BehaveNet® Clinical Capsule™:

DSM-IV & DSM-IV-TR:

Schizophrenia

Schizophrenia, a term introduced by Bleuler, names a persistent, often chronic and usually serious mental disorder affecting a variety of aspects of behavior, thinking, and emotion. Patients with delusions or hallucinations may be described as psychotic. Thinking may be disconnected and illogical. Peculiar behaviors may be associated with social withdrawal and disinterest.

Diagnostic criteria for Schizophrenia 
(cautionary statement)

A. Characteristic symptoms: Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated): 

(1) delusions

(2) hallucinations

(3) disorganized speech (e.g., frequent derailment or incoherence) 

(4) grossly disorganized or catatonic behavior

(5) negative symptoms, i.e., affective flattening, alogia, or avolition 

Note: Only one Criterion A symptom is required if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person's behavior or thoughts, or two or more voices conversing with each other. 

B. Social/occupational dysfunction: For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care are markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, failure to achieve expected level of interpersonal, academic, or occupational achievement). 

C. Duration: Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or two or more symptoms listed in Criterion A present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences). 

D. Schizoaffective and Mood Disorder exclusion: Schizoaffective Disorder and Mood Disorder With Psychotic Features have been ruled out because either (1) no Major Depressive, Manic, or Mixed Episodes have occurred concurrently with the active-phase symptoms; or (2) if mood episodes have occurred during active-phase symptoms, their total duration has been brief relative to the duration of the active and residual periods. 

E. Substance/general medical condition exclusion: The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition. 

F. Relationship to a 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). 

Classification of longitudinal course (can be applied only after at least 1 year has elapsed since the initial onset of active-phase symptoms): 

Episodic With Interepisode Residual Symptoms (episodes are defined by the reemergence of prominent psychotic symptoms); also specify if: With Prominent Negative Symptoms 

Episodic With No Interepisode Residual Symptoms 

Continuous (prominent psychotic symptoms are present throughout the period of observation); also specify if: With Prominent Negative Symptoms 

Single Episode In Partial Remission; also specify if: With Prominent Negative Symptoms 

Single Episode In Full Remission 

Other or Unspecified Pattern

Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision.  Copyright 2000 American Psychiatric Association

Also:

Practice Guidelines

Books and Other Media:
Follow the hypertext link to purchase items.

 

  • Lieberman, JA, Stroup, TS, Perkins, DO The American Psychiatric Publishing Textbook of Schizophrenia Hardcover 2006
  • A Beautiful Mind (Widescreen Awards Edition) DVD | DVD widescreen | VHS (2002) Russell Crowe, Christopher Plummer
  • Benny and Joon DVD widescreen | VHS Johnny Depp 1993
  • Burke, Ross David When the Music's Over - My Journey Into Schizophrenia Paperback 1996 The tragedy of schizophrenia cannot really be understood by anyone who's never been there, but Burke takes us very close. The psychotic chaos and the bizarre feelings are all written bravely by Burke in a way that moves one to compassion and admiration. Burke was born in Austria in 1953 and while he was in and out of mental hospitals and jails, plagued by paranoid schizophrenia for over ten years, he wrote his novel. As soon as it was finished, he took an overdose of drugs and ended his life. He was 32 years old at the time. The book takes you between Burke's moments of reality and his delusions. He complains about taking medication for various reasons such as weight gain, dry mouth, poor concentration, reduced sexual performance and low maturation. He preferred to medicate himself with alcohol and drugs. In one of his suicide notes, he wrote, "I'm a paranoid schizophrenic and for us, life is hell; I'm sorry God." W/AMI
  • Canvas Joe Pantoliano, Marcia Gay Harden 2006
  • Govig, Stewart D Souls are Made of Endurance This book was donated to W/AMI by the author who is a professor of religion at Pacific Lutheran University, Tacoma, Washington, and also a W/AMI member. It is a heartrending narrative of of his son's mental illness (schizophrenia) and reveals how the family grappled with rage, fear and frustration when first challenged by the irrational behaviors displayed by his son's illness. Even a question of faith and of God enters into the conflict. The conflict and ambivalence eventually turns to love, compassion, hope and understanding as schizophrenia, a neurobiological brain disease, is accepted. Analogies between various situations and symptoms of the illness and Bible passages throughout the book are thought-provoking. Govig takes the reader down a road many of us have traveled to the depths of pain and anguish. But faith and hope prevail. The book is intelligently written and easy to read. Reviewed by Susan Cleva, W/AMI
  • Heinrichs, R Walter In Search of Madness Hardcover 2001
  • Lachenmeyer, Nathaniel The Outsider - A Journey Into my Father's Struggle with Madness Hardcover 2000
  • Lamb, Wally I Know This Much Is True (Oprah's Book Club) Hardcover | Paperback (June 1998)
  • Modrow, John How to Become a Schizophrenic Mr. Modrow lives in Washington state and has done an enormous amount of research in writing this book. Although I do not always agree with the author's conclusions on mental illness, the information on his early childhood and adult life was interesting. Reviewed by Susan Cleva, W/AMI
  • Nasrallah, Henry A., M.D. (Editor), et al Contemporary Issues in the Treatment of Schizophrenia Hardcover
  • Schiller, Lori, Bennett, Amanda The Quiet Room - A Journey Out of the Torment of Madness Paperback 1996 | Audio Cassette 1994
  • Shine VHS | VHS widescreen | DVD widescreen 1996 Geoffrey Rush
  • Torrey, E. Fuller: Surviving Schizophrenia - A Manual for Families Consumers and Providers Paperback 1995 The updated 3rd edition of Surviving Schizophrenia by Dr. Torrey is EXCELLENT. It is easy to read and presents detailed information from a writer of great knowledge. Torrey is one of the few psychiatrists who truly understands the devastation that schizophrenia can cause to consumers and family members. Sections on medication, causes of the illness, and exemplary treatment programs, as well as the chapters on stigma and lessons in how to advocate, are welcome additions to earlier editions. The chapter on Rehabilitation of Schizophrenia is quite good, too. The book gives answers to questions most often asked by families, consumers and providers. Dr. Torrey states that the lack of continuity of care and treatment by mental health professionals who do not understand schizophrenia are major problems. He includes distressing facts gleaned from research that indicate "there are as many individuals with schizophrenia in jails and prisons as there are in all hospitals." Dr. Torrey says that 29% of jails hold such individuals with no charges against them and the vast majority who do have charges are charged with misdemeanors. Surviving Schizophrenia is a wonderful reference book which can be used by advocates when they give talks or present testimony before legislators, imparting basic knowledge about serious mental illness. This book has long been the most checked out book in the W/AMI Library. Reviewed by Susan Cleva, W/AMI
  • The Truman Show DVD | VHS | VHS Widescreen 1998 Jim Carrey's character's experience of being the unaware star of a lifelong TV show must be something akin to what it must be like to be schizophrenic and delusional.
  • Wyden, Peter Conquering Schizophrenia - A Father, His Son and a Medical Breakthrough Hardcover 1998 This book by Peter Wyden (1977) tells of the twenty five years that the author's son struggled with schizophrenia. It documents how he was hospitalized numerous times and of the many, many psychiatrists, clinics and group homes he was involved with. It also tells of the various medications taken, the shock treatments, and even the hypnosis tried. It then explains that he was put on olanzapine and in his father's words, "Jeff was like a civilian!" His mind was opening and even though there is no cure now there is home. It's a good book and full of solid information. W/AMI


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