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.
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References
American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders ( 3rd ed. ). Washington, DC: Author.
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., revised). Washington, DC: Author.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders ( 4th ed. ). Washington, DC: Author.
Bellack, A. S., Mueser, K. T., Gingerich, S., & Agresta, J. (1997). Social skills training for schizophrenia: A step-by-step guide. New York: Guilford.
Bleuler, E. (1950). Dementia praecox or the group of schizophrenias (J. Zinken, Trans. [1911]). New York: International Universities Press.
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.
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.
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.
Bruce, M. L., Takeuchi, D. T., & Leaf, P. J. (1991). Poverty and psychiatric status. Archives of General Psychiatry, 48, 470–474.
Buchsbaum, M. S. (1990). The frontal lobes, basal ganglia, and temporal lobes as sites for schizophrenia. Schizophrenia Bulletin, 16, 379–389.
Bustillo, J., Lauriello, J., Horan, W., & Keith, S. (2001). The psychosocial treatment of schizophrenia: An update. American Journal of Psychiatry, 158, 163–175.
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.
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.
Davies, N., Russell, A., Jones, P., & Murray, R. M. (1998). Which characteristics of schizophrenia predate psychosis. Journal of Psychiatric Research, 32, 121–131.
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.
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.
Endicott, J., & Spitzer, R. L. (1978). A diagnostic interview: The Schedule for Affective Disorders and chizophrenia. Archives of General Psychiatry, 35, 837–844.
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.
Flaum, M., Arndt, & Andreasen, N. (1991). The reliability of “bizarre” delusions. Comprehensive Psychiatry, 32, 59–65.
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.
Goldstein, J. M. (1988). Gender differences in the course of schizophrenia. Journal of Psychiatry, 145, 684–689.
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.
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.
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.
Jibson, M. D., & Tandon, R. (1998). New atypical antipsychotic medications. Journal of Psychiatric Research, 32, 215–228.
Kane, J. M. (1997). The new antipsychotics. Journal of Practical Psychiatry and Behavioral Health, 3, 343–355.
Kay, S. R., & Sevy, S. (1990). Pyramidical model of schizophrenia. Schizophrenia Bulletin, 16, 537–545.
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.
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.
Kraepelin, E. (1919). Dementia praecox and paraphrenia. Edinburgh: Livingston.
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.
Kuriansky, J. B., Deming, W. E., & Gurland, B. J. (1974). On trends in the diagnosis of schizophrenia. American Journal of Psychiatry, 131, 402–408.
Levinson, D. F., & Levitt, M. M. (1987). Schizoaffective mania reconsidered. American Journal of Psychiatry, 144, 415–425.
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.
Liberman, R. P., DeRisi, W. J., & Mueser, K. T. (1989). Social skills training for psychiatric patients. New York: Pergamon Press.
Matarazzo, J. D. (1983). The reliability of psychiatric and psychological diagnosis. Clinical Psychology Review, 3, 103–145.
Mattes, J. A., & Nayak, D. (1984). Lithium versus fluphenazine for prophylaxis in mainly schizophrenic schizo-affectives. Biological Psychiatry, 19, 445–449.
Mellor, C. S. (1970). First rank symptoms of schizophrenia. British Journal of Psychiatry, 117, 15–23.
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.
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.
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.
Mueser, K. T., Bellack, A. S., & Brady, E. U. (1990). Hallucinations in schizophrenia. Acta Psychiatrica Scandinavia, 82, 26–29.
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.
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.
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.
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.
Mueser, K. T., & Glynn, S. M. (1999). Behavioral family therapy for psychiatric disorders ( 2nd ed. ). Oakland, CA: New Harbinger.
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.
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.
Pristach, C. A., & Smith, C. M. (1996). Self-reported effects of alcohol use on symptoms of schizophrenia. Psychiatric Services, 47, 421–423.
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.
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.
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.
Robins, L. N., Cottler, L., Bucholz, K., & Compton, W. (1995). Diagnostic Interview Schedule for DSM-IV. St Louis: Washington University.
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.
Roy, A. (1986). Suicide in schizophrenia. In A. Roy (Ed.), Suicide (pp. 97–112). Baltimore: Williams & Wilkins.
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.
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.
Shea, S. C. (1998). Psychiatric interviewing: The art of understanding ( 2nd ed. ). Philadelphia: W.B. Saunders Company.
Walker, E., Downey, G., & Caspi, A. (1991). Twin studies of psychopathology: Why do the concordance rates vary? Schizophrenia Research, 5, 211–221.
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.
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.
Zarate, C. A., Jr., Tohn, M., & Land, M. (2000). First-episode schizophreniform disorder: Comparisons with first-episode schizophrenia. Schizophrenia Research, 46, 31–34.
Zhang-Wong, J., Beiser, M., Bean, G., & Iacono, W. G. (1995). Five-year course of schizophreniform disorder. Psychiatry Research, 59, 109–117.
Zigler, E., & Glick, M. (1986). A developmental approach to adult psychopathology New York: John Wiley & Sons.
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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
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DOI: https://doi.org/10.1007/978-1-4757-4963-2_7
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