Diagnosing Schizophrenia

With all the advances in medicine today, there are many different screening and detection tests which can be done for the majority of medical conditions. These include things such as blood tests, MRIs, and biopsies. Unfortunately, the same is not true for psychiatric disorders at this point in time.

Since schizophrenia is generally considered the most serious of all psychiatric disorders, much research is being done to find ways to detect or screen for the disorder before it develops. In the meantime, however, a diagnosis is based on the presence (or history of) clinical symptoms. The diagnosis is typically made by a mental health professional, such as a psychiatrist, psychologist, clinical social worker, or psychiatric nurse practitioner.

The value of lab tests

However, it is important to keep in mind that what various lab tests can do is to rule out medical disorders or substances which may be causing symptoms which mimic schizophrenia. For example, a brain tumor may cause psychotic symptoms such as hallucinations. Many street drugs can also cause symptoms which are typical of schizophrenia, such as paranoid ideation and hallucinations. If a person is having his/her first psychotic break, these should always be ruled out (as well as any other potential psychiatric disorder) before a definitive diagnosis of schizophrenia is given.

Arriving at a diagnosis

In order to determine a diagnosis of schizophrenia, a healthcare professional will interview and observe the patient, as well as family members or friends (if available) to get a full clinical picture. If the criteria for schizophrenia are met, and other possible causes are ruled out, then a diagnosis of schizophrenia is given.

One of the significant difficulties with this particular disorder is that the patient may be paranoid, and thus resistant to an evaluation. Also, there is generally a lack of insight – the patient doesn’t think any thing is wrong with him/her and will usually not seek treatment on his/her own. Usually the first diagnosis is made after the patient has become quite psychotic and ends up in a hospital ER, followed by an inpatient admission to stabilize the symptoms and clarify the diagnosis.

Research on other types of schizophrenia screening tests

In recent years there has been a lot of research looking at various tests to either provide early detection or to predict the likeliness of the development of schizophrenia. Following are a few which show promise or are close to becoming available:

Blood serum

University of Cambridge researchers discovered biomarkers for schizophrenia in blood serum. They partnered with Rules-based Medicine in 2010 to launch a protein-based (as opposed to genetics-based) blood test for schizophrenia called VeriPsych.1,6.

IQ

Various tests are showing promise for the prediction of schizophrenia by using IQ tests 2 3. Scientists at Edinburgh University in Scotland have developed a test which may prove useful in terms of thwarting the development of schizophrenia. They state they can accurately identify people who are not at risk, even if schizophrenia is part of their family history 3.

Smell

Scientists have known for some time that people with schizophrenia often have problems accurately distinguishing various smells. Researchers in Australia have been using a scratch and sniff test to determine someone’s risk of developing schizophrenia 4.

Online screening test

An online test designed for early screening of schizophrenia which consists of 12 questions may be available in April of 2010. This test essentially asks many of the questions a healthcare provider would ask, such as whether or not you hear voices which others cannot hear, etc. It has been developed by researchers at Yale 5.

written by Dr. Cheryl Lane, PsyD

References

  1. "A Systemic Look At Schizophrenia," Science & Technology, 1/18/10
  2. "Team Finds Childhood Clues to Adult Schizophrenia," Science Daily 1/22/10
  3. IQ test to predict schizophrenia
  4. "Smell and Schizophrenia," Catalyst, ABC Television
  5. Welcome to the PRIME Prodromal Test, An Early Screening Test for Schizophrenia
  6. "VeriPsych Says It Can Spot Depression, Schizophrenia in Blood," Fast Company, March, 2011

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