It can be a confusing and nerve-wracking journey to understand schizophrenia, whether you might have it, and how to seek effective treatment. The first step on the path towards a better life with schizophrenia often starts with a schizophrenia test.
What Is a Schizophrenia Test?
When you begin trying to figure out if you might have Schizophrenia, you might look for a Schizophrenia test. Those who are unfamiliar with the world of psychology might not realize the variety of tests, evaluations, and assessments that might be considered a kind of schizophrenia test. There are three general categories that we will review: online tests, self-assessments, and clinical evaluations and diagnoses.
The Online Schizophrenia Test
There are a number of places online where you can find quick tests that ask questions related to known symptoms of schizophrenia. These tests can be insightful for understanding schizophrenia, but it's important to understand that they do not represent an official schizophrenia test, evaluation, or diagnosis. If you are looking for a quick online test to provide a little insight into your own thought processes and experiences that might line up with schizophrenia, you might want to try an online schizophrenia test.
If you suspect you might have schizophrenia, you might be tempted to do a self-assessment. A web search returns clinician-created self-assessments for individuals to determine whether they have possible schizophrenia symptoms that might be disrupting their lives.
Use caution when doing a self-assessment. It is often human nature to overestimate our abilities and how well we function. Conversely, those with more severe schizophrenia commonly underestimate their own abilities, and self-assessments can lead or contribute to feelings of hopelessness and depression. The best option is to seek a professional evaluation from an expert.
Clinical Schizophrenia Evaluation and Diagnosis
The only way to determine whether you have schizophrenia and whether it is significantly impairing your life is to work with your physician and a trained psychological professional. It is usually a good idea to meet with your primary doctor first. Your doctor can work with you to rule out other medical causes of the symptoms and thought processes you may be experiencing. She or he can then refer you to a trained professional psychologist or psychiatrist to perform an evaluation.
When you begin working with your psychologist or psychiatrist to determine whether you have Schizophrenia, you will probably have to undergo something you might think of as a schizophrenia test. A diagnosis often begins and ends with referencing the symptoms and diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, currently in its fifth iteration (DSM-V). There is a range of what your psychologist might refer to as a "battery of tests." The psychologist will choose a specific battery of tests and evaluations based on your symptoms and their observations. If your symptoms seem to coincide with other diagnoses, you may work through several tests, including tests examining personality traits and possible mood disorders.
What Clinical Schizophrenia Tests Are There?
The schizophrenia test that your psychologist or psychiatrist chooses will vary. There are several Symptom Rating Scales used as a schizophrenia test, though a few scales tend to be used more commonly than others, some in conjunction with each other.
Scale for the Assessment of Negative Symptoms (SANS) and Scale for the Assessment of Positive Symptoms (SAPS)
These are two Symptom Rating Scales that clinicians often use in combination when evaluating a client for schizophrenia. The SANS and SAPS were developed in 1980 and 1981 to fill the need of searching for symptoms that consist of the absence of functional abilities, thoughts, and behaviors (negative symptoms), and the presence of abnormal behaviors or thought processes (positive symptoms). These symptoms are specifically geared to measure the likelihood of schizophrenia. It is based on symptoms backed up with empirical data—symptoms that have been found to go along with schizophrenia.
The SANS consists of 25 items/questions and tests for negative symptoms related to:
- Apathy
- Attention
- Mental confusion or difficulty speaking
- Inability to feel pleasure and the lack of desire to engage with others
- Difficulty expressing emotions
The SAPS consists of 34 items/questions and tests for positive symptoms related to:
- Thought disorder, such as incoherent or illogical speech
- Bizarre behaviors
- Thoughts and beliefs with no basis in reality (delusions)
- Hallucinations, usually heard, but sometimes seen
The Positive and Negative Symptom Scale (PANSS)
The PANSS is an evaluative scale that is largely used to measure the effectiveness of medications. Clinicians studying the effectiveness of a drug treatment might use this scale with the patients in their study. It is also sometimes used as a "stand-alone" screening tool for diagnosing schizophrenia. The PANSS consists of 30 items that separately test for the presence of positive symptoms, negative symptoms, and general psychopathology.
The PANSS tests for the following positive symptoms:
- Delusions
- Disorganized thoughts
- Hallucinatory behavior
- Excitement
- Beliefs about superiority
- Suspiciousness
- Hostility
Within the negative symptoms subscale, the PANSS tests for:
- Difficulty expressing emotions
- Emotional withdrawal
- Difficulty connecting with others
- Apathy in social situations
- Difficulty thinking about complex subjects
- Unable to naturally contribute to conversations spontaneously
- Repetitive thoughts and beliefs that may be unreasonable or excessive
The General psychopathology subscale on the PANSS tests for:
- Excessive concern with perceived physical problems
- Anxiety
- Feelings of guilt
- Tension
- Mannerisms and posturing
- Depression
- Slow physical movements
- Uncooperativeness
- Unusual thought content
- Disorientation
- Poor attention
- Lack of judgment and insight
- Inability to start working toward goals
- Poor impulse control
- Preoccupation
- Avoiding social interactions
Negative Symptoms Assessment 16 (NSA-16)
The NSA-16 is a 16-item assessment that your psychologist or psychiatrist will conduct as a structured interview with you. It is meant to be a significantly shorter evaluation of the presence of negative symptoms of schizophrenia. It is often used in conjunction with an evaluation of the positive symptoms of schizophrenia.
The Negative Symptoms Assessment 16 interview focuses on five factors:
- Communication
- Emotion
- Social involvement
- Motivation
- Developmental disabilities
Negative Symptoms Assessment 4 (NSA-4)
Like the NSA-16 which it was developed from, the Negative Symptoms Assessment 4 is a brief assessment of the presence of negative symptoms. It is only a 4-item assessment but has been found to be just as reliable and accurate as the NSA-16. The NSA-4 will usually be used with an assessment that focuses on positive symptoms. It focuses on most of the same factors as the NSA-16, just in a shortened form.
Clinical Global Impression-Schizophrenia (CGI-SCH) Scale
The CGI-SCH scale was developed to test the effectiveness of treatment for schizophrenia. It tests positive, negative, depressive and cognitive symptoms, as well as the severity of symptoms. The CGI-SCH scale is used by clinicians treating schizophrenia in private practice, as well as those doing clinical studies. It is often quicker and easier to administer since it only focuses on two categories: the severity of the illness and the degree of change.
Clinical Assessment Interview for Negative Symptoms and Brief Negative Symptom Scale (CAINS and BNSS)
The CAINS and BNSS were developed in 2005, following the National Institute of Mental Health conference on negative symptoms related to schizophrenia. It is based on the latest research and findings related to these types of schizophrenia symptoms. Both the CAINS and BNSS are increasingly used by clinicians to identify and evaluate negative symptoms. Both scales use 13-items in their assessments and focus on negative symptoms like lack of pleasure and lack of interest in social interactions.
5 Things You Need to Know before Taking a Schizophrenia Test
Online Tests Cannot Replace a Diagnosis
While online tests can be a good starting point for understanding the symptoms of schizophrenia, they cannot replace an actual clinical schizophrenia test. If you suspect you have schizophrenia, or conversely, if you have been diagnosed with schizophrenia and believe the diagnosis is incorrect, you should discuss your concerns with your doctor or psychologist.
Your Doctor Must First Rule Out Medical Conditions
To get an accurate diagnosis, your doctor will first need to rule out other medical conditions that cause symptoms similar to schizophrenia. They might need to conduct a physical exam, do an MRI (Magnetic Resonance Imaging), or a CT scan (Computerized Tomography). The doctor will need to know your family history and the mental and physical health history of your biological family. You should also be prepared to share a list and history of any medications or drugs you may have taken.
Your Psychiatric Testing Might Be Short or Extensive
There is a range of tests that your psychiatrist or psychologist might choose based on what she or he understands of your symptoms. Depending on the tests, assessments or scales your psychiatrist uses and your symptoms, your testing could take just an hour or two or could take place over a few days. Your symptoms might be related to other psychiatric disorders, such as bipolar disorder or schizoaffective disorder, so you could have additional tests to rule these possibilities out.
Time Is Important to Diagnosis
If your symptoms have just started recently, your doctor and psychologist may re-evaluate after a few months. A schizophrenia diagnosis requires that your symptoms are present for at least six months.
A Schizophrenia Test Is the First Step towards Hope
Many people feel nervous or even scared to receive a mental health diagnosis. People with schizophrenia are often able to lead full and successful lives. The earlier you receive a diagnosis, the quicker you can get your life back on track and achieve your goals. Commit to treatment, and you can still lead the life you've always wanted.
If you are preparing to take your first schizophrenia test, you might be feeling anxious about the results. It can help to know what might be involved beforehand. Even more important, you should realize that mental health diagnoses, including schizophrenia, is merely the first step in recovery and becoming the person you've always wanted to be. Don't be scared to take that first step. It's time to know for sure.
