Post-Schizophrenic Depression Diagnostic Criteria

The formal diagnosis of post-schizophrenic depression rests on these symptoms, which can be evaluated by psychiatrists and other mental health professionals.

ICD-10 Criteria for Post-Schizophrenic Depression

The following information is reproduced verbatim from the ICD-10 Classification of Mental and Behavioural Disorders, World Health Organization, Geneva, 1992. (Since the WHO updates the overall ICD on a regular basis, individual classifications within it may or may not change from year to year; therefore, you should always check directly with the WHO to be sure of obtaining the latest revision for any particular individual classification.)

F20.4 Post-Schizophrenic Depression

A depressive episode, which may be prolonged, arising in the aftermath of a schizophrenic illness. Some schizophrenic symptoms must still be present but no longer dominate the clinical picture. These persisting schizophrenic symptoms may be “positive” or “negative”, though the latter are more common. It is uncertain, and immaterial to the diagnosis, to what extent the depressive symptoms have merely been uncovered by the resolution of earlier psychotic symptoms (rather than being a new development) or are an intrinsic part of schizophrenia rather than a psychological reaction to it. They are rarely sufficiently severe or extensive to meet criteria for a severe depressive episode, and it is often difficult to decide which of the patient’s symptoms are due to depression and which to neuroleptic medication or to the impaired volition and affective flattening of schizophrenia itself. This depressive disorder is associated with an increased risk of suicide.

Diagnostic Guidelines

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The diagnosis should be made only if:

  1. the patient has had a schizophrenic illness meeting the general criteria for schizophrenia (see introduction to F20 above) within the past 12 months;
  2. some schizophrenic symptoms are still present; and
  3. the depressive symptoms are prominent and distressing, fulfilling at least the criteria for a depressive episode, and havew been present for at least 2 weeks.

If the patient no longer has any schizophrenic symptoms, a depressive episode should be diagnosed. If schizophrenic symptoms are still florid and prominent, the diagnosis should remain that of the appropriate schizophrenic subtype.

All clinical material on this site is peer reviewed by one or more qualified mental health professionals. This specific article was originally published by on and was last reviewed or updated by Dr Greg Mulhauser, Managing Editor on .

Our material is not intended as a substitute for direct consultation with a qualified mental health professional. Please seek professional advice if you are experiencing any mental health concern.

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