Disorders, 4th edn., Text Revision. Washington, DC: American Psychiatric Association, 2000.)

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  • Diagnostic criteria met, as specified in the box above. Note that these criteria allow the diagnosis in absence of prominent hallucinations or delusions (e.g., there is instead some combination of negative symptoms, disorganized speech, and/or disorganized or catatonic behavior).
  • Duration of active psychotic symptoms for at least 1 month, or for a shorter duration if active treatment was initiated.
  • Total duration of illness for at least 6 months, including prodrome, acute phase, and residual symptoms.
  • Cognitive impairment, characterized by disorganized, illogical, loosely associated or bizarre speech, or by inappropriate or bizarre behaviors.
  • The above symptoms ...

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