Schizophrenia diagnosis

Spencer, E.K. and Campbell, M. (1994) Children with schizophrenia diagnosis, phenomenology, and pharmacotherapy. Schizophr B //20 713-725. 

A diagnosis of schizophrenia is made clinically, as there are no psychological assessments, brain imaging, or laboratory examinations that confirm the diagnosis. 

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). 

The cross-national prescribing database using the same methodology provided a useful and valid comparison of patterns of prescribing psychotropic medications in mental health services in Australia, Thailand, and Malaysia (Ng et al, submitted). The study was carried out in three outpatient mental health centres in North Western Mental Health (NWMH) in Melbourne (September to November 2002), Prince of Songkla University Hospital in Hat Yai (January to March 2003), and Hospital Kuala Lumpur (January to March 2003). The proportions of outpatients treated with a primary diagnosis of a psychotic illness were 91%, 41%, and 75% in the Australian, Thai, and Malaysian samples respectively. Considering psychotropic prescriptions in schizophrenia alone, the majority of patients were prescribed antipsychotics Australia (93.7%), Thailand (92.9%), and Malaysia (97.7%). 

The Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision, specifies the following criteria for the diagnosis of schizophrenia / Persistent dysfunction lasting longer than 6 months... 

Carpenter, W. T., Strauss, J. S., Bartko, ]. J. (1973). Flexible system for the diagnosis of schizophrenia Report from the WHO International Pilot Study of Schizophrenia. Science, 182, 1275-1277. 

Chronic cocaine use can cause a syndrome of insomnia, hallucinations, delusions, and apathy. This syndrome develops around the time when the euphoria turns to a paranoid psychosis, which resembles paranoid schizophrenia. Further, after cessation of cocaine use, the hallucinations may stop, but the delusions can persist. Still, the incidence of a persistent cocaine-induced psychosis appears to be rare. One study found only 4 out of 298 chronic cocaine users receiving a diagnosis of psychotic disorder (Rounsaville et al. 1991). This incidence is approximately the... 

The differential diagnosis of depression is organized along both symptomatic and causative lines. Symptomatically, major depression is differentiated from other disorders by its clinical presentation or its long-term history. This is, of course, the primary means of distinguishing psychiatric disorders in DSM-1V. The symptomatic differential of major depression includes other mood disorders such as dysthymic disorder and bipolar disorder, other disorders that frequently manifest depressed mood including schizoaffective disorder, schizophrenia, dementia, adjustment disorder, and post-traumatic stress disorder, and, finally, other nonpsychiatric conditions that resemble depression such as bereavement and medical illnesses like cancer or AIDS. 

There are many illnesses that in one respect or another closely resemble schizophrenia. Therefore, it takes considerable skill to diagnosis this disorder reliably. It is so difficult to diagnose accurately at a single time point that a patient with psychotic symptoms may over time have his/her diagnosis changed to and from schizophrenia repeatedly. 

During its earliest stages, schizophrenia is notoriously difficult to diagnose reliably. Once diagnosed (even incorrectly), it is a label that tends to stick. Because the diagnosis of schizophrenia is associated with such significant social, medical, and... 

Brief Psychotic Disorder. This diagnosis also differs from schizophrenia by virtue of the duration of symptoms. The symptoms mnst last less than 1 month, and the patient must return to his/her previous level of social functioning when the illness subsides. Formerly called brief reactive psychosis, an episode of this illness usually arises in reaction to some markedly stressfnl event, thongh this is not always the case. 

---