Schizophrenia is a complex diagnosis, and the diagnostic criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria can be vague or misinterpreted. Here’s how to ensure an accurate schizophrenia diagnosis.

What Is Schizophrenia?

Schizophrenia is a complex mental issue that is not yet fully understood and has no known cure. What makes it so complex is that evidence has shown it’s the result of a breakdown in the balance between emotional regulation, thought patterns, brain chemistry, and the individual’s perception of reality. There’s also strong evidence that schizophrenia is rooted in past traumatic experiences that may need to be addressed before well-being can be achieved.

Ultimately, schizophrenia affects nearly every aspect of an individual’s life, including how they think, feel, behave, and, in many cases, what they hear or see. While there is no cure for schizophrenia, many individuals diagnosed as schizophrenic go on to live balanced, productive lives with proper treatment. However, schizophrenia remains a lifetime diagnosis (when diagnosed correctly). As such, it requires ongoing management to ensure symptoms do not return.

What Are the Symptoms of Schizophrenia?

Some of the most common symptoms of schizophrenia include:

• Delusional thoughts: Beliefs or anxieties that are not based in reality.
• Hallucinations: Auditory and/or visual experiences of voices, things, or people who aren’t actually present.
• Incoherent speech: Delusional thoughts may lead to speech that is incoherent or “word salad.”
• Erratic movements and behavior: Useless/excessive motion, random giddiness, or unfocused tendencies.

While these symptoms are often present in individuals struggling with schizophrenia, it’s important to remember that the presence of any of these symptoms, or the lack thereof, is not enough to confirm or deny a schizophrenia diagnosis.

Schizophrenia Risk Factors

The root cause of schizophrenia remains unknown, but research has shown that some underlying risk factors include:

• Having a family history of schizophrenia
• Taking mind-altering substances during adolescence and early adulthood
• Complications during pregnancy or birth, including malnutrition or toxic exposure

Again, while these factors may point to the possibility of a diagnosis, they are not enough to confirm schizophrenia is the issue.

Do you suspect that you or someone you care about may be struggling with schizophrenic tendencies or has been inaccurately diagnosed as schizophrenic? PCH may be able to help. Find Out if PCH Is Right for You

Early Signs of Schizophrenia

Schizophrenia can be difficult to recognize in young adults because normal developmental behavior at that age may mirror schizophrenic tendencies. The presence of any of the symptoms above may indicate the possibility of a diagnosis later on in life, but the teenage years are often too turbulent to make an accurate diagnosis. 

While schizophrenia may occur at any age, the onset of symptoms leading to an accurate diagnosis often happens in the early 20s for men and the late 20s for women. It can also occur after 30, but rarely begins after 40.

Along with the above symptoms, some of the early warning signs include:

• Depression or social withdrawal
• Hostility or suspicion toward others
• Neglect of personal hygiene
• An inability to show emotion
• A flat, expressionless gaze
• Oversleeping or insomnia

Schizophrenia Diagnostic Criteria

According to the DSM-5, the criteria for diagnosing schizophrenia include:

Overlapping Symptomatology

Two or more of the following symptoms must be present for a month or more:

1. Delusions
2. Hallucinations
3. Disorganized speech
4. Grossly disorganized or catatonic behavior
5. Negative symptoms

At least one of those symptoms must include 1, 2, or 3.

Impaired Functioning

For a significant time following the onset of symptoms, the level of function in one or more major life areas (e.g., work, self-care, interpersonal relationships) must be at or below the level achieved prior to the onset of symptoms.

Persistent Disturbance

Continuous signs of the disturbance must persist for a period of at least six months, including at least one month of symptoms.

Ruling Out Other Issues

Schizoaffective disorder and depressive or bipolar disorder with psychotic features must be ruled out.

Ruling Out Substance Use or Medical Conditions

The disturbance must not be attributable to the physiologic effects of a substance or another medical condition.

Ruling Out Autism and Communication Issues

If there is a history of autism or communication issues, an additional diagnosis of schizophrenia may only be made if prominent delusion or hallucinations are present in addition to the other required symptoms.

In light of these criteria, it’s critical to remember that only a professional can diagnose schizophrenia, but all six of the above criteria must first be confirmed. Even then, however, it should be easy to see how many gray areas exist when diagnosing schizophrenia accurately.

How Reliable Are Schizophrenia Tests?

First, you should not rely on an online test to diagnose schizophrenia. Accurately diagnosing schizophrenia, even when working with professionals, is already difficult. As seen from the diagnostic criteria above, an accurate diagnosis cannot be distilled to taking a simple test. It takes professionals working with an individual over a series of months or even years to confirm an accurate diagnosis and then identify the best course of treatment.

The PCH Approach to Schizophrenia

At PCH, we’ve found schizophrenia is prone to misdiagnosis because of how difficult it is to diagnose. That’s why when someone comes to us with a previous diagnosis, we always take the time to first confirm or deny that diagnosis. From there, we take a holistic approach to schizophrenia treatment. Discover more about our approach, and when you’re ready to take the next steps, find out if PCH is right for you.