Can Verbal Symptoms Determine a Diagnosis of Schizophrenia?

Can the reported symptoms determine if an individual has schizophrenia?

Hello Dr.
Su! I have a few questions regarding my brother's first visit to the psychiatric department.
The date was February 5, 2001, and prior to this, he had never sought treatment for mental health issues.
I accompanied him to the initial consultation, where the doctor repeatedly inquired about any special circumstances he had experienced.
The medical summary dated May 23, 2001, states the following:
1.
Initial consultation date: February 5, 2001 - Main issues at that time: auditory hallucinations, talking to himself - Diagnosis: suspected schizophrenia.
2.
Hospitalization dates: from February 16, 2001, to May 21, 2001 - Main issues: mutism, repetitive behaviors, incoherent speech - Diagnosis: schizophrenia.
3.
The medical advice section notes: The patient had episodes approximately ten years ago, during which he exhibited incoherent speech, talking to himself, and disruptive behavior.
He also attempted suicide several times under the influence of auditory hallucinations without seeking medical attention.
In February of this year, due to worsening symptoms such as social withdrawal and mutism, family members brought him to our hospital for treatment, leading to hospitalization.
After receiving psychotherapy and medication, some of the psychiatric symptoms improved, and he was discharged on May 21, 2001.
He has not yet returned for a follow-up appointment.
I would like to ask if the verbal account of past psychiatric symptoms can determine whether he had a mental illness at that time? Can the past psychiatric signs described by the patient or family members be considered part of his "medical history," and what does "medical history" mean? Based on the past psychiatric signs reported by the patient or family members, can we conclude that he has schizophrenia? According to the medical advice section of the summary dated May 23, 2001, can we determine that he had a mental illness at that time? Is the term "Psychiatric disorder" a recognized medical term? What does it represent? Does it refer to a mental illness?
I apologize for taking up your valuable time, and I appreciate your response.
Thank you, JENNY CHEN.

Jenny Chen, 30~39 year old female. Ask Date: 2006/08/04

Dr. Su Zongwei reply Psychiatry

Is it possible to determine that a person had a mental illness based on their verbal account of past psychiatric symptoms? Psychiatric assessments rely on the patient's verbal history, observations of their mental state, and, if necessary, psychological evaluations for diagnosis, rather than solely on reported symptoms.
Can the verbal accounts of past psychiatric signs from the patient or their family be considered part of their "medical history," and what does "medical history" mean? Medical history refers to the description of the development of past illnesses.
Can the verbal accounts of past psychiatric signs from the patient or their family lead to a diagnosis of schizophrenia? A diagnosis cannot be confirmed solely based on verbal accounts; the patient must undergo a personal evaluation for an accurate assessment.
Regarding the medical record summary dated May 23, 2001, can we conclude that the patient had a mental illness at that time based solely on the record? It is not possible to make such a determination based only on the record.
A personal evaluation of the patient must be conducted to meet diagnostic criteria before a diagnosis can be established.
Is the term "Psychastric disorder" a recognized psychiatric term? What does it mean? Does it refer to mental illness? I am not familiar with this term and wonder if it is a misspelling of "psychiatric disorder."

Reply Date: 2006/08/04

More Info

Hello Jenny,
Thank you for your detailed inquiry regarding the diagnosis of schizophrenia and the role of verbal symptoms in determining mental health conditions. Your questions touch on several important aspects of psychiatric evaluation, diagnosis, and the interpretation of medical history.

1. Verbal Symptoms and Diagnosis: Verbal symptoms, such as auditory hallucinations (hearing voices) and disorganized speech (speaking incoherently), are indeed significant in diagnosing schizophrenia. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines specific criteria for schizophrenia, which include the presence of at least two of the following symptoms for a significant portion of one month: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and negative symptoms (such as diminished emotional expression). Therefore, if a patient reports experiencing these symptoms, they can be indicative of schizophrenia, especially when corroborated by family members or medical records.

2. Patient and Family Reports as Medical History: The account of past symptoms provided by the patient or their family can be considered part of the patient's medical history. Medical history refers to the record of a patient's past health issues, treatments, and responses to therapies. It is crucial for understanding the patient's current condition and guiding treatment. In your case, the reported symptoms of hallucinations, disorganized speech, and self-harm behavior contribute to establishing a history of psychiatric illness, which is essential for diagnosis.

3. Determining Past Mental Illness: Based on the information you provided, including the documented symptoms and the diagnosis of schizophrenia during the hospital stay, it is reasonable to conclude that the individual had a psychiatric disorder at that time. The presence of symptoms such as auditory hallucinations and disorganized behavior, along with the need for hospitalization, supports this conclusion.

4. Understanding "Psychiatric Disorder": The term "psychiatric disorder" is indeed a recognized term in mental health. It encompasses a wide range of mental health conditions, including schizophrenia, mood disorders, anxiety disorders, and others. It indicates that there is a clinically significant disturbance in an individual's cognition, emotion regulation, or behavior, which reflects dysfunction in psychological, biological, or developmental processes.

5. Conclusion: In summary, verbal symptoms and the patient's history, as reported by both the individual and their family, are critical in diagnosing schizophrenia and other psychiatric disorders. The documentation from the hospital visit, including the symptoms and the diagnosis, provides a clear indication of the individual's mental health status at that time. It is essential for ongoing treatment and management to have a comprehensive understanding of the patient's history and symptoms.

If you have further questions or need clarification on any specific points, please feel free to ask. It's important to ensure that individuals with mental health concerns receive the appropriate support and treatment.

Best regards,
Doctor Q&A Teams

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