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Psychiatry · USMLE Step 1

USMLE Psychiatry: Psychotic Disorders

Schizophrenia spectrum disorder diagnostic criteria and distinguishing features tested on USMLE Step 1.

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What is the minimum total duration of continuous signs of disturbance (including prodromal and residual periods) required for a schizophrenia diagnosis?
6 months
What is the minimum duration of active-phase (Criterion A) symptoms required for schizophrenia, unless successfully treated?
1 month
How many Criterion A symptoms must be present for at least a month to diagnose schizophrenia?
At least 2
Per DSM-5, at least one of the required Criterion A symptoms for schizophrenia must come from which three symptom types?
Delusions, hallucinations, or disorganized speech
What are the five symptom domains that make up Criterion A for schizophrenia?
Delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and negative symptoms
DSM-5 removed DSM-IV's rule that only ____ Criterion A symptom was needed if it was a bizarre delusion or a Schneiderian-type hallucination.
one
What is the symptom duration range that defines schizophreniform disorder?
1 to 6 months
What is the symptom duration range that defines brief psychotic disorder?
1 day to 1 month, with eventual full return to premorbid functioning
In schizoaffective disorder, what must occur concurrently with Criterion A (active-phase) symptoms at some point in the illness?
A major mood episode (depressive or manic)
For schizoaffective disorder, delusions or hallucinations must be present for how long in the absence of a major mood episode, at some point during the illness?
At least 2 weeks
For schizoaffective disorder, mood symptoms must be present for what proportion of the total duration of the illness?
The majority of the active and residual periods
What is the minimum duration of delusions required to diagnose delusional disorder?
At least 1 month
Aside from the impact of the delusion itself, how is a patient's overall functioning affected in delusional disorder?
It is not markedly impaired
What are the subtypes of delusional disorder?
Erotomanic, grandiose, jealous, persecutory, somatic, mixed, and unspecified
What defines the erotomanic subtype of delusional disorder?
The belief that another person, often of higher status, is in love with the patient

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