Undifferentiated Schizophrenic

When a person is exhibiting symptoms which meet many of the symptoms of schizophrenia, but does not fully or clearly fit one of the other types of schizophrenia (paranoid, catatonic, disorganized or residual), then s/he is given a diagnosis of undifferentiated schizophrenia.

Symptoms and Diagnosis

The person with this type of schizophrenia must have at least two or more of the following symptoms:

Delusions
Firmly held beliefs which are not based in reality, and are maintained despite evidence which disproves the belief or even when practically no one else ascribes to the same belief
Hallucinations
Seeing or hearing or otherwise sensing things which aren’t really there
Disorganized speech
Person can’t stay on one topic, gives irrelevant responses, or his/her words make no sense at all
Extremely disorganized or catatonic behavior
Extremely unkempt appearance, bizarre dress, unresponsive to his/her surroundings, rigid posture, or exhibits bizarre or overly excited movements
“Negative” symptoms
Examples of negative symptoms as lack of emotional expression or response, or significantly impaired thinking, or is unable to initiate or carry out basic tasks)

Also, these symptoms must be present for at least one month, unless the person was treated successfully before the end of a one month period.

According to the DSM-IV, the person needs to meet only one (rather than two) of the above criterion when:

  • Delusions are bizarre. Bizarre delusions would involve a belief which is completely implausible, such as believing that an alien surgically removed the person’s heart and put another one inside the person’s body in its place.
  • The patient is hearing at least two voices talking to each other, or is hearing a voice which is giving an ongoing commentary on the person’s activities or thoughts.

Additional Diagnostic Criteria

In order to meet the diagnosis of schizophrenia, regardless of the type, these other criteria must also be met:

  • A marked decline in functioning, after the onset of symptoms, in at least one of the primary aspects of the person’s life (e.g., work, school, relationships, self-care).
  • Signs of the disorder are present continuously for a period of at least 6 months. For at least one month of that time period (less if they subside due to effective treatment), the active-phase symptoms (e.g. delusions, hallucinations, extremely disorganized behavior, etc.) must be present.
  • Schizoaffective disorder (a disorder similar to schizophrenia but with prominent mood episodes) or other mood disorder have been ruled out.
  • In the other types of schizophrenia, at least one of the above symptoms is very prominent. But in undifferentiated schizophrenia, none are prominent. However, as with all the types, it is possible that at a different point in time the individual will meet the criteria for one of the other types.

written by Dr. Cheryl Lane, PsyD

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