Schizophrenia: Definition, Symptoms, and Treatments

How Does the DSM-5-TR Define Schizophrenia?

The Diagnostic and Statistical Manual 5, Text Revision (DSM-5-TR) is the manual mental health professionals use to diagnose mental health disorders. Schizophrenia appears in the manual under “Schizophrenia Spectrum and Other Psychotic Disorders.” To diagnose a person with schizophrenia, a person must have two or more of the following symptoms present for a significant portion of time over the course of a month.

A person must have at least one of the first three symptoms for a doctor to diagnose the condition. These include:

• delusions
• hallucinations
• disorganized speech
• grossly disorganized or catatonic behavior
• negative symptoms, such as diminished emotional expressions

A person also must experience significant social and occupational performance changes for at least six months for a doctor to diagnose their condition.

A doctor must also rule out other conditions that may have somewhat similar symptoms. These include schizoaffective, depressive, or bipolar disorders. A person’s symptoms also cannot be related to taking medications (including illegal drugs) or other underlying medical conditions.

What Are the Types of Schizophrenia?

While the DSM-5-TR does not define different schizophrenia types, many mental health professionals recognize different clinical subtypes. These were outlined in previous versions of the DSM.  Examples of different clinical subtypes include paranoid, delusional/hallucination, and catatonic types. These are further explained in additional Symptom Media courses.

What Are the Symptoms of Schizophrenia?

Symptoms of schizophrenia tend to appear earlier in men than women. Men tend to begin experiencing symptoms in their late teenage years to early 20s while women have symptoms in their early 20s to 30s.³

Often, a person’s first schizophrenia symptoms are those of psychosis. This is when a person experiences altered perceptions of reality. They may hear, see, smell, or taste things that aren’t there. Their symptoms may include:

• Hallucinations: Seeing or hearing things that aren’t there
• Delusions: Believing things that are not true, often paranoid concepts. This may include that a person’s friends or family are “out to get them” or that a person is receiving secret messages through the television or radio.
• Problems thinking clearly: A person’s speech may become disorganized or difficult to understand as well.

Doctors consider these symptoms “positive” symptoms while some people with schizophrenia have “negative” symptoms. These include the following:

• Disinterest in activities one once enjoyed
• “Flat” facial expressions or flat vocal tone
• Lack of motivation
• Poor or no speaking

A person with schizophrenia may also experience changes in thinking that affect their decision-making, ability to pay attention, or to process information.

What Are Examples of Schizophrenia Treatment?

Schizophrenia treatments depend upon the symptom types a person is experiencing. Treatments usually include a combination of medications and counseling to help a person manage their symptoms. Examples include:

• Anti-psychotic medications: These medications are available in pill, injection, or liquid forms. Doctors may prescribe first-line anti-psychotics that have fewer symptoms, but if a person doesn’t respond to them, a doctor may consider prescribing other medications, such as clozapine.
• Mental health support: Therapies such as cognitive behavioral therapy and behavioral skills training can help a person learn how to better cope with their schizophrenia symptoms.

Because schizophrenia symptoms can vary based on the person, it’s important that a doctor treat a person as an individual and consider how a person’s schizophrenia affects them.

Call to Action: As a care provider, you may encounter patients diagnosed with schizophrenia. To find out more about this disorder and how it’s treated, please see Symptom Media’s learning tools on schizophrenia and its types.