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.
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.
Takeaway
Is schizophrenia a psychotic disorder?
Yes, schizophrenia is considered a psychotic disorder.
The ICD has a range of diagnostic criteria for schizophrenia, whether it occurs as a single episode or a recurrent disorder. For example, schizophrenia cannot be diagnosed if the person also has a brain disease or is experiencing withdrawal from psychoactive drug use. It specifies that cognitive deficits associated with schizophrenia can evolve over time, and has an additional “other specified cognitive deficit” designation. Other criteria can exclude this as a diagnosis. For example, schizophrenic reaction is included under schizotypal disorder but not schizophrenia.
Other diseases classified in the ICD have specific diagnostic criteria as well. For example, “manic episode” is broken down into hypomania, mania without psychotic symptoms, and mania with psychotic symptoms, and each of these has further specifications. Mania with psychotic symptoms is further clarified as having mood-congruent psychotic symptoms, mood-incongruent psychotic symptoms, and manic stupor. A mood disorder like bipolar disorder is broken down into two subcodes, including “bipolar affective disorder, current episode manic without psychotic symptoms,” “current episode depressed, mild,” and “current episode mixed.”
Is catatonic schizophrenia the same as schizophrenia?
The DSM-5 no longer recognizes subtypes of schizophrenia, instead treating it as a spectrum on which people have different symptoms and different levels of severity. However, before 2013, the DSM-4 recognized multiple subtypes, one of which was catatonic schizophrenia.
What are the symptoms of chronic schizophrenia?
Schizophrenia is a chronic brain disorder. While there is no cure, symptoms can be manageable. Some people with this condition may experience periods of remission when their symptoms are either well-controlled or disappear altogether, but they can also experience flares when their symptoms flare up.
When this condition is active, people can experience a range of symptoms, including hallucinations, delusions, lack of motivation, difficulty making decisions, or disorganized speech.
Multiple conditions can have overlapping symptoms with schizophrenia, including major depressive disorder, cyclic schizophrenia, antisocial personality disorder, avoidant personality disorder, schizoid personality disorder, panic disorder, attention deficit hyperactivity disorder, and manic-type schizoaffective disorders. Because of this, only a trained mental health professional can accurately diagnose someone with schizophrenia or any other mental health condition.
What triggers paranoid schizophrenia?
There is no single confirmed cause of schizophrenia, but experts believe that a combination of factors, including chemical changes in the brain, congenital brain problems, or disruptions in communication in the brain causes it. Risk factors for this mental disorder include family history, exposure to certain chemicals, recreational drug use, and complications during pregnancy.
What is an example of residual schizophrenia?
Residual schizophrenia occurs when someone has an episode of schizophrenia and negative symptoms gradually replace positive symptoms. In other words, symptoms like hallucinations and delusions are replaced with symptoms like reduced emotional expression, loss of interest or pleasure, lack of motivation, or social withdrawal. This subtype of schizophrenia is no longer used as a diagnostic term.
How is schizophrenia diagnosed ICD?
The World Health Organization developed the (ICD) International Classification of Diseases to help medical professionals around worldwide and diagnose physical and mental health conditions. Like the changes made between the DSM-4 and DSM-5, the ICD experienced numerous changes between regarding schizophrenia the ICD-10 and ICD-11 concerhe ICD-10, schizophrenia was listed under mental, behavioral, and neurodevelopmental disorders in the subcategory schizophrenia, schizotypal, and delusional disorders. There were multiple subtypes, including simple schizophrenia, catatonic schizophrenia, and paranoid schizophrenia.
With the introduction of the ICD-11 in 2022, specific types of schizophrenia are no longer recognized. Instead, schizophrenia is categorized under the “Schizophrenia or other primary psychotic disorders” section.
Psychotic features are also found in many other diagnoses in the ICD-10 but are no longer included or slightly altered in the ICD-11. For example, schizophrenic reaction NOS (not otherwise specified) in the ICD-10 may be classified as “unspecified schizophrenia” in the ICD-11.
What is the ICD-10 code for F22?
In both the ICD-10, F22 is the code for delusional disorders; in the ICD-11, it is persistent delusional disorders.
What is the ICD-10 code for F20-F29?
In the ICD-10, these codes are identified as follows:
- F20: Schizophrenia
- F21: Schizotypal disorder
- F22: Delusional disorders
- F23: Brief psychotic disorder
- F24: Shared psychotic disorder
- F25: Schizoaffective disorders
- F28: Other psychotic disorder not due to a substance or known physiological condition
- F29: Unspecified psychosis not due to a substance or known physiological condition
Note that there are no conditions classified as F26 or F27.
What is the ICD-10 AM schizophrenia?
The ICD-10-AM is the Australian modification of the ICD. Diagnosis codes for schizophrenia are F20.0–F20.3, F20.5, and F20.9.
What type of ICD is schizophrenia unspecified?
The code for schizophrenia unspecified in the ICD-10 is F20.9.
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