DSM IV

A. Schizophrenia and other Psychotic Disorders 

Diagnostic criteria for Schizophrenia 

A. Characteristic Symptoms: 2 or more of the ff. symptoms , present for a significant portion of time during a 1 month period (or less if successfully treated.)

Delusions  Hallucinations  Disorganized speech (derailment or incoherence)  Grossly disorganize or catatonic behavior  Negative symptoms (affective flattening, alogia, or avolition) 

Note: only one criteria A symptom if delusions are bizzare or hall.



B. Social/Occupational dysfunction Significant portion of time since the onset of the disturbance, one or more areas of functioning such as work, interpersonal relations, or self care markedly beloe the level ahieved prior to the onset. 

C. Duration 

Continuous signs of disturbances persist for 6 months. This 6 month period must include at least 1 month of symptoms (or less if successfully treated) that meet criterion A and may include prodromal and residual symptoms, it may be only a negative symptom or two or more symptoms listed in Criterion A.

. or mixed episodes have occurred concurrently with the active symptoms. (2)if mood episodes have occurred during the active phase symptoms.D. manic. Schizoaffective and Mood Disorder exclusion  Psychotic features have been ruled out because either. (1) no major de pressive. their total duration has been brief relative to the duration of the active and residual periods.

Substance/general medical condition exclusion  The disturbance is not due to the direct physiological effects of a substance or a general medical condition .E.

F. Relationship to a pervasive developmental disorder  If (+) history of autistic disorder or any pervasive developmental disorder. the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations are (+) for at least 1 month .

1. Schizophrenia and its Subtypes .

disorganize speech. catatonic behavior or flat or inappropriate affect  .Paranoid type  Preoccupation with one or more delusions or frequent auditory hallucinations None of the ff.

c. b. All of the following are prominent: Disorganized speech Disorganized behavior Flat or inappropriate affect a.Disorganize Type  A. Criteria are not met for Catatonic type . B.

Catatonic type  1. prominent mannerisms or grimacing Echolalia or echopraxia . Dominated by at least two of the following Motoric immobility. 2. 3. 4. 5. stereotype movements. catalepsy (waxy flexibility) or stupor Excessive motor activity Extreme negativism or mutism Peculiarities of voluntary movements as evidenced by posturing.

disorganized or catatonic type .Undifferentiated type  A type of schizophrenia in which symptoms that meet Criterion A are present. but criteria are not met for the paranoid.

hallucinations. Continuous presence of disturbances. disorganize speech and grossly disorganize or catatonic behavior.Residual Type  Absence of prominent delusions. presence of a negative symptoms or two or more symptoms listed in Criterion A for Schizphrenia  .

2. Schizophreniform Disorder .

3. Onset of prominent psychotic s/sx w/n 4 weeks Confusion or perplexity at the height of the psychotic episode Good premorbid social and occupational functioning absence of blunted or flat affect . )  1. D and E are met  An episode of the d/o lasts at least 1 month but less than 6 months. Specify if Without good prognostic features With good prognostic features (2 or more of the ff. 2.Schizophreniform Disorder Criteria A.

3. Schizoaffective Disorder .

Note: the Major depressive episode must include Criterion AI: depressed mood  . manic episode or mixed episode concurrent with the symptoms that meet Criterion A for Schizophrenia.Schizoaffective Disorder  Uninterrupted period of illness. at the same there is major depressive episode.

 Symptoms that meet the criteria for a mood episode are present for a substantial portion of the total duration of the active and residual periods of illness.  The disturbance is not due to the direct physiological effects of a substance  .During the same period of illness. hallucination and delusion for at least 2 weeks in the absence of prominent mood symptoms.

Specific type Bipolar type: manic or a mixed episode (or even Major Depressive Episodes)  Depressive Type: major depressive episodes Only  .

Brief Psychotic Disorder .4.

Disorganized speech (derailment or incoherence) d. Hallucinations c. Delusions b. Grossly disorganize or catatonic behavior . Presence of one or more of the following a.Brief Psychotic Disorder A.

B. Schizoaffective Disorder or Schizophrenia and not due to the physiologic effect of drug or substance Specify if With marked Stressor(s) ± response to events Without marked Stressor(s) ± do not occur shortly after a response With post partum onset. The disturbance is not accounted for by Mood disorder with psychotic features. Duration is at least 1 day but less than 1 month C.onset within 4 weeks post partum onset- .

5. Delusional Disorders .

Criterion A in Schizophrenia has never been met.A. the total duration has been brief relative to the duration of the delusional periods . C. Non bizarre delusions of at least 1 month duration B. Apart from impacy of delusions. functioning is not markedly impaired and behavior is not obviously bizarre or odd D. Note Tactile and olfactory hallucinations may be present if they are related to the delusional theme. Mood episodes occurred with delusions.

power.E. The disturbance is not due to the physiologic effect of drug or substance Types according to theme Erotomatic type: Delusions that others usually of higher status is in love with the individual Grandiose type: inflated worth. knowledge. identity or special relationship to a deity or famous person Jealous type: partner is unfaithful Persecutory type: is being malevolently Somatic type: physical defect or medical condition Mixed type: more than the above types but no theme predominates .

6. Substance Induced Psychosis .

Evidence of history.Substance Induced Psychosis A. Symptoms in Criterion A. developed during oe within a month o substance intoxication ow withdrawal 2. medication use is etiologically related to the disturbance . findings of either 1. Prominent hallucinations or delusions (note do not include hallucinations if the person has insight that they are substance induced) B.

D.C. The disturbance does not occur exclusively during the course of delirium Note: This diagnosis should be made instead of a diagnosis of substance intoxication or withdrawal only when the symptoms are in excess associated with the intoxication and when symptoms are sufficiently severe to warrant independent clinical attention . The disturbance is not better accounted for by a psychotic disorder that is not substance induced.

Shared Psychosis .7.

Shared Psychosis A. C. Delusion develops in an individual in the context of close relationship with another person The delusion is similar in the content to that person who already has established delusion The disturbance is not better accounted for by another psychotic disorder or mood disorder with psychotic features and is not due to the direct physiological effects of a substance or a general medical condition. . B.

8. Psychotic Disorder not otherwise Specified .

.8. Psychotic Disorder not otherwise Specified Includes psychotic symptomatology about which there is in adequate information to make a specific diagnosis which there is a contradictory information or disorders with psychotic symptoms that do not meet criteria for any specific psychotic disorder.

Mood/Affective Disorder .B.

Depressive Disorder .1.

Five or more of the ff symptoms during the same 2week period and represent change in previous functioning. at least one of the symptoms either (1) depressed mood or (2) loss of interest or pleasure.A. Note: do not include symptoms clearly due to general medical condition or mood incongruent delusions or hallucinations . Major Depressive Disorder A.

nearly every day. activities most of the day. almost.      Depressed mood most of the day Markedly diminished interest or pleasure in all. or decrease or increase in appetite nearly everyday. Insomnia or hypersomnia nearly everyday Psychomotor agitation or retardation nearly everyday Fatigue or loss of energy nearly everyday . Significant weight loss when not dieting or weight gain.

or a suicide attempt.Feelings of worthlessness or inappropriate guilt nearly everyday  Diminished ability to think or concentrate nearly everyday  Recurrent thoughts of death. recurrent suicidal ideation without a specific plan.  .

B. E. Symptoms are not due to direct physiological effects of a substance or a general medical condition. The symptoms do not meet criteria for a mixed episode C. occupational or other important areas of functioning D. . Symptoms are not better accounted for by bereavement persist for longer than 2 months. The symptoms cause clinically significant distress or impairment in social.

Dysthymia .B.

      Depressed mood most of the day. Presence.Dysthymia A. while depressed of two or more of the following. B. Poor appetite/overeating Insomia/hypersomnia Low energy/fatigue Low self esteem Poor in concentration Feelings of hopelessness . observed by others for at least 2 years.

Mixed or a hypomanic and have never been mey for cyclothymic disorder. No major Depressive episode has been persistent during the first 2 years of disturbance E. There has never been episodes of Manic.c. the person has never been without the symptoms in Criteria A and B for more than 2 months time. . D. During the 2 year period (1 year for children and adolescents) of the disturbance.

H.F. occupational or other important areas of functioning . The disturbance does not occur exclusively during the course of a chronic psychotic disorder. The symptoms cause clinically significant distress or impairment in social. G. Symptoms are not due to direct physiological effects of a substance or a general medical condition.

Early onset: onset before the age of 21years. Late onset: onset is 21 years and older.Specify if. .

Depressive disorder not otherwise specified .C.

Premenstrual dysphoric ± In most menstrual cycles during the past year.Depressive disorder not otherwise specified   Does not fit with the other criteria of depressive disorders. . Examples of Depressive disorder not otherwise specified include 1. symptoms regularly occurred during the last week of the luteal phase.

Recurrent brief depressive disorderlasting 2 days to 2 weeks.2. Postpsychotic depressive disorder of schizophreniaschizophrenia. occurring at least once a month for 12 months 4.a major depressive disorder that occurs during the residual phase of schizophrenia .episodes of at disorderleast 2 weeks of depressive symptoms but with fewer than the five items required for a major depressive disorder disorder3. Minor depressive disorder.

A major depressive episode superimposed on delusional disorder. psychotic disorder not otherwise specified or the active phase of schizophrenia 6. . Situations in which the clinician has concluded that a depressive disorder is present but unable to determine whether it is primary. due to a general medical condition or substance induced.5.

D. Minor Depression .

Man and women age 18-85 who meet the criteria 18for minor depression are eligible to participate. .Minor Depression It may impair a persons functioning and quality of life and is a serious risk factor for major depression. They must have experienced depressive symptoms for at least 6 months but less than 2 years continuously without meeting criteria for a major depressive episode or dysthymia with the past year. Yet it is under diagnosed and untreated.

They include   Either a depressed mood most of the day Or a markedly diminished interest or pleasure in daily activities .Its symptoms are the same as those of major depression. though fewer in number and causing less impairment.

Plus two of the following symptoms         Significant weight loss or gain. indecisiveness Recurrent thoughts of death suicide Symptoms must last at least 6 mos but < 2 years . decrease or increase appetite Disturbance in sleep pattern Noticeable agitation or slowness Fatigue Inappropriate feelings of worthlessness or guilt Diminished ability to concentrate.

2. Bipolar Disorder .

lasting at least 1 week (or any duration if hospitalization is necessary) . or irritable mood.Bipolar Disorder A distinct period of abnormally and persistently elevated. expansive.

Three or more of the following (four if the mood is only irritable)        Inflated self esteem Decreased need for sleep More talkative than the usual or pressure to keep talking Flight of ideas or subjective experience that thoughts are racing Distractibility Increase in goal directed activity Excessive involvement in pleasurable activities .

The symptoms do not meet the criteria for a mixed episode D. Symptoms are not due to direct physiological effects of a substance or a general medical condition. .C. Mood disturbances can severely cause impairment in occupational functioning E. Note: Episodes that are clearly caused by somatic antidepressants should not count toward a diagnosis of bipolar I disorder.