Schizophrenia Criteria: What Makes A Person Schizophrenic?

Reviewed by Aaron Horn, LMFT

Published 12/22/2020

Whether you have realized it or not, schizophrenia is a common mental illness. You can often see it referenced in pop culture like movies, TV series, and books. You might even use it casually to describe someone inconsistent or distant. However, there is so much more to schizophrenia and a schizophrenic person.

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Here, you’ll learn more about schizophrenia – as well as what it isn’t. You’ll also find out more about the specific diagnostic criteria that mental health professionals use when identifying patients with schizophrenia, the most common treatments for schizophrenia, and how you can support a loved one if they’re suffering from schizophrenia. Let’s get started!

What Schizophrenia Is

To put it in the most basic terms, schizophrenia is an intense and serious mental illness that impacts a person’s entire life. It affects everything from how they think and feel, to how they behave. A person’s schizophrenia also has a large effect on those around them.

Often, when schizophrenia is portrayed in pop culture, it is linked to multiple personality disorder. In fact, schizophrenia and multiple personality disorder are depicted as being the same thing in many cases. When a fictional character supposedly has schizophrenia, they are shown as talking to or hearing from many different voices in their head or slipping in and out of different personalities separate and discrete. However, schizophrenia and multiple personality disorders are not the same. Many researchers believe they aren’t even closely related. Pop culture distorts these disorders, and for this reason, many people have an incorrect view of schizophrenia.

Schizophrenia can be recognized by some very clear symptoms that doctors and mental health professionals are trained to notice. Let’s take a look at some of these diagnostic criteria and the common symptoms of schizophrenia.

Diagnosing Schizophrenia

Just like any other illness, doctors use a list of symptoms to diagnose a patient with schizophrenia. These symptoms are spelled out in the American Psychiatry Association’s (APA) publication called DSM-5, which is the most recent and up-to-date diagnostic manual for mental health professionals. The APA defines schizophrenia with the following diagnostic criteria:

“The individual experiences two or more of the following for a significant portion of time for 1 month. And at least one of these must be (1), (2), or (3):

1) Delusions

2) Hallucinations

3) Disorganized speech (incoherence or derailment)

4) Completely disorganized or catatonic behavior

5) Negative symptoms, such as diminished emotional expression

For a significant amount of time since the disturbance began, the level of functioning in one or more significant areas (e.g., work, interpersonal relations, or self-care) is clearly below the level achieved before onset.

  • There is a failure to achieve the expected level of interpersonal, academic, or occupational functioning in children or adolescents.

Signs of the disturbance continue for 6 months or longer. This period must include at least 1 full month of symptoms that meet the first criteria and may have periods of residual symptoms. During these residual periods, the disturbance signs may be manifested only by negative symptoms or by two or more symptoms outlined in the first criteria, only in a lesser form.

The disturbance cannot be better explained by schizoaffective disorder, depressive, or bipolar disorder because either:

No major depressive or manic episodes have occurred concurrently with the active-phase symptoms or…

If mood episodes have occurred during active phase symptoms, it’s been for a minor amount of time.

The disturbance cannot be attributed to the physiological effects (e.g., a drug of abuse or medication) or another medical condition.

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Suppose the individual has a history of autism spectrum disorder or a communication disorder of childhood-onset. In that case, the additional diagnosis of schizophrenia is only made if delusions or hallucinations, as well as the other required symptoms of schizophrenia, are present for a month or more” (American Psychiatry Association, DSM-5).

In addition to these technical diagnoses, there are some observable symptoms of schizophrenia that you might observe for yourself.

  • An episode of psychosis, such as displaying psychotic symptoms such as altered perceptions, abnormal thinking, and out-of-the-ordinary behavior
  • Acute and noticeable changes in the person’s sensory perception, such as vision, hearing, touch, taste, or smell
  • Hallucinations involve hearing or seeing things that aren’t really there.
  • Irrational fear, paranoia, and delusions that are not rooted in reality
  • Unusual thinking thought disorder or disorganized speech.
  • Negative symptoms, such as being disinterested in things that they are usually quite interested in, withdrawal from their normal social circles, and difficulty functioning in their day-to-day lives
  • “Flat affect,” or fewer and less obvious facial expressions or voice tones
  • Cognitive symptoms, such as difficulty paying attention or concentrating
  • Problems with their memory
  • Difficulty making decisions and processing necessary information

If you’re interested in learning more about whether you or someone close to you is at risk for developing schizophrenia symptoms, you can check out this schizophrenia quiz. Through this quiz, you’ll learn more about the symptoms of schizophrenia as they present in everyday life. You’ll also be able to find some great resources for exploring treatment options for schizophrenia and other mental health issues.

Treating Schizophrenia

When it comes to treatment for schizophrenia, it usually requires a very intense course of therapy, which involves psychological and social aspects. Mental health professionals will often employ cognitive behavioral therapy and cognitive remediation interventions on the psychological therapy side. During these treatments, the mental health professional seeks to understand the thought processes that underlie their patient’s behavior. The mental health professional then attempts to help the patient realize how their thinking processes and thought patterns contribute to their feelings and actions. The ultimate goal of these therapy treatments is to affect change in the patient’s behavior.

Socially focused treatment options are also available for treating schizophrenia. These include programs such as skill training and supported employment. These approaches aim to get the patient to fit into the wider social setting despite their schizophrenia. The patient receives guided support from the mental health professionals throughout the entire process. With the professionals' help, the patient can learn ways to minimize and reduce the effect of their schizophrenia on their life and their role in the larger society.

In intense or extreme cases of schizophrenia, the patient will likely have to go through coordinated specialty care. This involves working with an entire network of mental health professionals, and it is usually implemented in the early stages of schizophrenia. It is usually started during the patient’s first episode of psychosis. This type of treatment for schizophrenia is designed to keep it from getting worse as time goes on.

Loving Someone With Schizophrenia

If one of your loved ones is diagnosed with schizophrenia, you are probably wondering what you can do to support them through the process of dealing with schizophrenia. One of the best things you can do for a loved one suffering from schizophrenia is to encourage them to get professional help. This might look like practical and logistical help, such as driving them to their appointments. But there is also the emotional and moral support: you should remind them often that getting professional service is the right thing to do, that you’re proud of them for seeking help, and that there is absolutely no shame in getting professional help.

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Also, it’s important to remember that for a person who is struggling with schizophrenia, their hallucinations and beliefs seem extremely real to them. The way they perceive reality may not be accurate, but it is the reality that they are experiencing. So, you should acknowledge what they’re expressing, even if you don’t agree with it. Let them know that you see things differently, but that everyone see things their own way, and that you love and support them even if you don’t agree with their view of reality at the moment.

Supporting a loved one through schizophrenia isn’t easy, but friends and family's involvement in getting treatment is a massive benefit to the patient!

Conclusion

Schizophrenia is an intense and serious mental illness that touches millions of people's lives. It is often mischaracterized in the media and popular culture, which means that many people confuse schizophrenia with multiple personality disorder. However, they are not the same thing. Doctors and researchers have yet to find a single, definite, cause of schizophrenia. They can still accurately diagnose schizophrenia by adhering to a list of strictly curated symptoms in the DSM-5. You can also recognize symptoms of schizophrenia in your daily interactions with people since the symptoms affect their thinking, feelings, and behavior. Treatment for schizophrenia often involves therapy, social support, and deep understanding and involvement from the patient’s loved ones.