Schizophrenia differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2]

Overview

Differential Diagnosis

  • Autism spectrum disorder or communication disorders
  • Major depressive or bipolar disorder with psychotic or catatonic features
  • Schizoaffective disorder
  • Schizophreniform disorder and brief psychotic disorder
  • Delusional disorder
  • Schizotypal personality disorder
  • Obsessive-compulsive disorder and body dysmorphic disorder
  • Posttraumatic stress disorder
  • Other mental disorders associated with a psychotic episode
  • Schizophrenia needs to be differentiated from epilepsy and certain brain lesions. Chronic disease and metabolic disturbances also need to be ruled out. Systemic infection, including HIV and syphilis should be ruled out. The patient should be evaluated for drug abuse, as many drugs can cause psychotic symptoms, either during intoxication or during withdrawal. It is important to rule out a delirium which can be distinguished by visual hallucinations, acute onset and fluctuating level of consciousness and indicates an underlying medical illness. There are several psychiatric illnesses which may present with psychotic symptoms other than schizophrenia. These include bipolar disorder,[1] borderline personality disorder,[2] drug intoxication, brief drug-induced psychosis, and schizophreniform disorder.

References

  1. Pope HG (1983). Distinguishing bipolar disorder from schizophrenia in clinical practice: guidelines and case reports. Hospital and Community Psychiatry, 34: 322–328.
  2. McGlashan TH (1987) Testing DSM-III symptom criteria for schizotypal and borderline personality disorders. Archives of General Psychiatry, 44: 15–22.

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