Schizophrenia (schizoaffective disorder)
Schizophrenia is a group of psychiatric disorders of unknown etiology, most often starting in young adults, often with a slow onset, with multiple impairments in thinking, emotion, behavior, and uncoordinated mental activity. Some patients may develop cognitive impairment in the course of the disease. The natural course of the disease is prolonged, with repeated exacerbations or deterioration, but some patients can remain cured or basically cured.
[Symptom criteria] At least 2 of the following, not secondary to impaired consciousness, impaired intelligence, high or low affect, and simple schizophrenia are separately specified.
(1) Recurrent verbal hallucinations;
(2) Significant laxity of thought, rupture of thought, incoherence of speech, or paucity of thought or content of thought;
(3) Thought insertion, withdrawal, seeding, thought interruption, or compulsive thinking;
(4) Passive, controlled, or insightful experiences;
(5) Primary delusions (including delusional perceptions, delusional states of mind) or other absurd delusions;
(6) Logical inversions of thought, pathological symbolic thinking, or verbal novelty;
(7) Emotional inversions, or apparent emotional indifference;
(8) Tension syndrome, bizarre behavior, or silly behavior;
(9) Apparent hypoactive will or lack of will.
Severity Criteria】Self-awareness impairment with severe impairment of social function or inability to carry out effective conversation.
[Criteria of disease course
(1) Meet the symptom criteria and severity criteria has lasted for at least 1 month, simple type is otherwise specified.
(2) If the symptom criteria for both schizophrenia and affective psychosis are met, when the affective symptoms are reduced to the point that the symptom criteria for affective psychosis cannot be met, the schizophrenic symptoms need to continue to meet the symptom criteria for schizophrenia for at least 2 weeks before the diagnosis of schizophrenia is made.
[Exclusion criteria] Exclude organic mental disorders, and psychoactive and non-addictive substance-induced mental disorders. Patients with schizophrenia not yet in remission who also have the two previously mentioned disorders in this item should be diagnosed concurrently.
Paranoid schizophrenia
Meets the diagnostic criteria for schizophrenia, predominantly delusional, often accompanied by hallucinations, with auditory hallucinations being more common.
Youthful (disintegrative) schizophrenia
It meets the diagnostic criteria for schizophrenia and often begins in young adulthood, with a predominance of thought, emotion, and behavior disorders or disturbances. Examples include marked thought relaxation, thought breakdowns, emotional inversions, and bizarre behavior.
Catatonic schizophrenia
It meets the diagnostic criteria for schizophrenia and is dominated by catatonic syndromes, of which catatonic mydriasis is more common.
Mono-type schizophrenia
[Diagnostic criteria
(1) Poverty of thought, emotional indifference, or negative symptoms such as reduced volition are predominant, from no obvious positive symptoms;
(2) Social function is severely impaired, tending to mental decline;
(3) insidious onset and slow progression, with a duration of at least 2 years, often starting in adolescence.
Undetermined schizophrenia
Diagnostic criteria
(1) Meet the diagnostic criteria of schizophrenia, with obvious positive symptoms;
(2) Does not meet the diagnostic criteria for the above subtypes, or is a mixed form of paranoid, adolescent, or catatonic type.
[Note] This type is also known as mixed or undifferentiated type.
Other types or schizophrenia to be classified
Meet the diagnostic criteria for schizophrenia that do not meet the diagnostic criteria for each of the above types, such as 20.91 childhood schizophrenia, 20.92 late-onset schizophrenia, etc.
The 4th digit code of schizophrenia indicates
Post-schizophrenic depression
[Diagnostic criteria].
(1) Diagnosed with schizophrenia within the last 1 year, depressive symptoms appear when the schizophrenic condition improves but does not heal;
(2) At this time, depression lasting at least 2 weeks is the main symptom, although there are psychotic symptoms, but no longer the main clinical phase;
(3) Depression and schizoaffective psychosis are excluded.
Schizophrenia in remission [schizophrenic remission type]
The diagnosis of schizophrenia was confirmed, and now the clinical symptoms have disappeared, and self-awareness and social function have been restored for at least 2 months.
Residual schizophrenia [Schizophrenia residual type]
[Diagnostic criteria
(1) Past schizophrenia meets the diagnostic criteria and has not been in complete remission for at least 2 years;
(2) The disease has improved, but at least 1 of the following remains: individual positive symptoms; individual negative symptoms, such as paucity of thought, emotional indifference, decreased volition, or social withdrawal; personality changes;
(3) Social functioning and self-knowledge deficits were not severe;
(4) Relatively stable symptoms in the last 1 year, without significant improvement or deterioration.
Chronic [other disease course types]
[Diagnostic criteria
(1)Meet the diagnostic criteria of schizophrenia;
(2)The course of the disease lasted at least 2 years.
Schizophrenic decline [other disease course types]
[Diagnostic criteria
(1) Meet the diagnostic criteria of schizophrenia;
(2) The last 1 year is dominated by mental decline, and social function is severely impaired, becoming mentally disabled.
Paranoid psychotic disorder [Delusional psychotic disorder]
Paranoid psychotic disorder refers to a group of psychotic disorders in which systematic delusions are the main symptom and the etiology is not known, and hallucinations, if any, are brief and not prominent. In the absence of delusions, there are no other psychological abnormalities, and the disease is more frequent after the age of 30.
Symptom Criteria】The main symptom is systematic delusions with fixed content and certain reality, which are difficult to recognize without understanding. The main manifestations are victimization, jealousy, exaggeration, suspicion of illness, or belligerence.
Severity criteria】Severe impairment of social function and self-awareness.
Criteria for disease duration】Meeting the symptom criteria and severity criteria has lasted for at least 3 months.
Exclusion criteria】Exclude organic mental disorders, psychoactive and non-addictive substance-induced mental disorders, schizophrenia, or affective mental disorders.
Acute transient psychosis [acute transient psychotic disorder]
Acute transient psychosis refers to a group of transient psychotic disorders with an acute onset and predominantly psychotic symptoms, which can be remitted or largely remitted in most patients.
[Symptom criteria] Psychotic symptoms, at least 1 of the following must be met.
(1) Fragmentary delusions, or multiple delusions;
(2) Fragmentary hallucinations, or multiple hallucinations;
(3) Speech disorder;
(4) Behavior disorder or catatonia.
Severity Criteria】Severe impairment of daily life, social function or causing danger or adverse consequences to others.
Criteria for the duration of the disease] Meet the criteria for symptoms and severity for at least a few hours to 1 month, or as otherwise specified.
Exclusion criteria】Exclude organic mental disorders, psychoactive and non-addictive substance-induced mental disorders, schizophrenia, or affective mental disorders.
Schizophrenic-like psychosis
Meets all diagnostic criteria for schizophrenia, but meets the symptom criteria for a duration of less than 1 month.
Traveling psychosis [acute brief psychotic disorder to be classified]
Refers to a psychotic disorder with an acute onset during travel (rail, road, waterway, or air travel, etc.) in the presence of significant pre-morbid integrative stressors (e.g., mental stimulation, overexertion, overcrowding, chronic hypoxia, lack of sleep, lack of nutritional hydration, etc.), mainly manifesting as impaired consciousness, fragmentary delusions, hallucinations, or behavioral disturbances. The duration of the disease is short, and it can resolve on its own within a few hours to a week after stopping travel and adequate rest. Diagnosis should exclude hysteria and other mental disorders occurring during the journey, such as schizophrenia and affective psychosis.
[Symptom Criteria] Acute onset during travel (rail, road, waterway, or air travel, etc.). There are obvious mental stress, excessive fatigue, overcrowding, chronic hypoxia, lack of sleep, lack of nutrition and water and other combined factors before the disease. Often there can be disorders of consciousness, fragmentary delusions, hallucinations, or behavioral disturbances.
Severity Criteria】Severe impairment of social function, or causing danger or adverse consequences to others.
Criteria for duration of illness】The illness is brief, and resolves on its own within a few hours to a week after stopping travel and adequate rest.
Exclusion criteria】Exclude hysteria and other mental disorders that occur during the journey, such as schizophrenia and affective psychosis.
Delusional paroxysm (acute delusional episode)
There is no obvious cause for the onset of delusional episodes, and they often start suddenly and acutely, with symptoms peaking within 1 week. It is mostly seen in young adults, not in children, and rare after the age of 50.
Diagnostic criteria
(1) Meet the symptom criteria of acute transient psychosis. Suddenly, a variety of loosely structured and variable delusions, such as victimization, exaggeration, jealousy, or religious delusions, are the main symptoms. It may be accompanied by trance, delusions, transient hallucinations, depersonalization, or increased or decreased movement;
(2) The duration of the illness is brief, but in some cases it can last up to 3 months;
(3) Exclude reactive psychosis, psychoactive and non-addictive substance-induced psychosis, or schizoid psychosis with persistent hallucinations and characteristic thought disorders.
Sensorimotor psychosis [sensorimotor delusion disorder]
A mental disorder with systemic delusions as the prominent symptom, often occurring in two extremely close relatives or close friends in the same environment or family (e.g., mother and daughter, sister, husband and wife, teacher and student, etc.) with similar delusional content.
Symptom Criteria
(1) The patient has a long-standing, close relative with delusional symptoms of psychosis before the onset of the disease, and then the patient develops psychosis with similar delusional content;
(2) The patient lives in a relatively closed family with little interaction with the outside world. (2) The patient lives in a relatively closed family with little interaction with the outside world. The sensed patient and the primary patient have ideological and emotional empathy, the sensed person is in a position of authority, and the sensed person has personality characteristics such as tameness and dependence;
(3) Delusional thinking is the main clinical phase.
Severity Criteria】Severe impairment of social function.
Criteria for course of illness】There is a tendency for the course of illness to be prolonged, but the inductee can be remitted after isolation from the original patient.
Exclusion criteria】Exclude cases with occasional simultaneous or sequential onset, but no obvious influence on each other.
[Note] Occasionally a psychiatric patient with delusional symptoms can lead to the development of similar disorders in multiple relatives with whom he or she has had a long and close relationship.
Schizoaffective psychosis [schizoaffective psychosis]
A group of psychiatric disorders in which both schizophrenic and affective symptoms are present and equally prominent, often with recurrent episodes. The schizophrenic symptoms are delusions, hallucinations, and thought disorders, and the affective symptoms are manic episodes or depressive episodes.
Symptom Criteria】Meets the symptom criteria for both schizophrenia and affective psychosis manic or depressive episodes.
Severity criteria】Severe impairment of social function and incomplete or lack of self-awareness.
Course of illness criteria】The schizophrenic symptoms and affective symptoms that meet the symptom criteria are present simultaneously for at least 2 weeks throughout the course of the illness, and the time of appearance and disappearance is close.
Exclusion criteria】Exclude organic mental disorders, psychoactive and non-addictive substance-induced mental disorders, schizophrenia, or affective mental disorders.
Note]
If schizophrenic symptoms or affective symptoms are the main clinical phase in different episodes, the respective diagnosis is still made according to the main clinical phase of each episode.
Schizo-affective psychosis subtypes.
Schizoaffective psychosis, manic type
Schizoaffective psychosis, depressive
Dissociative affective psychosis, mixed
Other or to be classified psychotic disorders
Cyclical psychosis [other non-organic psychotic disorders]
This is a group of psychiatric disorders with acute onset, recurrent episodes, similar symptoms, predominantly endocrine disorders with autonomic symptoms, and disorders of thinking, emotion, and behavior, with a short course and unremarkable efficacy of antipsychotic drugs, mostly in adolescent females. If it is often associated with the menstrual cycle, it is called menstrual cycle psychosis.
Symptom criteria]
(1) Endocrine disorder with autonomic symptoms and at least 1 of the following.
(1) uncoordinated psychomotor excitement and, rarely, motor depression;
(2) Behavioral disturbances with mild impairment of consciousness;
(iii) intermittent hallucinations, delusions and speech disorders;
(4) marked emotional elevation or depression;
(2) The symptoms are almost the same in each episode.
Severity Criteria】Severe impairment of social function during the seizure period, complete remission during the interval, and return to the pre-morbid state.
Criteria for disease duration】Acute onset, each episode does not exceed 2 weeks; at least 3 episodes within 6 months.
Exclusion criteria】Exclusion of rapid cyclic affective psychosis, hysterical psychosis and schizophrenic-like psychosis.