Schizophrenia

Abstract

Schizophrenia is a complex, heterogeneous disorder that is often confusing and frightening not only for the individual who experiences it, but also for family members, health providers, and others that he or she encounters in day-to-day life. Diagnosis of schizophrenia poses many challenges but an accurate diagnosis is critical to the provision of appropriate information and treatment recommendations to individuals and their family members. Unlike most disorders in medicine, the symptoms of schizophrenia cannot be linked to a specific pathophysiological mechanism, and must be assessed solely on the basis of observations, verbal reports, and inferences. Thus, self-report is central to making a diagnosis. However, for various reasons, individuals with schizophrenia may either be reluctant or have considerable difficulty describing their experiences. This may be due to the direct effects of symptoms but can also be compounded by poor insight and cognitive impairment. Additionally, high rates of substance use, mood symptoms, and traumatic experiences in this population can complicate self-reporting and the differentiation of schizophrenia symptoms from these other factors. In this chapter, we will describe these challenges in more detail and offer strategies to address them in the context of clinical and diagnostic interviews. © 2010 Springer-Verlag US.