Friday, September 23, 2016

Into the DSM - Schizophrenia

Schizophrenia will doubtless come up for social workers employed in clinic settings. That means it's one of the diagnoses that you may find appear on the social work licensing exam. Here are the criteria:

A. At least two of the following for a significant portion of the time during a one-month period:

1. Delusions
2. Hallucinations
3. Disorganized speech
4. Grossly disorganized or catatonic behavior
5. Negative symptoms (e.g., flat affect)

B. Level of functioning is markedly below level at onset of symptoms.

C. Disturbance persists at least six months.

D. Schizoaffective, depressive, and bipolar disorder ruled out.

E. Symptoms not attributable to the effects of a substance.

F. If there is a history of autism spectrum disorder or a communication disorder of childhood onset, a schizophrenia diagnosis is made only if prominent delusions or hallucinations are present for at least one month.

Specifiers include:
  • First episode, currently in acute episode
  • First episode, currently in partial remission
  • First episode, currently in full remission
  • Multiple episodes (acute, partial, or full remission)
  • Continuous
  • With catatonia
DSM-5 also includes a severity rating for schizophrenia--each symptom can receive its own rating ranging from 0 (not present) to 4 (present and severe).

For further reading, including risk factors and treatment, take a look at

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