How is it Diagnosed?
Schizophrenia is a chronic psychiatric disorder characterized by distortions in thinking,
perception, emotions, and behavior. Diagnosis is clinical and based on criteria outlined in
the DSM-5 or ICD-11.
The primary features include delusions, hallucinations (especially auditory), disorganized
speech, grossly disorganized or catatonic behavior, and negative symptoms (like
emotional flatness or social withdrawal). At least two of these symptoms must be
present for a significant portion of a one-month period, with one symptom being
delusions, hallucinations, or disorganized speech. The condition must persist for at least
six months, including prodromal or residual phases.
Initial assessment includes a detailed psychiatric history and mental status examination.
Family history of psychiatric illness and social or occupational dysfunction also provide
diagnostic clues.
Laboratory and imaging studies, such as CBC, thyroid function tests, vitamin B12 levels,
urine toxicology, and brain MRI or CT, are used to exclude other causes like substance
use, neurological disorders, or metabolic abnormalities.
Standardized rating scales such as the PANSS (Positive and Negative Syndrome Scale)
or BPRS (Brief Psychiatric Rating Scale) may be used to assess symptom severity and
monitor treatment response.
Diagnosis must differentiate schizophrenia from schizoaffective disorder, bipolar
disorder with psychotic features, severe depression, and drug-induced psychosis.