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Diagnosis   

Schizophrenia

Schizophrenia is a disease involving distortions of thinking and perception with inappropriate or blunted affect. The main features of according to ICD-10 are listed below.

In order to make diagnosis the patient must have had at least one of the ‘first-rank features (in bold) or two of the other features for a period of at least 1 month.

In schizophrenia consciousness is normally clear and intellectual capacity is usually maintained (although cognitive deficits may appear in time)

Thought phenomena

'Do you ever think your thoughts are interfered with in any way?'
'Do you think others can read your thoughts?'
''Do you ever think an outside entity is affecting your thoughts?'
''Do you ever hear echo’s of your thoughts in your head like a voice?'

Delusions / Delusional perception / Over-valued ideas

'Is there anything bothering you at the moment?'
'Have you ever felt that any one or any entity is out to get you?'
'Do you have different understanding of things to other people?'
'Do you ever get any special information from things which happen?'
'Do you get ever get special messages or communication form newspapers, radio, television or any other source?'

Delusions of control; influence or passivity

'Do you ever feel that a force can control or influence you?'
'Do you think that some of your actions or thought are not being controlled by you?'

Hallucinatory voices (discussing the patient) / Hallucinations occurring in any modality

'Do you ever hear voices when there is no one present?'
'Are these from inside your head (pseudohallucination) or outside (hallucination)?'
'Do they talk directly to you (2nd person) or about you (3rd person)?'
'How many?'
'Who are they?'
'What do they say?'
'Do they ever tell you to harm/kill yourself or others?'

Inquire about the hallucinations and how they affect the patient and quote verbatim in the documentation.

'When?'
'How often?'
'How does it make you feel?'
'Can you control stop them?'

Blunted affect / Apathy loss of drive (avolition)

'Do you still get emotional or exited about things you used to?'
'Do you have drive and ambition for anything at the moment?'