Schizophrenia classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2], Irfan Dotani

• Historically, schizophrenia in the West was classified into simple, catatonic, hebephrenic (now known as disorganized), and paranoid.
• The DSM- IV contains five sub-classifications of schizophrenia: Paranoid, disorganized, catatonic, undifferentiated and residual type, but, this classification has been eliminated due to their limited diagnostic stability, low reliability and poor validity.^[1]

• There is no established system for the classification of schizophrenia as per the diagnostic and statistical manual of mental disorders, Fifth Edition, (DSM-V)

• According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM-V, to meet the criteria for diagnosis of schizophrenia, the patient must have experienced at least 2 (or more) of the following symptoms:^[2]
  • Delusions
  • Hallucinations
  • Disorganized speech
  • Disorganized or catatonic behavior
  • Negative symptoms
  • At least 1 of the symptoms must be the presence of delusions, hallucinations, or disorganized speech.

• Continuous signs of the disturbance must persist for at least 6 months, during which the patient must experience at least 1 month of active symptoms (or less if successfully treated), with impairment in social, occupational and other significant areas of functioning. The symptoms are not attributable to any other psychiatric, medical, or substance use disorder.^[3]

• If there is a history of autism spectrum disorder or a communication disorder of childhood onset, diagnosis of schizophrenia is made only if prominent delusions or hallucinations, in addition to the other required symptoms of schizophrenia, are also present for at least 1 month(or less if successfully treated).^[4]

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