Which diagnosis best fits duration, episodicity, and exclusions?
A
Schizotypal personality disorder
Pervasive pattern of social/interpersonal deficits with acute discomfort in close relationships, cognitive/perceptual distortions, and eccentricities of behaviour, beginning by early adulthood; ≥5 of 9: ideas of reference; odd beliefs/magical thinking; unusual perceptual experiences; odd thinking/speech; suspiciousness/paranoid ideation; inappropriate/constricted affect; odd/eccentric behaviour/appearance; lacks close friends; excessive social anxiety
APervasive pattern of social/interpersonal deficits with acute discomfort in close relationships, cognitive/perceptual distortions, and eccentricities of behaviour, beginning by early adulthood; ≥5 of 9: ideas of reference; odd beliefs/magical thinking; unusual perceptual experiences; odd thinking/speech; suspiciousness/paranoid ideation; inappropriate/constricted affect; odd/eccentric behaviour/appearance; lacks close friends; excessive social anxiety
B≥2 of: delusions; hallucinations; disorganised speech; grossly disorganised/catatonic behaviour; negative symptoms — ≥1 must be delusions, hallucinations, or disorganised speech
Additional criteria
ANo additional structured criteria supplied
BB. ≥1 area of functioning (work, relationships, self-care) markedly below premorbid level C. Continuous signs ≥6 months; includes ≥1 month of active-phase symptoms (or less if successfully treated) D. Schizoaffective and mood disorders excluded
Key features
AA. Pervasive pattern of social/interpersonal deficits with acute discomfort in close relationships, cognitive/perceptual distortions, and eccentricities of behaviour, beginning by early adulthood; ≥5 of 9: ideas of reference; odd beliefs/magical thinking; unusual perceptual experiences; odd thinking/speech; suspiciousness/paranoid ideation; inappropriate/constricted affect; odd/eccentric behaviour/appearance; lacks close friends; excessive social anxiety
BA. ≥2 of: delusions; hallucinations; disorganised speech; grossly disorganised/catatonic behaviour; negative symptoms — ≥1 must be delusions, hallucinations, or disorganised speech B. ≥1 area of functioning (work, relationships, self-care) markedly below premorbid level C. Continuous signs ≥6 months; includes ≥1 month of active-phase symptoms (or less if successfully treated)
Common specifiers
ASeverity (Mild / Moderate / Severe)
BFirst episode, currently acute / partial remission / full remission; Multiple episodes, currently acute / partial remission / full remission; Continuous; With catatonia
Differential flags
ASchizophrenia (active psychosis; duration criteria; role decline); Delusional disorder (fixed false beliefs at full intensity); Schizoid PD (isolation without odd beliefs)
BSchizoaffective disorder (mood episode for majority of illness duration); Bipolar/MDD with psychotic features (psychosis only during mood episodes); Schizophreniform disorder (duration 1-6 months)