Getting an Accurate Schizophrenia Diagnosis
By Dennis Thompson Jr.
Medically reviewed by Lindsey Marcellin, MD, MPH
Schizophrenia symptoms primarily involve a loss of connection to reality, a condition known as psychosis. Psychotic patients are unable to tell what is real from what is imaginary. They experience delusions, which means having false beliefs about who they are or what is happening to them, and hallucinations — seeing, hearing, smelling, or tasting something that is not really there.
However, a number of other medical conditions can cause behaviors that suggest schizophrenia. To reach a schizophrenia diagnosis, doctors must consider and rule out these other psychosis-inducing illnesses and medical problems.
Conditions That Cause Psychosis
Medical conditions and health problems that can lead a person to appear schizophrenic include:
- Delirium. Delirium is sudden and severe confusion caused by illness that disrupts brain function. Delirium-inducing conditions include encephalitis (inflammation of the brain), head trauma, hypoglycemia, infection, and stroke. Patients with delirium may have the sort of disorganized thinking and speech normally associated with schizophrenia. They also may have hallucinations.
- Dementia. Older people with advanced Alzheimer's disease and other forms of dementia may exhibit psychotic symptoms like delusions and hallucinations. They may be convinced that caregivers are stealing from them or that they can see and converse with long-deceased relatives.
- Mood disorders. People with severe anxiety, deep depression, or raging manic episodes can experience psychotic symptoms. A severely depressed person may hear voices telling him to harm himself, for example, or a person with high anxiety may have paranoid delusions.
- Schizoaffective disorder. This occurs when severe psychosis occurs along with a mood disorder. Patients with schizoaffective disorder typically exhibit major schizophrenia symptoms accompanied by periods of mania, depression, or anxiety.
- Substance abuse. People who abuse alcohol or drugs may experience a variety of hallucinations and delusions. Some drugs like PCP, methamphetamine, and LSD predictably cause periods of psychosis. Psychotic symptoms also can occur when a substance abuser tries to kick his habit.
- Prescription medications. Drugs prescribed for health reasons can cause psychotic side effects in some patients. Patients taking corticosteroids, narcotic painkillers, anti-anxiety medications, and others may have delusions, for example. Many medications have what are called “anti-cholinergic effects” that can cause hallucinations in some people, particularly the elderly.
Schizophrenia Diagnosis
To accurately determine a schizophrenia diagnosis, doctors must also weed out potential medical causes of psychosis. Steps to do this may include:
- Medical examination. Delirium always results from some other medical condition. A physical exam combined with a review of the patient's medical history can point to the cause of psychotic delirium.
- Blood and urine tests. Such testing can reveal the presence of illicit drugs or prescription medications that can be causing apparent schizophrenia symptoms. Blood tests can help diagnosis viral and bacterial infections such as syphilis or encephalitis, which cause psychotic delirium.
- Brain scans. An MRI of the brain can show evidence of a stroke or other medical problem that has caused psychosis.
Once physical and medical causes are ruled out, psychotic patients must undergo psychological evaluation to determine if they have schizophrenia or another type of mental illness:
- Dementia. Patients with psychotic dementia also exhibit other evidence of continuing cognitive decline, including forgetfulness and difficulty performing tasks that require thought.
- Mood disorders with psychotic features. People who have psychotic symptoms caused by a mood disorder tend to have hallucinations and delusions only when in the grip of severe depression, anxiety, or mania. The psychotic symptoms fade when their mood disorder resolves itself.
- Schizoaffective disorder. This can be the most difficult to differentiate from schizophrenia. Typically, the mood symptoms that occur in schizoaffective disorder are longer-lasting and more profound than those occurring as a result of schizophrenia.
- Schizophrenia. People are diagnosed as schizophrenic when they experience chronic delusions or hallucinations for at least six months. Other symptoms include disorganized thought and speech, repetitive behaviors, stupor, and an utter lack of emotion.
Diagnosing schizophrenia takes a certain amount of time because of the many other conditions that need to be ruled out. These necessary steps help ensure that your medical team makes an accurate assessment and can prescribe the best treatment.
The Have I Got A Problem website is a free online resource to help people better understand any issues or concerns they may have about mental health or addiction. The website includes resources specifically focused to; general Mental Health, Depression, Stress, Anxiety, Insecurities, Self-harm Schizophrenia, Bipolar, Anger Management, Eating Disorders, Coping, general Addiction, Alcohol, Smoking, Gambling, Drugs, Cocaine, Heroin, Marijuana (Cannabis) Ecstasy, PCP, Mephedrone, Ketamine & Crystal Meth.
The site was created to give the public information to help them understand mental health and addiction issues and to assist people in making better informed decisions about their life and personal choices.
www.haveigotaproblem.com was created and is run by 'Advising Communities’, which is a UK registered charity (Charity No. 1061055)
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