Diagnosis Q: If a patient that might have schizophrenia has a social or occupational dysfunction after the?

onset of the disorder, does it have to be caused by the schizophrenia to count as a symptom? The diagnostic criteria don't specifically say that the dysfunction is caused by schizophrenia.
What if the person is basically capable of working, but they quit soley because they had a delusion or two that they were causing great harm to a coworker just by being there(not because of any positive symptoms)? Thank you!

B. Social/occupational dysfunction: For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care are markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, failure to achieve expected level of interpersonal, academic, or occupational achievement).

Quitting a job because of the belief that being there harmed a co-worker is a symptom of delusional thinking. Delusional thinking is a major symptom of schizophrenia and it did cause them occupational dysfunction because the thoughts lead them to quit their job.

The dysfunction is a direct result of the illness. That's why it is lumped in as a symptom. If this incident at the office occurred as well as other characteristic symptoms, and other illnesses have been ruled out, then you're probably looking at schizophrenia. Of course the best person to do this would be a licensed psychiatrist.

It's like this: The following diagnostic criteria must be met before a diagnosis of Schizophrenia is warranted, according to the DSM-IV-TR:

A) Characteristic Symptoms: Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated)
1. delusions
2. hallucinations
3. disorganized speech (e.g., frequent derailment or incoherence)
4. grossly disorganized or catatonic behavior
5. negative symptoms, i.e., affective flattening, alogia, or avolition


B) Social/occupational dysfunction: For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care are markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, failure to achieve expected level of interpersonal, academic or occupational achievement).

C) Duration: Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or two or more symptoms listed in Criterion A present in an attenuated form (e.g.,odd beliefs, unusual perceptual experiences).

D) Schizoaffective and Mood Disorder exclusion: Schizoaffective Disorder and Mood Disorder With Psychotic Features have been ruled out because either 1) no Major Depressive, Manic or Mixed Episodes have occurred concurrently with the active-phase symptoms; or 2) if mood episodes have occurred during active-phase symptoms, their total duration has been brief relative to the duration of the active and residual periods.

E) Substance/general medical condition exclusion: The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

F) Relationship to a Pervasive Developmental Disorder: If there is a history of Autistic Disorder or another Pervasive Developmental Disorder, the additional diagnosis of Schizophrenia is made only if prominent delusions or hallucinations are also present for at least a month (or less if successfully treated).