New DSM criteria for schizophrenia

Many exam specifications require students to be familiar with the clinical characteristics of the mental disorder they study.

The new DSM 5, published in May this year, has changed the criteria for a diagnosis of schizophrenia. However, the good news is, the changes are fairly small from the point of view of A level students.

The changes are as follows:

  • There is no longer a distinction between subtypes. There were 5 subtypes (paranoid, disorganised, cataonic, undifferentiated and residual) but it was felt that the criteria for these overlapped and the result was a lack of reliability in diagnosis. In addition the categorisation of patients by subtype was found to have little benefit for treatment.
  • There is now a requirement that an individual shows at least two symptoms from the following list: (1) delusions, (2) hallucinations, (3) disorganised speech, (4) grossly disorganised behaviour, (5) negative symptoms (e.g. diminished emotional response or avolition) (DSM 4 had only required one symptom). Therefore a single episode of bizarre delusions would no longer be sufficient for a diagnosis of schizophrenia.
  • In addition, one of the symptoms must be delusions, hallucinations or disorganised speech.
  • Continuous disturbance should persist for 6 months including at least 1 month of symptoms.
  • The symptoms are now rated on a dimensional scale to indicate the severity of the symptoms.

Many of these features were already in use in DSM 4R.

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  1. Keith E Rice September 11, 2013 at 4:33 pm #

    Thanks, Cara.

    Very helpful summary of the changes that should be easy to teach and for students to digest.

    The changes in DSM criteria make the distinction with ICD-10 criteria that much sharper – potentially good AO2 to be developed with a bit of thought! It will be interesting to see if ICD-11 follows a similar line or keeps the insistence on sub-types.


    • Cara Flanagan September 11, 2013 at 4:36 pm #

      Thanks Keith! Some useful extra points. And thanks for prompting me to write something.

  2. SajDevshi April 16, 2014 at 8:07 pm #

    Hey Cara,

    Thanks for posting this it is appreciated,


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