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. He Ming, Department of Psychiatry, Mental Health Center, Zhejiang University School of Medicine
Symptom criteria: at least 2 of the following, not secondary to impaired consciousness, impaired intelligence, high or low affect, with simple schizophrenia specified separately.
1, recurrent verbal hallucinations.
2. apparent laxity of thought, rupture of thought, incoherent speech, or paucity of thought or content of thought
3. insertion, withdrawal, sowing, interruption of thought, or compulsive thinking of thoughts.
4. passivity, control, or insightful experience.
5. primary delusions (including delusional perceptions, delusional states of mind) or other absurd delusions.
6. logical inversions of thought, pathological symbolic thinking, or verbal neologisms.
7. emotional inversions, or apparent emotional indifference.
8. catatonic syndrome, bizarre behavior, or stupidity
9. marked hypoactive will or lack thereof.
Severe criteria: impaired self-awareness with severely impaired social functioning or inability to converse effectively.
Criteria of disease course
1.Meeting the symptom criteria and severity criteria has lasted for at least 1 month, simple type is otherwise specified.
2, if both schizophrenia and affective psychotic disorder symptom criteria are met, when the affective symptoms are reduced to the point that the affective psychotic disorder symptom criteria cannot be met, schizophrenic symptoms need to continue to meet the symptom criteria of schizophrenia for at least 2 weeks before the diagnosis of schizophrenia is made.
Exclusion criteria: Exclusion of organic mental disorders, and psychoactive and non-addictive substance-induced mental disorders. Patients with unremitting schizophrenia who also suffer from the two previous categories of 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
Meets the diagnostic criteria for schizophrenia and is dominated by catatonic syndromes, of which catatonic xerostomia is more common.
Simplex-type schizophrenia
Diagnostic criteria.
1, dominated by negative symptoms such as paucity of thought, emotional indifference, or reduced volition, from the absence of obvious positive symptoms.
2, severe impairment of social function, tending toward mental decline.
3, insidious onset, slow progression, duration of at least 2 years, often starting in adolescence.
Undetermined schizophrenia
Diagnostic criteria.
1, meeting the diagnostic criteria for 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.
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 for schizophrenia indicates.
20.x1 post-schizophrenic depression [F20.4]
Diagnostic criteria.
1. a diagnosis of schizophrenia within the last 1 year and depressive symptoms when the schizophrenia is improving but not cured.
2. depression lasting at least 2 weeks as the main symptom at this time, although there are psychotic symptoms remaining, but they are no longer the main clinical phase.
3. exclude depression and schizoaffective psychosis.
20.x2 schizophrenia in remission [F20.x5 schizophrenia in remission]
Previously diagnosed with schizophrenia, now the clinical symptoms have disappeared and self-awareness and social functioning have been restored for at least 2 months.
20. x3 residual schizophrenia [F20.x4 residual schizophrenia type]
Diagnostic criteria.
1. met the diagnostic criteria for schizophrenia in the past and has not been in complete remission for at least 2 years.
2. improved, but at least 1 of the following remains.
(1) individual positive symptoms.
(2) Individual negative symptoms, such as paucity of thought, emotional indifference, reduced volition, or social withdrawal.
(3) personality changes.
(3) non-severe deficits in social functioning and self-awareness
(4) relatively stable symptoms in the last 1 year, without significant improvement or deterioration.
20.x4 chronic [F20.x8 other disease course types]
Diagnostic criteria.
1, meeting the diagnostic criteria for schizophrenia.
2. The course of the disease lasts for at least 2 years.
20.x5 schizophrenic decline [F20.x8 other disease course types]
Diagnostic criteria.
1, meeting the diagnostic criteria for schizophrenia.
2. The last 1 year was dominated by mental decline, with severe impairment of social function and becoming mentally disabled.