- How is schizophrenia diagnosed?
There is no lab test to confirm for sure the diagnosis of schizophrenia. Diagnosis is done by clinical evaluation of psychiatrists in detail. When one suffers from symptoms such as fixed false beliefs (delusions), hearing voices (hallucinations), disordered thinking, changes to emotions, behaviour and getting more isolated etc. If these symptoms are continuously present for over a month and affects one’s functioning and ability to do their work then a diagnosis of schizophrenia is given
2.What questions does a psychiatrist ask?
The psychiatrist who is a highly trained doctor and professional who is apt at dealing with mental health conditions like schizophrenia can ask questions about the symptoms in detail. The reason for this is to confirm if the symptoms are indeed psychotic symptoms.
Questions can be asked about your sleep, eating habits, work performance, socializing, behaviour at home and work, your mood and thought related questions.
Questions may be asked about your family history of mental illness, any substances that you may be abusing including alcohol or cannabis, any associated medical health conditions, your development as a child etc.
3.What are two characteristic symptoms used to diagnose schizophrenia?
The two main characteristic symptoms of schizophrenia can be thought to be DELUSIONS which as fixed, false beliefs which are out of keeping with a person’s educational and cultural background.
Other symptoms being HALLUCINATIONS, mainly auditory hallucinations where a person may start hearing voices when no one is around and believes them to be true.
More details are given in the previous blogs on schizophrenia.
4.Why does the doctor request blood tests and scans?
Blood tests and MRI brain scan may be requested especially if it is the first episode. This is not only to rule out the presence of any physical / medical condition that may be contributing to these symptoms but also to monitor the side effects of medications which will be administered.
5.Are there any assessment tools for schizophrenia?
There are several tools for assessment used along with the clinical questions during assessment for schizophrenia.
These tools include:
CAINS (Clinical Assessment Interview for Negative Symptoms)
BNSS (Brief Negative Symptom Scale)
PANSS (Positive and Negative Symptoms Scale)
SAPS (Scale for the Assessment of Positive Symptoms)
SANS (the Scale for the Assessment of Negative Symptoms)
NSA-16 (Negative Symptom Assessment-16)
CGI-SCH (Clinical Global Impression Schizophrenia.
The above tools are commonly used and can be used to monitor the improvement of symptoms as well.
6.What other mental health conditions are confused with schizophrenia?
Any other mental illness and psychotic illnesses can be confused with schizophrenia. Hence a thorough and detailed assessment is vital.
Common differential diagnosis includes Bipolar disorder, depression with psychotic symptoms and schizoaffective disorder.
7.What happens after a diagnosis of schizophrenia is given?
You will be given information and advised on best treatment options which will be depending on your clinical situation. Family members will be educated if required.
8.What treatment options will be suggested?
The mainstay management of schizophrenia is long term use of antipsychotic medications. Other medications can be used as adjunct treatment.
If the person is very unwell such as not eating or very agitated or suicidal then admission will be advised.
9.Can I be treated at home with schizophrenia?
If there is no risk present and with good social support, treatment at home is a viable and preferred option.
10.What should the family members be aware after the diagnosis?
Family members must be given information about the condition and the possibility of heritability.
The importance of regular medications will be emphasized. Good social support and a relaxed, understanding family will aid with good recovery and long term remission in schizophrenia.