What Is a Schizophrenia Test?

Schizophrenia is a serious mental illness causing difficulty in the way one thinks, feels, and behaves.

Sometimes previously referred to as paranoid schizophrenia, diagnosing the condition can be challenging. There isn’t a schizophrenia test that can be used for a definitive diagnosis. Also, several other mental illnesses can present with symptoms similar to schizophrenia, and other factors (such as methamphetamine or LSD drug use) may cause schizophrenic-like symptoms.

Another obstacle to overcome in the diagnostic process is that many people with schizophrenia can't recognize that their symptoms are due to a mental illness. This lack of awareness (anosognosia) lends itself to complicating the diagnostic process as well as subsequent treatment efforts. 

This article discusses testing for schizophrenia. It also includes a self-assessment test that can help lead you to a clinical diagnosis.

Self-Assessment

A number of online self-assessment tools are available that can help a person determine whether certain symptoms are present that may be a part of a diagnosis of schizophrenia. The information gathered from a self-assessment quiz may help a person decide whether to seek medical attention. 

You can find one self-assessment tool at Mental Health America. Examples of questions on this self-evaluation include:

• Have you felt that you are not in control of your ideas or thoughts?
• Do familiar surroundings sometimes seem strange, confusing, threatening, or unreal to you?
• Do you struggle to trust that what you are thinking is real?
• Do you struggle to keep up with daily living tasks such as showering, changing clothes, paying bills, cleaning, and cooking?

Symptoms of Schizophrenia

The symptoms of schizophrenia can involve a range of cognitive, behavioral, and emotional challenges, and may present differently, depending on the stage of the disorder. Diagnosis can be more challenging during certain stages of the illness.

For example, when a person is in the early stage of the condition—called the prodromal stage—often during adolescence, symptoms may mimic common adolescent behavior. The first signs of schizophrenia may be symptoms such as:

• A decrease in performance (such as a drop in grades)
• A change in a person’s social or friends’ group
• Withdrawal or isolation

These early symptoms can also be normal developmental hurdles that an adolescent goes through. This factor is one of several that complicate the diagnosis process.

In addition to a decline in functioning that must be present for at least six months, common symptoms that are observed when a person has schizophrenia include:

• Hallucinations: Hearing voices, seeing things, or having other sensory perceptions that others do not perceive. Auditory hallucinations (hearing voices) and visual hallucinations (seeing people or other things that do not exist) can appear very real to a person with schizophrenia.
• Delusions: False beliefs that a person resolutely holds onto regardless of evidence to the contrary
• Disorganized thinking: Talking in a jumbled, nonsensical way, or frequently derailed way.
• Disorganized behavior: A symptom that may exhibit itself in a few different ways, from acting unpredictably to agitation, bizarre posture, a total lack of response, or excessive physical movements
• Negative symptoms: Symptoms of schizophrenia that represent a lack of normal behaviors or expressions, such as those that enable a person to experience enjoyment

Examples of negative symptoms of schizophrenia include:

• Lack of emotion
• Blunted expression
• Speech that appears dull
• Poor hygiene
• Lack of energy and enthusiasm
• Social isolation
• A decreased interest in work, school, goals, and other activities
• Cognitive issues, including trouble remembering, learning, concentrating, organizing thoughts, completing tasks, and making decisions

The negative symptoms of schizophrenia often begin some time before the person experiences the first positive psychotic symptoms (hallucinations, delusions, and disorganization). Psychotic episodes (the active stage) begin during the second stage of the illness.

Diagnosis

Although there are not specific lab tests to diagnose schizophrenia, certain procedures may be performed to rule out medical or neurological contributions to the symptoms.

Medical Evaluation

• A history and physical (H&P): Includes a physical examination and the person’s medical and family history
• MRI scan: An image of the brain may be taken to rule out a brain abnormality that may be causing symptoms similar to those in the diagnosis of schizophrenia.
• CT scan: This may be done to look for structural findings (such as a brain tumor) that could be the underlying cause of schizophrenia-like symptoms.
• Blood tests: These can be used to rule out other underlying physical contributions to schizophrenia-like symptoms such as alcohol or drug abuse or hormonal or metabolic abnormalities.
  

Psychiatric Evaluation

A psychiatric evaluation is a diagnostic assessment that includes looking at a person’s history, symptoms, mental status, abilities, behavior, and many other psychiatric and cognitive characteristics. The evaluation is used to gather many different aspects of a person’s history, symptoms, concerns, and more. It is aimed at making a mental health diagnosis.

Diverse psychiatric data is gathered during a mental health evaluation, including information about:

• The presence of signs and symptoms of psychiatric disorders, such as anxiety, substance use, depression, mania, psychosis, and other symptoms.
• Nonpsychiatric issues, such as goals, career interests, intelligence level, and more

The exam may gather information using a wide range of diagnostic tools, including:

• Interviews
• Self-reports
• Standardized tests
• Psychological measurement devices
• Other specialized procedures

Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Criteria

The DSM-5 is considered the standard reference book in mental illness diagnoses (including schizophrenia). It is published by the American Psychiatric Association.

According to the DSM-5, before a diagnosis of schizophrenia can be made, a person must have two or more of the following symptoms in the past 30 days (as well as having other signs of the disturbance for at least the past six months):

• Delusions
• Hallucinations
• Disorganized speech
• Disorganized or catatonic behavior
• Negative symptoms

In addition to the requirement of having at least two of the symptoms on the list to be diagnosed with schizophrenia, at least one of the symptoms must be a symptom of psychosis (including delusions, hallucinations, or disorganized speech).

After medical tests are performed to rule out other possible causes of symptoms of schizophrenia, the diagnostician determines whether the person’s symptoms are such that they qualify for a diagnosis of schizophrenia, according to these criteria outlined by the DSM-5.

Other Related Conditions

During a psychiatric evaluation, a person with symptoms of schizophrenia may be found to have other types of mental illness that could cause similar symptoms such as:

• Brief psychotic disorder: An episode of psychotic symptoms lasting less than 30 days
• Delusional disorder: Experiencing some type of delusion, such as having a delusion of grandeur without other accompanying symptoms
• Schizoaffective disorder: Symptoms of psychosis, along with a mood disorder
• Schizophreniform disorder: A psychotic disorder, similar to schizophrenia, but the symptoms only last one to six months
• Schizotypal personality disorder: A condition involving an ongoing pattern of social and interpersonal deficits, often marked by eccentricities and thought distortions

A Word From Verywell

It’s important to realize that an early diagnosis is said to improve the outcome of schizophrenia.

According to the National Mental Health Alliance (NAMI), the role of psychotropic medication (drugs that treat symptoms of mental illness) for early treatment is evolving, but psychotherapy and psychosocial intervention are an absolute must.