How do doctors diagnose schizophrenia definitively?

Doctor's Answer

Schizophrenia is a severe form of mental disorder and it can be quite a painful process to go through when one realises that one is unwell or when a family member or a close friend has the condition. The important step to do is to seek treatment early as there are medications that can effectively manage the condition. You should not give up on these treatments and follow closely as advised.

Diagnosing schizophrenia is not easy. Sometimes using drugs, such as methamphetamines or LSD, can cause a person to have psychotic symptoms and lose touch with reality.

While there is no single physical or lab test that can diagnose schizophrenia. A healthcare provider who evaluates the symptoms and the course of a person's illness over six months can help ensure a correct diagnosis. The health care provider must rule out other factors such as:

  • brain tumours,
  • possible medical conditions and
  • other psychiatric diagnoses, such as bipolar disorder.

To be diagnosed with schizophrenia, a person must have two or more of the following symptoms occurring persistently in the context of reduced functioning:

  • Delusions
  • Hallucinations
  • Disorganised speech
  • Disorganised or catatonic behaviour
  • Negative symptoms

People can describe symptoms in a variety of ways. How a person describes symptoms often depends on the cultural lens she is looking through. It is therefore important for the mental health professional to think of possible cultural influences and how that could shape a person’s beliefs and behaviours.

I think when you ask for a definitive diagnosis, you are asking for a PET scan of the brain. In my clinical practice, many patients do request for that. No, there is no neuroimaging studies that can help to diagnose schizophrenia definitively at this point in time.

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