II. Symptoms: Positive
- Delusions (often bizarre)
- Hallucinations (not fantasy)
-
Disorganized Speech
- Frequent derailment or incoherence
- Conceptional disorganization
- Bizarre disorganized or Catatonic behavior
- Delusions
- Excitement
- Grandiosity
- Suspiciousness or persecution
- Hostility
III. Symptoms: Negative (Lack of normal function)
- See Negative Symptoms in Psychosis
- Diminished emotional expression or avolition
- Blunted affect
- Alogia (fewer words spoken)
- Avolition (decreased motivation, decreased goal directed activity)
- Asocial
- Anhedonia
IV. Diagnosis: Criteria
- Symptoms (active phase)
- Two symptoms or more from list above
- At least one positive symptom (Delusions, Hallucinations or Disorganized Speech) AND
- At least one negative symptom OR grossly disorganized or Catatonic behavior
- In DSM IV, one symptom was sufficient if significant, bizarre Delusion or Hallucination (e.g. 2 voices conversing)
- Each symptom present for a significant amount of time during a one month period
- Symptoms may be less prominent during the month if treated
- Two symptoms or more from list above
- Severe for at least one month (or less if receiving clinical treatment)
- Impaired social or occupational function
- Continuous signs and symptoms for at least 6 months
- Not due to secondary cause
- Not due to schizoaffective disorder
- Not due to Bipolar Disorder (minimal or no concurrent mania or Major Depression during active phase)
- Not due to Mood Disorder
- Not due to Substance Abuse
- Not due to underlying medical illness
- Not due to pervasive Developmental Disorder
- Not due to Autism, unless Delusions or Hallucinations are prominent
V. References
- (2000) DSM IV, American Psychiatric Association, p. 297-343
- (2013) DSM V, American Psychiatric Association, p. 99
- Crawford (2022) Am Fam Physician 106(4): 388-96 [PubMed]
- Freedman (2003) N Engl J Med 349:1738-49 [PubMed]
- Holder (1014) Am Fam Physician 90(11): 775-82 [PubMed]
- Schultz (2007) Am Fam Physician 75:1821-9 [PubMed]