Skip to main content

Schizophrenia

  • Chapter
Diagnostic Interviewing

Abstract

Schizophrenia is a complex and confusing illness that can baffle family members, friends, the patient, and mental health professionals alike. Schizophrenia can be contrasted to psychiatric illnesses such as major depression, manic-depression, and anxiety disorders that were described long ago by Hippocrates as common behavioral disturbances. Schizophrenia has been recognized only over the past 100 years as a separate illness with its own unique pattern of onset, symptomatology, course, and treatment. The diagnosis of schizophrenia can be complicated by two important factors. First, the symptoms of the illness overlap with many other disorders (e.g., affective disorders, substance abuse), requiring careful attention to issues of differential diagnosis. Second, patient self-report is critical in establishing the diagnosis of schizophrenia, yet many patients deny the characteristic symptoms or are inconsistent in their report of these internal experiences. While there are difficulties inherent in the assessment of schizophrenia, accurate diagnosis has important implications for pharmacological and psychosocial intervention for the disorder. Indeed, misdiagnosis can result in ineffective treatment and a poor outcome. In order to diagnose schizophrenia accurately, the interviewer must possess an adequate fund of knowledge about the psychopathology of the illness, the relative merits of available assessment instruments, interviewing techniques, and methods for obtaining information necessary for the assessment. We begin this chapter with an overview of the nature of schizophrenia, including its prevalence, course, and outcome, followed by a review of its symptomatology and the criteria for its diagnosis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders ( 3rd ed. ). Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., revised). Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders ( 4th ed. ). Washington, DC: Author.

    Google Scholar 

  • Bellack, A. S., Mueser, K. T., Gingerich, S., & Agresta, J. (1997). Social skills training for schizophrenia: A step-by-step guide. New York: Guilford.

    Google Scholar 

  • Bleuler, E. (1950). Dementia praecox or the group of schizophrenias (J. Zinken, Trans. [1911]). New York: International Universities Press.

    Google Scholar 

  • Bond, G. R., Becker, D. R., Drake, R. E., Rapp, C. A., Meister, N., Lehman, A. E, Bell, M. D., & Blyler, C. R. (2001). Implementing supported employment as an evidence-based practice. Psychiatric Services, 52, 313–322.

    Article  PubMed  Google Scholar 

  • Bond, G. R., Drake, R. E., Becker, D. R., & Mueser, K. T. (1999). Effectiveness of psychiatric rehabilitation approaches for employment of people with severe mental illness. Journal of Disability Policy Studies, 10, 18–52.

    Google Scholar 

  • Bracha, H. S., Wolkowitz, O. M., Lohr, J. B., Karson, C. N., & Bigelow, L. B. (1989). High prevalence of visual hallucinations in research subjects with chronic schizophrenia. American Journal of Psychiatry, 146, 526–528.

    PubMed  Google Scholar 

  • Bruce, M. L., Takeuchi, D. T., & Leaf, P. J. (1991). Poverty and psychiatric status. Archives of General Psychiatry, 48, 470–474.

    Article  PubMed  Google Scholar 

  • Buchsbaum, M. S. (1990). The frontal lobes, basal ganglia, and temporal lobes as sites for schizophrenia. Schizophrenia Bulletin, 16, 379–389.

    Article  PubMed  Google Scholar 

  • Bustillo, J., Lauriello, J., Horan, W., & Keith, S. (2001). The psychosocial treatment of schizophrenia: An update. American Journal of Psychiatry, 158, 163–175.

    Article  PubMed  Google Scholar 

  • Cornblatt, B. A., Lenzenweger, M. F., Dworkin, R. H., & Erlenmeyer-Kimling, L. (1992). Childhood attentional dysfunctions predict social deficits in unaffected adults at risk for schizophrenia. British Journal of Psychiatry, 161(Suppl. 18 ), 59–64.

    Google Scholar 

  • Crow, T. J. (1990). Meaning of structural changes in the brain in schizophrenia. In A. Kales, C. N. Stefanis, & J. Talbott (Eds.), Recent advances in schizophrenia (pp. 81–94 ). New York: Springer-Verlag.

    Google Scholar 

  • Davies, N., Russell, A., Jones, P., & Murray, R. M. (1998). Which characteristics of schizophrenia predate psychosis. Journal of Psychiatric Research, 32, 121–131.

    Article  PubMed  Google Scholar 

  • Deering, C. G., Glover, S. G., Ready, D., Eddleman, H. C., & Alarcon, R. D. (1996). Unique patterns of comorbidity in posttraumatic stress disorder from different source of trauma. Comprehensive Psychiatry, 37, 336–346.

    Article  PubMed  Google Scholar 

  • Done, D. J., Crow, T. J., Johnstone, E. C., & Sacker, A. (1994). Childhood antecedents of schizophrenia nd affective illnesses: Social adjustment at ages 7 and 11. British Medical Journal, 309, 699–703.

    Article  PubMed  Google Scholar 

  • Endicott, J., & Spitzer, R. L. (1978). A diagnostic interview: The Schedule for Affective Disorders and chizophrenia. Archives of General Psychiatry, 35, 837–844.

    Article  PubMed  Google Scholar 

  • First, M. B., Spitzer, R. L., Williams, J. B. W., & Gibbon, M. (1996). Structured Clinical Interview for DSM-IV-Patient Edition (SCID-P, Version 2.0). New York: Biometrics Research Department, New York State Psychiatric Institute.

    Google Scholar 

  • Flaum, M., Arndt, & Andreasen, N. (1991). The reliability of “bizarre” delusions. Comprehensive Psychiatry, 32, 59–65.

    Google Scholar 

  • Fox, J. W. (1990). Social class, mental illness, and social mobility: The social selection-drift hypothesis for serious mental illness. Journal of Health and Social Behavior, 31, 344–353.

    Article  PubMed  Google Scholar 

  • Goldstein, J. M. (1988). Gender differences in the course of schizophrenia. Journal of Psychiatry, 145, 684–689.

    Google Scholar 

  • Gould, R. A., Mueser, K. T., Bolton, E., Mays, V., & Goff, D. (2001). Cognitive therapy for psychosis in schizophrenia: A preliminary meta-analysis. Schizophrenia Research, 48, 335–342.

    Article  PubMed  Google Scholar 

  • Harding, C. M., Brooks, G. W., Ashikaga, T., Strauss, J. S., & Breier, A. (1987). The Vermont longitudinal study of persons with severe mental illness, I. Methodology, study sample, and overall status 32 years later. American Journal of Psychiatry, 144, 718–726.

    PubMed  Google Scholar 

  • Jablensky, A., & Sartorius, N. (1975). Culture and schizophrenia. In H. M. Van Praag (Ed.), On the origin of schizophrenia psychoses (pp. 99–124 ). Amsterdam: De Erven Bohn.

    Google Scholar 

  • Jibson, M. D., & Tandon, R. (1998). New atypical antipsychotic medications. Journal of Psychiatric Research, 32, 215–228.

    Article  PubMed  Google Scholar 

  • Kane, J. M. (1997). The new antipsychotics. Journal of Practical Psychiatry and Behavioral Health, 3, 343–355.

    Google Scholar 

  • Kay, S. R., & Sevy, S. (1990). Pyramidical model of schizophrenia. Schizophrenia Bulletin, 16, 537–545.

    Article  PubMed  Google Scholar 

  • Kirby, K. C., Hay, D. A., Daniels, B. A., Jones, I. H., & Mowry, B. J. (1998). Comparison between register and structured interview diagnoses of schizophrenia: A case for longitudinal diagnostic profiles. Australian and New Zealand Journal of Psychiatry, 32, 410–414.

    Article  Google Scholar 

  • Klosterkötter, J., Hellmich, M., Steinmeyer, E. M., & Schutze-Lutter, F. (2001). Diagnosing schizophrenia in the initial prodromal stage. Archives of General Psychiatry, 58, 158–164.

    Article  PubMed  Google Scholar 

  • Kraepelin, E. (1919). Dementia praecox and paraphrenia. Edinburgh: Livingston.

    Google Scholar 

  • Kramer, M. S., Vogel, W. H., DiJohnson, C., Dewey, D. A., Sheves, P., Cavicchia, S., Litle, P., Schmidt, R., & Kimes, I. (1989). Antidepressants in “depressed” schizophrenic inpatients. Archives of General Psychiatry, 46, 922–928.

    Article  PubMed  Google Scholar 

  • Kuriansky, J. B., Deming, W. E., & Gurland, B. J. (1974). On trends in the diagnosis of schizophrenia. American Journal of Psychiatry, 131, 402–408.

    PubMed  Google Scholar 

  • Levinson, D. F., & Levitt, M. M. (1987). Schizoaffective mania reconsidered. American Journal of Psychiatry, 144, 415–425.

    PubMed  Google Scholar 

  • Lewine, R. R. J. (1990). A discriminant validity study of negative symptoms with a special focus on depression and antipsychotic medication. American Journal of Psychiatry, 147, 1463–1466.

    PubMed  Google Scholar 

  • Liberman, R. P., DeRisi, W. J., & Mueser, K. T. (1989). Social skills training for psychiatric patients. New York: Pergamon Press.

    Google Scholar 

  • Matarazzo, J. D. (1983). The reliability of psychiatric and psychological diagnosis. Clinical Psychology Review, 3, 103–145.

    Article  Google Scholar 

  • Mattes, J. A., & Nayak, D. (1984). Lithium versus fluphenazine for prophylaxis in mainly schizophrenic schizo-affectives. Biological Psychiatry, 19, 445–449.

    PubMed  Google Scholar 

  • Mellor, C. S. (1970). First rank symptoms of schizophrenia. British Journal of Psychiatry, 117, 15–23.

    PubMed  Google Scholar 

  • Milton, F., Patwa, V. K., & Hafner, R. J. (1978). Confrontation vs. belief modification in persistently deluded patients. British Journal of Medical Psychology, 51, 127–130.

    Article  PubMed  Google Scholar 

  • Morrison, R. L. (1988). Structured interviews and rating scales. In A. S. Bellack, & M. Hersen (Eds.), Behavioral assessment: A practical handbook (3rd ed., pp. 252–278 ). New York: Pergamon Press.

    Google Scholar 

  • Mueser, K. T., Bellack, A. S., Sr Blanchard, J. J. (1992). Comorbidity of schizophrenia and substance abuse: Implications for treatment. Journal Consulting and Clinical Psychology, 60, 845–856.

    Article  Google Scholar 

  • Mueser, K. T., Bellack, A. S., & Brady, E. U. (1990). Hallucinations in schizophrenia. Acta Psychiatrica Scandinavia, 82, 26–29.

    Article  Google Scholar 

  • Mueser, K. T., Bellack, A. S., Morrison, R. L., & Wade, J. H. (1990). Gender, social competence, and symptomatology in schizophrenia: A longitudinal analysis. Journal of Abnormal Psychology, 99, 138–147.

    Article  PubMed  Google Scholar 

  • Mueser, K. T., Bennett, M., & Kushner, M. G. (1995). Epidemiology of substance use disorders among persons with chronic mental illnesses. In A. F. Lehman & L. B. Dixon (Eds.), Double jeopardy: Chronic mental illness and substance use disorders (Vol. 3, pp. 9–25 ). Langhorne, PA: Harwood Academic.

    Google Scholar 

  • Mueser, K. T., Bond, G. R., & Drake, R. E. (2001). Community-based treatment of schizophrenia and other severe mental disorders: Treatment outcomes. Medscape Mental Health (online journal), 6, http:/ /psychiatry.medscape.com.

    Google Scholar 

  • Mueser, K. T., Douglas, M. S., Bellack, A. S., & Morrison, R. L. (1991). Assessment of enduring deficit and negative symptom subtypes in schizophrenia. Schizophrenia Bulletin, 17, 565–582.

    Article  PubMed  Google Scholar 

  • Mueser, K. T., & Glynn, S. M. (1999). Behavioral family therapy for psychiatric disorders ( 2nd ed. ). Oakland, CA: New Harbinger.

    Google Scholar 

  • Mueser, K. T., Goodman, L. B., Trumbetta, S. L., Rosenberg, S. D., Osher, F. C., Vidaver, R., Auciello, P., & Foy, D. W. (1998). Trauma and posttraumatic stress disorder in severe mental illness. Journal of Consulting and Clinical Psychology, 66, 493–499.

    Article  PubMed  Google Scholar 

  • Mueser, K. T., Rosenberg, S. D., Goodman, L. A., & Trumbetta, S. L. (2002). Trauma, PTSD, and the course of severe mental illness: An interactive model. Schizophrenia Research, 553, 123–143.

    Article  Google Scholar 

  • Pristach, C. A., & Smith, C. M. (1996). Self-reported effects of alcohol use on symptoms of schizophrenia. Psychiatric Services, 47, 421–423.

    PubMed  Google Scholar 

  • Reiger, D. A., Farmer, M. E., Rae, D. S., Locke, B. Z., Keith, S. J., & Judd, L. L. (1990) Co-morbidity of mental disorders with alcohol and other drug abuse: Results from the Epidemiological Catchment Area (ECA) Study. Journal of the American Medical Association, 264, 2511–2518.

    Article  Google Scholar 

  • Robins, L. N., Heizer, J. E., Ratcliff, K. S., & Seyfried, W. (1982). Validity of the Diagnostic Interview Schedule, version II: DSM-III diagnoses. Psychological Medicine, 12, 855–870.

    Article  PubMed  Google Scholar 

  • Robins, L. N., Heizer, J. E., Croughan, J., & Ratcliff, K. S. (1981). National Institute of Mental Health Diagnostic Interview Schedule: Its history, characteristics, and validity. Archives of General Psychiatry, 38, 381–389.

    Article  PubMed  Google Scholar 

  • Robins, L. N., Cottler, L., Bucholz, K., & Compton, W. (1995). Diagnostic Interview Schedule for DSM-IV. St Louis: Washington University.

    Google Scholar 

  • Rosenthal, R. N., & Miner, C. R. (1997). Differential diagnosis of substance-induced psychosis and schizophrenia in patients with substance use disorders. Schizophrenia Bulletin, 23, 187–193.

    Article  PubMed  Google Scholar 

  • Roy, A. (1986). Suicide in schizophrenia. In A. Roy (Ed.), Suicide (pp. 97–112). Baltimore: Williams & Wilkins.

    Google Scholar 

  • Sautter, F. J., Brailey, K., Uddo, M. M., Hamilton, M. E., Beard, M. G., & Borges, A. H. (1999). PTSD and comorbid psychotic disorder: Comparison with veterans diagnosed with PTSD or psychotic disorder. Journal of Traumatic Stress, 12, 73–88.

    Article  PubMed  Google Scholar 

  • Schwartz, J. E., Fenning, S., Tanenberg-Karant, M., Carlson, G., Craig, T., Galambos, N., Lavelle, J., & Bromet, E. J. (2000). Congruence of diagnoses 2 years after a first-admission diagnosis of psychosis. Archives of General Psychiatry, 57, 593–600.

    Article  PubMed  Google Scholar 

  • Shea, S. C. (1998). Psychiatric interviewing: The art of understanding ( 2nd ed. ). Philadelphia: W.B. Saunders Company.

    Google Scholar 

  • Walker, E., Downey, G., & Caspi, A. (1991). Twin studies of psychopathology: Why do the concordance rates vary? Schizophrenia Research, 5, 211–221.

    Article  PubMed  Google Scholar 

  • Walker, E., & Lewine, R. J. (1990). Prediction of adult-onset schizophrenia from childhood home movies of the patients. American Journal of Psychiatry, 147, 1052–1056.

    PubMed  Google Scholar 

  • Wing, J. K. (1970). A standard form of psychiatric Present-State Examination and a method for standardizing the classification of symptoms. In E. H. Hare & J. K. Wing (Eds.), Psychiatric epidemiology: An international symposium (pp. 93–108 ). London: Oxford University Press.

    Google Scholar 

  • Zarate, C. A., Jr., Tohn, M., & Land, M. (2000). First-episode schizophreniform disorder: Comparisons with first-episode schizophrenia. Schizophrenia Research, 46, 31–34.

    Article  PubMed  Google Scholar 

  • Zhang-Wong, J., Beiser, M., Bean, G., & Iacono, W. G. (1995). Five-year course of schizophreniform disorder. Psychiatry Research, 59, 109–117.

    Article  PubMed  Google Scholar 

  • Zigler, E., & Glick, M. (1986). A developmental approach to adult psychopathology New York: John Wiley & Sons.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2003 Springer Science+Business Media New York

About this chapter

Cite this chapter

Sayers, S.L., Carsia, K., Mueser, K.T. (2003). Schizophrenia. In: Hersen, M., Turner, S.M. (eds) Diagnostic Interviewing. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-4963-2_7

Download citation

  • DOI: https://doi.org/10.1007/978-1-4757-4963-2_7

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4757-4965-6

  • Online ISBN: 978-1-4757-4963-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics