International Classification of Diseases (ICD-10) [4] and the APA Diagnostic and Statistical Manual, fourth edition, DSM-IV, [5] now serve as a common language for psychiatry and mental health care worldwide. The two systems identify schizophrenia in a broadly similar manner (see Table 7-1).

Notwithstanding international agreement on diagnosis, it is important to bear in mind that schizophrenia remains a clinical syndrome and that the neuro-biology underlying its manifestations is not yet fully understood. There is at present no biological test or marker that can identify the disease (or a predisposition to it) independently of clinical assessment. Furthermore, the clinical

TABLE 7-1 Overview of the ICD-10 and DSM-IV Criteria for Diagnosis of Schizophrenia

ICD-10 Schizophrenia (F20)

DSM-IV Schizophrenia (295)

One month or more of at least one of the following symptoms:

  1. thought echo, withdrawal, insertion, broadcasting

  2. delusions of control and passivity

  3. voices; 3rd person, commentary, coming from part of body

  4. persistent delusions

or at least two of the following:

  1. persistent hallucinations accompanied by delusions

  2. incoherence, irrelevant speech, neologisms

  3. catatonic signs

  4. negative symptoms

  5. significant consistent change in personal behavior

  1. One month or more of at least two of the following symptoms:

  1. delusions

  2. hallucinations

  3. disorganized speech

  4. grossly disorganized or catatonic behavior

  5. negative symptoms

  1. Social and occupational dysfunction

One or more areas affected (work, relationships, self-care)

  1. Duration

Continuous symptoms and signs for ≥ 6 months

These 6 months must include:

  • At least 1 month of symptoms meeting criterion A

  • Various combinations of prodromal and residual symptoms

Exclude:

Exclude:

Full manic or depressive episode preceding the onset of schizophrenic symptoms

Organic brain disease

Alcohol or drug intoxication or withdrawal

Schizoaffective and mood disorder

Substance use or a medical condition

Autism or pervasive developmental disorder

Source: [4,5]



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