How Schizophrenia Is Diagnosed

Different factors will help your psychiatrist make a diagnosis

Stressed woman
Juanmonino / Getty Images

Schizophrenia is a type of mental illness characterized by symptoms of psychosis, which can make you appear out of touch with reality. 

There is no blood test or brain scan to diagnose schizophrenia. Only someone with special training, like a psychologist or psychiatrist, can accurately diagnose of schizophrenia. if your mental health practitioner believes you have schizophrenia, they will speak with you and perform some psychological tests to determine your mental health history, beliefs and evaluate any symptoms you may be experiencing.

 

Types of Schizophrenia Symptoms

There are three types of schizophrenia symptoms that a doctor will look for when trying to make a diagnosis—positive, negative, and cognitive symptoms.

Positive symptoms are psychotic symptoms that can make you appear to be out of touch with reality. These include: 

  • Delusions
  • Hallucinations
  • Disorganized speech
  • Disorganized behavior and movement 

Negative symptoms appear as disruptions to what are considered normal behaviors and emotions. Symptoms include: 

  • "Flat affect" muted facial expressions and emotions 
  • Reduced feelings of joy 
  • Difficulty speaking and expressing oneself 

While positive and negative symptoms are key to diagnosing schizophrenia, cognitive symptoms can help your psychiatrist make a diagnosis as well. Cognitive symptoms can include: 

  • Poor decision-making  
  • Difficulty paying attention
  • Trouble using your working memory  

Beyond evaluating your symptoms, you doctor will likely ask about your family history.

Having a family member with schizophrenia increases your risk of developing the condition.

Five Types of Schizophrenia

There are five basic subtypes of schizophrenia, which are distinguished by how symptoms are experienced. 

  • Paranoid Type Schizophrenia. This type of schizophrenia frequently includes hallucinations or delusions fixated on a theme that often involves being plotted against, betrayed or persecuted. Negative symptoms such as flattened affect, catatonia, or disorganized speech are not as prominent as in other types of schizophrenia.
  • Disorganized Type Schizophrenia. Symptoms include disorganized behavior and speech as well as negative symptoms, but relatively fewer hallucinations or delusions.
  • Catatonic Type Schizophrenia. This diagnosis is made when the most prominent symptoms are bizarre behavior and abnormal activity, either very little activity or overly excited behavior.
  • Undifferentiated Type Schizophrenia. This type of schizophrenia features a mixture of psychotic symptoms—delusions, hallucinations, disorganized speech, disorganized behavior, and negative symptoms—with no one type of symptom dominating.
  • Residual Type Schizophrenia. This diagnosis is rarer and describes a person who, at one time, met the criteria for one of the other four types but no longer has significant delusions, hallucinations, disorganized speech or disorganized behavior. To meet this diagnosis, you will either have negative symptoms like flattened affect or reduced activity or speech, or have greatly reduced, residual positive symptoms like delusions, hallucinations, or disorganized speech or behavior.

Other Psychotic Disorders

Most of the symptoms of schizophrenia are symptoms of psychosis, but it is possible to have psychotic symptoms without having schizophrenia.

Other psychotic disorders include:

  • Schizophreniform Disorder
  • Schizoaffective Disorder
  • Brief Psychotic Disorder
  • Delusional Disorder
  • Shared Psychotic Disorder
  • Psychotic Disorder Due to a General Medical Condition
  • Substance-Induced Psychotic Disorder
  • Psychotic Disorder Not Otherwise Specified

There are also disorders that can have psychosis as a symptom, including mood disorders with psychosis, cognitive disorders with psychosis, and personality disorders. If you think you may have or if you have been diagnosed with schizophrenia, seek professional help. It’s important to begin treatment as soon as possible to best manage your symptoms.

It is possible to control your symptoms with the help of a mental health practitioner, treatment plan, and prescription medication. 

Sources

  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Washington, DC: American Psychiatric Association, 2000.
  • Morrison, J. DSM-IV Made Easy: the Clinician’s Guide to Diagnosis. New York: The Guilford Press, 2006.
  • National Institute of Mental Health. Schizophrenia. 2016. 
  • Schizophrenia: a detailed booklet that describes symptoms, causes, and treatments, with information on getting help and coping. National Institutes of Mental Health. (2006) 
  • Torrey, E.F. Surviving Schizophrenia: a Manual for Families, Patients, and Providers, 5th Edition. New York: HarperCollins Publishers, 2006.

Continue Reading