by Scholten A

Diagnosis of Schizophrenia

Before a diagnosis of schizophrenia can be made, your doctor must rule out other illnesses. People can suffer severe mental symptoms and even psychosis due to underlying medical conditions that have not been detected.
It is often difficult to differentiate one mental disorder from another as many psychiatric illnesses share similar features and symptoms. Obtaining an early and accurate diagnosis is extremely important for patients
People who are diagnosed early are able to:
  • Receive earlier treatment to stabilize their symptoms
  • Decrease the risk of suicide
  • Decrease alcohol and substance abuse
  • Reduce the chance of relapse and/or hospitalization
  • Reduce the possibility of social conflict or isolation
  • Reduce the decline in functioning and long-term impairments commonly associated with schizophrenia
Diagnosis includes the following:
  • Initial evaluation—Your doctor will ask about your medical and family history and perform a physical examination.
  • Blood and urine tests—Laboratory tests will be taken to rule out possible medical causes of the symptoms. For example, commonly abused drugs (such as amphetamines or cocaine) may cause symptoms resembling bipolar disorder or schizophrenia. Some metabolic illnesses or infections may also cause psychotic episodes. These drugs and conditions can be tested for in blood or urine samples.
  • Psychiatric evaluation—A psychiatrist will conduct a psychiatric interview to evaluate you for any psychiatric disorders that could be causing your symptoms.
Diagnosis is often based on the criteria outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). In order to be diagnosed with schizophrenia, you must have psychotic symptoms for at least six months and show increasing difficulty in functioning normally.

References

Carson RC, Butcher JN, et al. Abnormal Psychology and Modern Life. 11th ed. Boston, MA: Allyn and Bacon; 2000.

Keshavan MS, Roberts M, et al. Guidelines for clinical treatment of early course schizophrenia. Curr Psychiatry Rep. 2006;8:329-334.

MacDonald AW, Schulz SC. What we know: findings that every theory of schizophrenia should explain. Schizophr Bull. 2009;35(3):493-508.

McCormick LM, Flaum M. Diagnosing schizophrenia circa 2005: how and why? Curr Psychiatry Rep. 2005;7:311-315.

National Alliance on Mental Illness. Early onset schizophrenia. National Alliance on Mental Illness website. Available at: http://www.nami.org/Template.cfm?Section=By%5FIllness&template=/ContentManagement/ContentDisplay.cfm&ContentID=103175. Updated July, 2010. Accessed August 18, 2010.

National Institute of Mental Health website. Available at: http://www.nimh.nih.gov.

Stern TA, et al. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, PA: Mosby Elsevier; 2008.

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