Journal List > Korean J Schizophr Res > v.17(1) > 1122196

Cho and Lee: Schizophrenia Spectrum Disorder in DSM-5: Is this a New Change?

Abstract

The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth version (DSM-5) finally introduced in 2013. Psychiatrists and researchers of neuroscience were looking forward that DSM-5 will introduce a new paradigm of diagnostic criteria. However, they have criticized on DSM-5 about not including of neurobiological criteria after DSM-5 published. Since schizophrenia spectrum disorder is heterogeneous and hard to diagnose correctly, we can guess that there might be a big affliction in preparation of DSM-5. Diagnostic criteria of schizophrenia spectrum disorder in DSM-5 changed in several points including changes of Criteria A of schizophrenia. The most outstanding change is the elimination of subtypes of schizophrenia, and introducing of Clinician-Rated Dimensions of Psychosis Symptom Severity for further division into homogenous subgroups depending on psychosis symptoms. Until now, the results of various neurobiological investigations are not consistent, so neurobiological criteria of schizophrenia spectrum disorder deserved no inclusion in DSM-5. Thinking comprehensively, DSM-5 might decide to choose stability rather than challenge. In the future, the diagnostic criteria of schizophrenia spectrum disorder in DSM will progress with inclusion of neurobiological criteria, and researches of schizophrenia spectrum disorder will make advance that match changes in progression of DSM. (Korean J Schizophr Res 2014;17:5–11)

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Table 1.
DSM-IV와 DSM-5에서 조현병 진단기준의 비교
조현병의 DSM-IV 진단기준 조현병의 DSM-5 진단기준
진단기준 A에서 “주의(note)” 항목 진단기준 A에서 “주의(note)” 항목 삭제
–0기괴한 망상 또는 슈나이더 1급 환각 중, 한 개 증상만 있어도 진단  
가능  
진단기준 A에서 망상, 환각, 와해된 언어, 심하게 와해된 행동이나 긴장증 진단기준 A에서 망상, 환각, 와해된 언어의 3개 증상 중, 최소 1개 이상
적 행동, 음성증상 중 2개 이상의 증상이 있어야 진단 가능 의 증상이 있고 전체 5개 증상 중 2개 이상의 증상이 있어야 진단 가능
아형 분류 아형 분류 삭제
0편집형, 해체형, 긴장형, 감별 불능형, 잔류형  
경과의 세부 진단(course specifiers) 경과의 세부 진단(course specifiers)
0단일 삽화(single episode) vs. 삽화성(episodic) 0초발 삽화(first episode) vs. 다발 삽화(multiple episodes)
0지속성(continuous), 부분 관해상태(partial remission), 완전 관해 0지속성(continuous), 급성 삽화(acute episode), 부분 관해상
상태(full remission) 태(partial remission), 완전 관해상태(full remission)
긴장증 동반 명시(with catatonia specifier) 추가
중증도 명시(current severity specifier) 추가
  0 Clinician-Rated Dimensions of Psychosis Symptom Severity
  (Section III)
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