Classification & Diagnosis of Schizophrenia

The term 'schizophrenia' was coined by Eugen Bleuler and literally means 'split mind'. This may be the reason for many of the misconceptions regarding this particular mental illness which is, actually, more to do with disconnected thought processes and the loss of contact with reality.

1% of the population is likely to suffer from schizophrenia during their lifetime

The risk is higher for twins

Early diagnosis notoriously unreliable, better since intro of DSM-IV and ICD classification systems

DSM-IV

• 5 categories
  • Disorganised (hebephrenic) - most commonly seen in teenagers
  • Paranoid
  • Catatonic
  • Undifferentiated
  • Residual
• multi-axial - takes into account other factors
• requires symptoms to be present for 6 months

ICD

• 7 categories
• diagnosis based on 1st rank symptoms (hallucinations and delusions)
• requires symptoms to be present for 1 month

• Type 1, Acute, sudden onset - characterised by +ve symptoms (excess or distortion of normal functions)
• hallucinations
• delusions of grandeur and paranoid delusions
• catatonia
• violence
• assuming bizarre postures
• disorganised thoughts
• Type 2, Chronic, gradual onset - characterised by -ve symptoms (diminution or loss of normal functions)
• low mood
• lack of emotion
• poor personal hygiene
• incoherent speech
• negativism