An Introduction To Schizophrenia

If you’ve been diagnosed with schizophrenia, you may have noticed that your doctor or mental health provider has included an ICD code in your records. 

The International Classification of Diseases (ICD)—a listing of mental and physical health conditions published by the World Health Organization (WHO)—is regularly revised as science progresses. Understanding the differences between new and old listings can be complicated, so it may be helpful to take a closer look at the ICD entry for schizophrenia. Explore differences between the ICD-10 and ICD-11 listings, key schizophrenia symptoms to be aware of, and support options. 

An introduction to schizophrenia

Schizophrenia is a severe mental illness that often develops early in life. The exact cause of this condition is still unknown, but research has identified a few possible risk factors, including:

• Having a relative with schizophrenia
• Having a low birth weight
• Being born prematurely
• Using cannabis regularly at a young age

Schizophrenia can cause a range of symptoms that affect the ways people think, act, and express themselves. These symptoms can make it difficult to tell what’s real and what’s not; sometimes, they cause people to lose touch with reality. Some people with schizophrenia experience “psychosis” episodes. People with schizophrenia often go through multiple periods of psychosis during their lives. It can also be common for schizophrenia to accompany other mental illnesses, like depression, obsessive-compulsive disorder (OCD), and anxiety disorders. 

Exploring schizophrenia symptoms

Positive symptoms may include:

• Hallucinations: Experiencing sensory perceptions that are not truly occurring, such as hearing voices or seeing shadow figures 
• Delusions: Having strictly held false beliefs that aren’t changed when presented with logic or proof otherwise 
• Disorganized thinking: Experiencing thoughts that jump around or don’t follow logic
• Disorganized speech: Rambling, going on tangents, mixing up words, or talking in a way that doesn’t make sense to others
• Movement changes: Standing or sitting in unusual positions, moving excessively, or being excessively still

Negative symptoms may include:

• Social withdrawal: Losing interest in relationships and social activities
• Loss of pleasure: Loss of interest in previously enjoyed activities 
• Lack of motivation: Losing interest in tasks, such as bathing, going to work, or paying bills
• Reduced expression: Showing less emotion, speaking in a flat voice, or lacking facial expressions

Getting familiar with these symptoms may make it easier to understand the different ICD diagnoses for schizophrenia. 

About the schizophrenia ICD-10 listing

The International Classification of Diseases is a system developed by the World Health Organization for labeling and defining mental and physical health conditions. Doctors worldwide use this manual to make diagnoses and record them in their patients’ medical histories. A doctor may also use a code from the ICD when they bill a patient’s insurance. This code is known as a “billable/specific code.”

Subtypes under schizophrenia ICD 10 diagnosis

In the ICD-10, schizophrenia can be found in the section on “Mental, behavioral and neurodevelopmental disorders.” It is listed under “Schizophrenia, schizotypal and delusional disorders,” and its ICD-10-CM code is F20. The ICD-10 listing also provides separate codes for specific subtypes of schizophrenia, such as:

Simple schizophrenia

This ICD-10 diagnosis centers on schizophrenia symptoms that come on gradually and get progressively worse. It also includes negative symptoms that come on without being preceded by obvious positive symptoms. 

Catatonic schizophrenia

This diagnosis features symptoms that mainly relate to movement. Symptoms may include excessive movement or excessive stillness. 

Disorganized schizophrenia

Disorganized schizophrenia features symptoms relating to mood, speech, and behavior. Social isolation is considered another common symptom. 

Paranoid schizophrenia

This ICD-10 diagnosis features symptoms relating to paranoid delusions, which are usually accompanied by hallucinations, mainly the auditory type.

Residual schizophrenia

Residual schizophrenia is characterized by having long-term negative symptoms of schizophrenia.

Schizophrenia, unspecified

In the ICD-10, this diagnosis could be applied to schizophrenia symptoms that don’t meet the full criteria for a more specific diagnosis. The “unspecified” label could also be given to other related disorders. For example, “unspecified psychosis” or “brief psychotic disorder, unspecified” may be listed under this label. 

The release of the ICD-11 

Note that the ICD-10 listings are no longer up to date. The entry for schizophrenia was changed in the ICD-11, released in 2022. Mental health research is constantly evolving, and so is the psychological community’s understanding of how to define and talk about different mental illnesses. The changes in the ICD-11 reflect this change. 

Changes from schizophrenia ICD 10 diagnosis to ICD-11

The ICD-11 no longer includes separate listings for specific types of schizophrenia. Rolling them all into one blanket entry may better capture the diverse range of ways schizophrenia can affect people and make it easier to distinguish between schizophrenia and other disorders. In the ICD-11, schizophrenia can now be found in the “Schizophrenia or other primary psychotic disorders” section. Its code has been updated to 6A20. 

The ICD-11 also includes codes for disorders that are separate from schizophrenia but share similar symptoms. Examples include the following conditions: 

Schizoaffective disorder

Schizoaffective disorder can cause symptoms of schizophrenia like hallucinations and delusions. However, it also causes additional manic- or depressive-type symptoms. It differs from bipolar disorder in that the condition involves hallucinations and delusions, which bipolar disorder does not.  

Schizotypal disorder

Schizotypal disorder that can make social interactions and relationships difficult. The condition can also cause unusual behaviors and beliefs without the more intense delusions and hallucinations of schizophrenia. 

Delusional disorder

Delusional disorder causes delusions in the same way schizophrenia does. However, it doesn’t cause many of the other symptoms of schizophrenia, like hallucinations. 

Acute and transient psychotic disorder (brief psychotic disorder)

This diagnosis may be given to someone who shows psychotic symptoms that last more than a day but no more than a few months. This condition is generally not due to a substance or known physiological condition. In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), this condition is called “brief psychotic disorder.”

If you’ve been diagnosed with schizophrenia or a related disorder, your doctor or psychologist might include an ICD code in your diagnosis for reimbursement purposes. Insurance companies often require an ICD code to cover services. 

Explore professional support options for schizophrenia

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Moving forward after a schizophrenia diagnosis

While schizophrenia is a lifelong condition, it can often be managed through a combination of medication and mental health support. If you’ve been diagnosed with schizophrenia, talking to your doctor may be the first step toward finding a treatment plan that works for you. 

Therapy often plays a key role in the management of schizophrenia. Working with a therapist may give you helpful tools to manage your symptoms, maintain healthy relationships, and support your overall mental health. However, attending therapy may be a challenge if schizophrenia symptoms make it hard to leave the house. If so, online therapy may be a solution. Platforms like BetterHelp can connect you with a therapist from wherever you’re most comfortable. In addition, you can choose between phone, video, or live chat sessions to have more control over your care. 

A growing body of research shows that online therapy can effectively treat mental illnesses that often go hand-in-hand with schizophrenia. For example, a 2017 analysis looked at data from 373 studies of internet-based therapy. Online therapy was found to effectively treat symptoms of OCD, anxiety, depression, and others. 

Consult a medical doctor before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis.