Schizophreniform Disorder DSM-5 295.40 (F20.81) - Therapedia

Thought Disorders DSM

Disorders / November 23, 2019

The schizoaffective disorder DSM diagnostic criteria encompass mood and thought symptoms. Details on DSM schizoaffective disorder criteria.Schizoaffective disorder criteria are defined in both the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and the International Classification of Diseases, Tenth Revision (ICD-10). This complex disorder is challenging to diagnose and treat even when the DSM-IV-TR criteria are properly applied.

The DSM-IV-TR diagnostic criteria for schizoaffective disorder stem from the criteria for mania, mixed moods (in bipolar disorder), depression and schizophrenia.

The DSM-IV-TR is the manual that contains the criteria doctors use to make diagnoses of mental illnesses. As such the criteria can be quite technical.

The schizoaffective DSM-IV-TR diagnostic criteria are the following:

  • An uninterrupted period of illness occurs during which a major depressive episode, a manic episode, or a mixed episode occurs with symptoms that meet criterion A (see below) for schizophrenia. The major depressive episode must include a depressed mood.
  • Symptoms that meet the criteria for mood episodes are present for a substantial portion of the total active and residual periods of illness.
  • The disturbance is not due to the direct physiologic effects of a substance (e.g. illicit drugs, medications) or a general medical condition.
  • The bipolar type is diagnosed if the disturbance includes a manic or a mixed episode (or a manic or a mixed episode and major depressive episodes).
  • The depressive type is diagnosed if the disturbance includes only major depressive episodes.

In the DSM-IV-TR, criterion A for schizophrenia requires two of the following:

  • Disorganized speech (e.g. frequent derailment or incoherence)
  • Grossly disorganized or catatonic behavior
  • Negative symptoms such as a flattened affect, lack of speech, lack of motivation

Note that only one of the above is required if the delusions are bizarre or the hallucinations consist of a voice keeping up a running commentary on the person's behavior or thoughts, or two or more voices conversing with each other.

Schizoaffective Disorder Criteria Rating Scales

Schizoaffective disorder severity can also be measured using a variety of rating scales. Tools that may help measure the severity of schizoaffective disorder are those typically associated with schizophrenia, bipolar disorder and depression. These tools include:

  • Positive and Negative Symptom Scale for Schizophrenia [PANSS] – rates positive symptoms like delusions, negative symptoms like emotional withdrawal and general psychopathology like anxiety
  • Young mania scale – rates the severity of mania symptoms like increased energy and sexual interest
  • Cut down, annoyed, guilty, and eye opener (CAGE) questionnaire – regarding substance use and abuse

Severity scales are useful as they can plot a starting point when the schizoaffective disorder is first diagnosed and then track improvement throughout treatment.

Reviewed by Harry Croft, MD