Schizophrenia Diagnosis

Schizophrenia can be difficult to diagnose because diagnosing the condition means not only that a person has certain characteristics or symptoms, but also that there are no other explanations for symptoms. A mental health specialist will likely consult the criteria set forth in the most recent Diagnostic and Statistical Manual of Mental Disorders (DSM-5). According to the DSM-5, in order to be diagnosed^[11] with schizophrenia, a patient must have:

• Two or more core symptoms One of these must be hallucinations, delusions, or disorganized speech. A person can have at least two of the above symptoms but may also demonstrate gross disorganization or diminished emotional expression to round out the two that are required.
• Symptoms lasting at least a month: Shorter-term symptoms will not qualify a person for a diagnosis of schizophrenia. Some patients end up needing to wait on a diagnosis until their symptoms have been present for long enough.
• Diminished functioning: The symptoms must be diminishing the person’s functioning such that their level of work, interpersonal relationships, or self-care is significantly lower than it was in the past. If the symptoms are not lowering a person’s quality of life or well being, they will not qualify for a diagnosis of schizophrenia even if they have many symptoms.
• Disturbed living The person’s life must show signs of being disturbed for at least six months prior to diagnosis. Because schizophrenia often has the prodromal period mentioned above and can come on slowly, there must be an indication that this was going on prior to the current symptoms and diagnosis.
• No other causes: The symptoms are not caused by schizoaffective disorder, bipolar disorder, depression, substance abuse, or another medical condition. A healthcare provider will know how to differentiate between these conditions and how to make sure that they provide the correct diagnosis.

In order to rule out these other possible diagnoses, most practitioners will test patients to rule out other existing conditions. These tests^[12] may include:

• A thorough physical exam: This ensures that there is nothing going on with the person’s body that might be causing their symptoms or that requires further investigation before a diagnosis of schizophrenia can be made.
• Blood tests: These rule out substance use and can help ensure that there is nothing in a patient’s system that might cause whatever symptoms the patient is suffering from. They can also help check for problems like malnutrition, which can indicate schizophrenia in some people.
• Imaging tests: These can include an MRI, a CT scan, or both. These scans can help determine whether a particular person’s brain shows signs of schizophrenia. It can also help medical practitioners rule out other possible causes of the symptoms, like a head injury or an aneurysm.
• Psychological testing: A mental health professional may interview the person and speak to those close to them. They may also observe the person at work, with family and friends, and in other everyday situations. They may ask or look for evidence of certain thoughts or moods, substance use, delusions, hallucinations, and more.
• A detailed family history: A healthcare provider will want to determine whether the person has schizophrenia in their family background. Information about other mental illnesses or about substance abuse will also be useful.

Once a healthcare provider has all the facts, they can make informed decisions about a patient’s signs and symptoms, including the decision to diagnose someone with schizophrenia.

Schizophrenia test

There is no definitive test^[13] for schizophrenia. Because researchers have not determined its exact cause (or causes), there’s nothing in particular that they can test for that would indicate the presence of the disorder. A schizophrenia diagnosis often comes after every other possible cause of a person’s symptoms has been ruled out. Even brain imaging tests cannot diagnose the condition unequivocally. Some people affected by schizophrenia do not show the changes in the brain usually associated with the condition (or do not show them for many years). Others may show some of the signs but never develop visible symptoms. Many patients and those who love them wish that a test was available when it comes to diagnosing schizophrenia. However, a good mental health practitioner who has worked with schizophrenic patients before is the best option when it comes to obtaining the diagnosis patients need.