Running head: SCHIZOPHRENIA DIAGNOSTIC CHANGES
SCHIZOPHRENIA DIAGNOSTIC CRITERIA CHANGES
Schizophrenia Diagnostic Criteria Changes Between the DSM-IV-TR and DSM-5
Schizophrenia Diagnostic Changes Between the DSM-IV-TR and DSM-5
Schizophrenia is a complex mental disorder that has existed for over a century. It was first identified in 1898 by psychiatrists Dr. Emile Kraeplin and Dr. Eugen Bleuler as dementia praecox; early onset and an intellectual deterioration. In 1908, Dr. Eugen Bleuler changed the name to schizophrenia (schizein “split” and phren “mind”) because he no longer believed there was an early onset or progression towards dementia (Blackstein, Davidson, Flett, & Neale, 2014). Since then, immense research has gone into the schizophrenia diagnosis. In May 2013, the most recent Diagnostic and Statistical Manual for Mental Disorders (DSM-5) was released. In order to be considered for a diagnosis there must be, “abnormalities in one or more of the following domains: delusions, hallucinations, disorganized thinking (speech), grossly disorganized or abnormal motor behaviour (including catatonia), and negative symptoms” (American Psychiatric Association, 2013a, p. 87). The disorder is still vastly misunderstood, yet the improvements since the previous DSM-IV-TR have made diagnoses more precise and accurate.
DSM-IV-TR Diagnostic Criteria
According to the DSM-IV-TR, there are a variety of symptoms that make up the disorder schizophrenia. Criterion A symptoms include: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behaviour and negative symptoms. The symptoms are separated by two broad categories – positive and negative. The positive symptoms are a distortion of normal functions, that include hallucinations, delusions, disorganized speech and grossly disorganized or catatonic behaviour. The negative symptoms are a decrease in normal functions such as emotional control and the fluency of thought and speech. Two out of the five Criterion A symptoms must be present to be considered for a diagnosis, or one out of the five if the hallucinations or delusions are considered bizarre or first-rank (American Psychiatric Association, 2000).
Schizophrenia is split into five subtype diagnoses in the DSM-IV-TR: paranoid, disorganized, catatonic, undifferentiated and residual. The paranoid type is diagnosed when delusions or hallucinations are prominent. The delusions and hallucinations are often related and can result from themes of persecutory, jealousy, religiosity or somatization. The disorganized type is diagnosed when disorganized speech or behaviour is present. The individual may become silly at inappropriate times or is unable to complete daily living tasks (hygiene, finance management, goal orientation). Catatonic type is diagnosed when an individual alternates between immobility and excitement. They will often do repetitive actions such as echo the speech of others and...