DSM-IV-TR in Action: DSM-5 E-Chapter Update by Sophia F. Dziegielewski

Author:Sophia F. Dziegielewski
Language: eng
Format: mobi
Publisher: Wiley
Published: 2013-09-03T21:00:00+00:00

Schizophrenia Spectrum and Other Psychotic Disorders

This chapter in DSM-5 will provide the updated information relative to children, adolescents, and adults with schizophrenia spectrum and the other psychotic disorders. The changes in DSM-5 are somewhat extensive although helpful in clarifying the criteria for this devastating illness while recognizing the affect it can have on the development of close relationships and disturbed family relations. Complicating the diagnostic assessment for this disorder is its varied course and reoccurrences that can occur at any time throughout a client's life (Menezes, Arenovich, & Zipursky, 2006). This section of the update highlights the guidelines for using the DSM-5 (2013), comparing to what was expected in DSM-IV focusing on updates related to the diagnosis and treatment of Schizophrenia. See criteria listed in Quick Reference 22 for what was previously required in DSM-IV/DSM-IV-TR.

Quick Reference 22

DSM-IV-TR —Summary Highlights for Schizophrenia and the Psychotic Disorders

DSM-IV brought together three sections that were listed separately in the previous version (DSM-III-R): schizophrenia, delusional disorder, and psychotic disorder not otherwise classified.

Added the concept of schizophrenia spectrum to represent the range of disorders that were most likely to occur in family members of individuals with schizophrenia (schizoaffective disorder, schizotypal personality disorder, etc.).

In DSM-5, the chapter now titled Schizophrenia Spectrum and the Other Psychotic Disorders was retitled. The title change is reflective of the fact that some researchers continue to question whether schizophrenia is actually one disorder or a combination of disorders, refuting the original five subtypes that were postulated in DSM-IV. Schizophrenia is believed to be a heterogeneous clinical syndrome (APA, 2013). Although these subcategories have been used for years, research has never confirmed them and therefore they were removed relative to their application and validity (Linscott, Allardyce, & van Os, 2009). Furthermore, the other Psychotic Disorders listed in this chapter, including schizophrenia, have all received some modifications to the criteria. See Quick Reference 23 for a list of the disorders now covered in this chapter.

Quick Reference 23

DSM-5 —Other Psychotic Disorders

Schizotypal Personality Disorder

Delusional Disorder

Brief Reactive Psychosis

Schizophreniform Disorder

Schizophrenia

Schizoaffective Disorder

Substance/Medication Induced Psychotic Disorder

Psychotic Disorder Due to Another Medical Condition

Catatonia as a Specifier or as a Disorder Due to Another Mental Disorder

Other Specified Schizophrenia Spectrum and Other Psychotic Disorder

Unspecified Schizophrenia Spectrum and Other Psychotic Disorder

For the most part, this chapter has been reorganized to reflect the gradient of psychopathology of the disorders listed ranking them from least to most severe. In addition, all of the severity dimensions have been updated. There was also a name change where psychotic disorder not otherwise classified was changed to psychotic disorder NOS (specified). Also, although schizotypal personality disorder is explained in depth in the chapter related to the personality disorders, it is listed in this chapter because of its relationship to schizophrenia spectrum. There is also a disorder that was added to section three as an area for further study. This disorder is termed attenuated psychosis syndrome and outlines the possibility of delusions, hallucinations, and disorganized speech but the occurrences are not nearly as intense as in a psychotic episode although the symptoms can cause distress or disability.

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