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Pr William Carpenter: Schizophrenia diagnosis after DSM-5

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Prof. William Carpenter, Baltimore

Schizophrenia diagnosis after the DSM-5

 

 

Many things won’t be the same from DSM-IV to DSM-5. The changes related to schizophrenia, one important one is that we are dropping the subgroups.

 

The subtypes of schizophrenia have not been very usefull in reducing heterogeneity. They are not used much either in clinical practice or in research and we know it’s an heterogenous syndrome and we thought we would have more information in looking at psychopathology dimensions, instead of trying to look at subtypes.

 

And we also wanted to deinforcize the catatonia schizophrenia connection, because catatonia is fairly common and occurs more often in mood disorders and a number of medical conditions, and we don’t want people jump into the conclusion in schizophrenia because of the presence of catatonia.

 

So the major change that we proposed and will turn out to be in section 3 or the appendix rather than in the main text, are a group of dimensions.

 

So clinicians would be able to have a drop down menu. It says ok, this patient has a psychotic condition, are they depressed, are they manic, do they have hallucinations, do they have dellusion, do they have desorganisation of though, do they have psychomotor, and importantly do they have cognition impairment.

 

And these would be simple clinical readings, things we believe clinicians have to know if they are diagnosing and treating a person with psychotic disorder because the classification itself does not give you information on what actually wrong with that specific individual.

 

So this doesn’t take the place of the classification but supplement it with the clinically relevant informations about the individual patient

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