ICD-11 introduced a significant change to schizophrenia criteria compared to ICD-10. Which change is MOST notable?

• A ICD-11 requires a 6-month minimum duration (same as DSM-5)
• B ICD-11 requires at least 3 positive symptoms for diagnosis
• C ICD-11 requires hospitalization for schizophrenia diagnosis
• D ICD-11 removed Schneiderian first-rank symptoms as pathognomonic and no longer requires them; any two core symptoms for at least 1 month suffice ✓

Explanation

ICD-11 made a major revision by removing the special diagnostic weight of Kurt Schneider's first-rank symptoms (e.g., thought insertion, passivity experiences, third-person auditory hallucinations). Previously, ICD-10 considered even a single first-rank symptom sufficient for diagnosis. ICD-11 now requires at least two characteristic symptoms present for at least 1 month (same symptom groups as DSM-5: positive, negative, disorganization, catatonia, cognitive). The minimum duration in ICD-11 is 1 month of active symptoms, unlike DSM-5's 6-month minimum (including prodrome). This alignment with phenomenological rather than pathognomonic symptoms reflects the dimensional approach.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

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Written and medically reviewed by the StethoPrep medical team.