title: Considering DSM-5: the personal experience of schizophrenia in relation to the DSM-IV-TR criteria.
abstract: Previous analyses have suggested that the personal experience of schizophrenia might be different from its depiction in the DSM-IV-TR. In this study, 17 people with schizophrenia or schizoaffective disorder were interviewed about their experiences of the DSM-IV-TR diagnostic criteria for schizophrenia. Descriptive phenomenological analysis was used to analyze the ways in which the personal experiences of the people in this study were similar to or different from the depiction of schizophrenia in the DSM-IV-TR. The personal experience of schizophrenia was similar in some way to each of the five diagnostic criteria for schizophrenia. Participants' personal experiences also went beyond the DSM-IV-TR criteria. Specifically, participants described strong emotional reactions to their symptoms, including fear, sadness, embarrassment, and alienation. Also, participants described intense interest but severe disruptions in goal-directed behavior due to their hallucinations being engrossing, confusing, and distracting. Further, participants described not sharing their experiences in order to avoid social stigma. These findings suggest that the description of schizophrenia in DSM-5 may benefit from a change to DSM-IV-TR criteria to incorporate more of the personal experience of schizophrenia. Further research is needed to establish the representativeness, reliability, and validity of the qualitative findings described here.
authors.affiliation: Yale University in New Haven, Connecticut 06513, USA. elizabeth.flanagan@yale.edu
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Flanagan
authors.forename: Lesley Anne
authors.initials: LA
authors.lastname: Solomon
authors.forename: Amy
authors.initials: A
authors.lastname: Johnson
authors.forename: Priscilla
authors.initials: P
authors.lastname: Ridgway
authors.forename: John S
authors.initials: JS
authors.lastname: Strauss
authors.forename: Larry
authors.initials: L
authors.lastname: Davidson
mesh_terms: D001037:Aphasia / Q000523:psychology; D001294:Attitude to Health; D003702:Delusions / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004644:Emotions; D005260:Female; D006212:Hallucinations / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology; D036301:Qualitative Research; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000175:diagnosis*; D012565:Schizophrenic Psychology; D057545:Social Stigma; D014836:Volition