The diagnosis of schizophrenia involves a comprehensive multidisciplinary assessment that addresses multiple domains. This assessment should include psychiatric evaluation, a review of medical history and physical examination to rule out organic causes, and an evaluation of physical health and well-being NICE CG178. It is also crucial to assess psychological and psychosocial factors, including social networks, relationships, and history of trauma, as well as developmental, social, occupational, and educational aspects NICE CG178. A thorough assessment of risk to self and others is also a critical component NICE CKS,NICE CKS. For individuals presenting with psychotic symptoms, a referral to a specialist mental health service or an early intervention in psychosis service is recommended without delay NICE CG178. Structural neuroimaging techniques are not routinely recommended as part of initial investigations for first-episode psychosis according to NICE technology appraisal guidance NICE CG178. However, it is important to monitor for coexisting conditions such as depression, anxiety, and substance misuse, particularly in the early stages of treatment NICE CG178.
Key References
- NG54 - Mental health problems in people with learning disabilities: prevention, assessment and management
- CKS - Psychosis and schizophrenia
- CKS - Schizophrenia and psychosis
- CG155 - Psychosis and schizophrenia in children and young people: recognition and management
- CG178 - Psychosis and schizophrenia in adults: prevention and management
- (Faraone et al., 1995): Diagnostic accuracy and linkage analysis: how useful are schizophrenia spectrum phenotypes?
- (Siafis et al., 2024): Relapse in clinically stable adult patients with schizophrenia or schizoaffective disorder: evidence-based criteria derived by equipercentile linking and diagnostic test accuracy meta-analysis.