Diagnosis and Clinical Characteristics
These are the approved guidelines published by the South African Society of Psychiatrists to provide an overview on treatment and management of commonly diagnosed psychiatric illnesses. The guidelines include consensus recommendations, based on peer contribution and using the international evidence based guidelines that are suitable for the local South African health service.
Please note that parts of this guideline may be out of date, an update will be published as soon as it is available.
Schizophrenia is a heterogeneous cluster of psychotic conditions characterised by positive (delusions, hallucinations) and negative or ‘deficit’ (blunting of affect, avolition) symptoms, disorganised speech and behaviour, as well as mood (depressive) and cognitive impairments.
Diagnosis in terms of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)[7] requires the presence for at least 1 month (or less if successfully treated) of 2 or more of the following characteristic symptoms (in the context of the disturbance persisting for at least 6 months which includes 1 month of symptoms) (criterion A):
- Delusions
- Hallucinations
- Disorganised speech
- Grossly disorganised or catatonic behaviour
- Negative symptoms.
Further, the disorder must cause social and/or occupational dysfunction, and cannot be better accounted for by:
- Schizoaffective or mood disorders
- Substance-related disorders
- General medical conditions