Schizophrenia, Schizophreniform, and Schizoaffective Disorders
F20.xx Schizophrenia
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):
- Delusions
- Hallucinations
- Disorganized speech (e.g., frequent derailment or incoherence)
- Grossly disorganized or catatonic behavior
- Negative symptoms, such as affective flattening, alogia, or apathy
Note: Only one symptom is required in Criterion A if delusions are bizarre, or if delusions consist of a voice commenting on the person’s thoughts or behavior, or if two or more voices are 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 relationships, or self-care, are markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, there is a failure to achieve the expected level of interpersonal, academic, or occupational functioning).
C. Duration
Continuous signs of the disturbance persist for at least six months. This six-month period must include at least 1 month of symptoms that meet Criterion A (or less if successfully treated) 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 by two or more symptoms listed in Criterion A present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences).
D. Exclusion of Schizoaffective Disorder and Mood Disorder
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. Exclusion of Substance Use and Medical Condition
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 1 month (or less if successfully treated).
Schizophreniform Disorder F20.8 (295.40)
A. Criteria A, D, and E for schizophrenia are met.
B. An episode of the disorder (including prodromal, active, and residual phases) lasts at least 1 month but less than 6 months. (When the diagnosis must be made without waiting for recovery, it is qualified as “provisional.”)
Specify if:
- Without Good Prognostic Features
- With Good Prognostic Features: as indicated by two (or more) of the following:
- Onset of prominent psychotic symptoms within 4 weeks of the first noticeable change in usual behavior or functioning.
- Confusion or perplexity at the height of the psychotic episode.
- Good premorbid social and occupational functioning.
- Absence of blunted or flat affect.
F25.x Schizoaffective Disorder (295.70)
A. An uninterrupted period of illness during which, at some time, there is either a major depressive episode, a manic episode, or a mixed episode concurrent with symptoms that meet Criterion A for schizophrenia.
Note: The major depressive episode must include Criterion A1: Depressed mood.
B. During the same period of illness, there have been delusions or hallucinations for at least 2 weeks in the absence of prominent mood symptoms.
C. Symptoms that meet criteria for a mood episode are present for a substantial portion of the total duration of the active and residual periods of the illness.
D. 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.
Specify type:
- Bipolar Type: if the disturbance includes a manic or mixed episode (or a manic or mixed episode and major depressive episodes)
- Depressive Type: if the disturbance only includes major depressive episodes