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What is the difference between chronic psychosis and schizophrenia?

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singsongfun

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Am I right in thinking in the USA or internationally if you have persistent chronic psychosis and it's not something else, you will get a schizophrenia diagnosis. However, in the UK, the NHS want negative symptoms sometimes or always present, as well as the positive symptoms, to diagnose schizophrenia.
Is this just because the NHS is shit, or is there some reason for it?
 
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Aurelius

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No the NHS is not being sh.. about this. There are a number of psychoses, of which schizophrenia is one. A lot of further harm can be done to daily lives if people are prescribed the wrong treatments, especially where heavy duty medications might be involved - some of which, if wrongly prescribed, can make conditions far worse (i.e., even make some people suicidal). This is also why they try to identify if there are any comorbid health/mental health conditions that need to be taken into consideration.
 
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Aurelius

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Answering your question about what health practitioners in the NHS may look for before giving a diagnosis of schizophrenia, it is published on their public information website:

Diagnosis - Schizophrenia

Schizophrenia can usually be diagnosed if:

  • you've experienced 1 or more of the following symptoms most of the time for a month: delusions, hallucinations, hearing voices, incoherent speech, or negative symptoms, such as a flattening of emotions
  • your symptoms have had a significant impact on your ability to work, study or perform daily tasks
  • all other possible causes, such as recreational drug use or bipolar disorder, have been ruled out
You will see that it is or negative symptoms, not and negative symptoms. Both the UK and USA use internationally agreed diagnostic criteria. There are two main frameworks, DSM-V (American Psychiatric Association - APA) and ICD-10/11 (World Health Organisation - WHO). There are some differences, but they mainly agree in terms of the key diagnostic criteria.
 
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singsongfun

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Answering your question about what health practitioners in the NHS may look for before giving a diagnosis of schizophrenia, it is published on their public information website:

Diagnosis - Schizophrenia

Schizophrenia can usually be diagnosed if:

  • you've experienced 1 or more of the following symptoms most of the time for a month: delusions, hallucinations, hearing voices, incoherent speech, or negative symptoms, such as a flattening of emotions
  • your symptoms have had a significant impact on your ability to work, study or perform daily tasks
  • all other possible causes, such as recreational drug use or bipolar disorder, have been ruled out
You will see that it is or negative symptoms, not and negative symptoms. Both the UK and USA use internationally agreed diagnostic criteria. There are two main frameworks, DSM-V (American Psychiatric Association - APA) and ICD-10/11 (World Health Organisation - WHO). There are some differences, but they mainly agree in terms of the key diagnostic criteria.

Thanks for this.
However, many people in the UK get diagnosed with Psychosis Not Otherwise Specified or things like "anxiety induced psychosis", when they actually have schizophrenia. I am not really sure why the NHS do this.
 
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singsongfun

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A CPN once told me that some psychiatrists are reluctant to diagnose schizophrenia, other than in the worse cases, because they worry people will behave like the stereotype of their diagnosis.
 
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Aurelius

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So many symptoms are shared by different mental health disorders that accurate diagnosis sometimes requires a psychiatrist who is particularly skilled in 'differential diagnosis'. This does not mean that other psychiatrists will be less skilled in treating mental health disorders. Different psychiatrists may bring different viewpoints, concepts, diagnostic interpretations and clinical skill sets to their work with patients - what is important is that they work in partnership with patients to identify patient's needs and priorities and to agree how they will seek to address those needs in ways that hopefully match the patient's priorities.
 
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