- F20
- Psychotic Disorders
Schizophrenia (F20)
DSM-5-TR: Schizophrenia
ICD-10-AM and DSM-5-TR may classify conditions differently. Refer to APA and WHO for complete diagnostic criteria.
Key Facts
- ICD-10 RangeF20-F29
- Subcodes9 subcodes
- Australian PrevalenceAffects approximately 0.4-0.7% of the Australian population. Management primarily through public mental health services.
- Global PrevalenceLifetime prevalence approximately 0.3-0.7% worldwide with relatively uniform distribution across countries.
- Duration RequirementSymptoms present for most of the time during at least one month
Overview
Schizophrenia involves fundamental distortions of thinking and perception, with inappropriate or blunted affect. Clear consciousness and intellectual capacity are usually maintained. Key psychopathological phenomena include thought echo, thought insertion or withdrawal, thought broadcasting, delusional perception, hallucinatory voices, and passivity experiences.
Diagnostic Criteria (ICD-10)
Core Features
- Thought echo, insertion, withdrawal, or broadcasting
- Delusions of control, influence, or passivity
- Hallucinatory voices (running commentary, discussing the person, or emanating from body parts)
- Persistent bizarre delusions
- Persistent hallucinations in any modality with partial delusions
- Thought disorder (breaks, interpolations, neologisms, incoherence)
- Catatonic behaviour
- Negative symptoms: apathy, paucity of speech, blunting of affect, social withdrawal
Duration Symptoms present for most of the time during at least one month
Severity Specifiers
- Paranoid (F20.0)
- Hebephrenic/disorganised (F20.1)
- Catatonic (F20.2)
- Undifferentiated (F20.3)
- Residual (F20.5)
- Simple (F20.6)
Exclusion Criteria
- Extensive depressive or manic symptoms (use F30-F33 or F25)
- Brain disease or drug intoxication/withdrawal (use F00-F09 or F10-F19)
ICD-10-AM Subcodes
| Code | Name | Description |
|---|---|---|
| F20.0 | Paranoid schizophrenia | Dominated by relatively stable delusions, usually paranoid, usually accompanied by hallucinations, particularly of the auditory variety, and perceptual disturbances. |
| F20.1 | Hebephrenic (disorganised) schizophrenia | Characterised by prominent affective changes, fleeting and fragmentary delusions and hallucinations, and irresponsible and unpredictable behaviour. |
| F20.2 | Catatonic schizophrenia | Dominated by prominent psychomotor disturbances, which may alternate between extremes of hyperkinesis and stupor, or automatic obedience and negativism. |
| F20.3 | Undifferentiated schizophrenia | Conditions meeting the general criteria for schizophrenia but not fitting any specific subtype, or showing features of more than one subtype. |
| F20.4 | Post-schizophrenic depression | A depressive episode arising in the aftermath of a schizophrenic illness, where some schizophrenic symptoms may persist. |
| F20.5 | Residual schizophrenia | A chronic stage dominated by long-term negative symptoms (psychomotor slowing, underactivity, blunting of affect, passivity). |
| F20.6 | Simple schizophrenia | Insidious but progressive development of oddities of conduct, inability to meet the demands of society, and decline in total performance without prominent positive symptoms. |
| F20.8 | Other schizophrenia | Other specified forms of schizophrenia. |
| F20.9 | Schizophrenia, unspecified | Schizophrenia where the specific subtype is unspecified. |
Classification Boundaries
Includes
- Schizophrenic reaction
- Schizophrenia NOS
- Paraphrenia
Excludes1 (coded elsewhere)
- Schizoaffective disorder (F25)
- Schizotypal disorder (F21)
- Schizoid personality disorder (F60.1)
Excludes2 (may co-occur)
- Acute schizophrenia-like psychotic disorder (F23)
Australian Clinical Context
Schizophrenia affects approximately 0.4–0.7% of the Australian population. Management is primarily through public mental health services, with community mental health teams providing ongoing care. RANZCP guidelines recommend long-acting injectable antipsychotics for adherence support. NDIS provides disability support. Early psychosis intervention services (e.g., EPPIC model) are available in major centres.
Medicare (MBS) Pathways
Better Access to Mental Health Care
The primary Medicare pathway for mental health treatment in Australia. Requires a GP Mental Health Treatment Plan (MHTP) referral. Available for any clinically diagnosed mental disorder.
10 individual + 10 group sessions per calendar year
| Provider Type | MBS Items | Session Type |
|---|---|---|
| Clinical Psychologist | 80000–80025 | Psychological therapy (higher rebate) |
| Registered Psychologist | 80100–80123 | Focused psychological strategies |
| Occupational Therapist | 80125–80145 | Focused psychological strategies |
| Social Worker | 80150–80175 | Focused psychological strategies |
| Psychiatrist | 291, 296–299, 300–308 | Psychiatric consultation |
GP referral items: 2700, 2701, 2715, 2717
Eligibility: Any clinically diagnosed mental disorder as defined by WHO ICD-10 Chapter V. Requires a GP or psychiatrist referral.
Exclusions:
- Intellectual disability (use Complex Neurodevelopmental Disorder pathway or specialist referral)
- Dementia and organic mental disorders (use specialist referral pathway)
- Tobacco use disorder
Psychiatrist-led care is the primary pathway. Allied health under Better Access may support comorbid conditions and psychosocial rehabilitation.
Grounded Scribe suggests the right MBS item codes from your recording so you can claim accurately without re-keying.
Reference information sourced from MBS Online (mbsonline.gov.au). Item availability, rebates, and eligibility criteria may change. This is not billing advice — always verify current items before claiming. Last verified: April 2026.
Clinical Documentation Notes
DSM-5-TR removed the schizophrenia subtypes (paranoid, disorganised, etc.) as they had limited clinical utility and poor reliability. ICD-10-AM retains them. In Australian practice, subtypes are still commonly used in clinical descriptions. Monitor for metabolic side effects of antipsychotic medication (weight, glucose, lipids). The AIMS should be used to screen for tardive dyskinesia.
Related Assessment Tools
Other validated instruments commonly used alongside the Schizophrenia (F20).
- BPRS
Psychiatric MonitoringAn 18-item clinician-rated scale for assessing the severity of psychiatric symptoms including psychosis, mood disturbance, and anxiety.Calculate → - CGI
Psychiatric MonitoringA 2-item clinician-rated scale: illness severity (CGI-S) and global improvement (CGI-I). The most widely used brief assessment of the clinician's view of a patient's global functioning. Each item is read against its own anchor labels.Calculate → - AIMS
Psychiatric MonitoringA 12-item clinician-rated scale for assessing tardive dyskinesia and other abnormal involuntary movements in patients taking antipsychotic medication.Calculate →
Related Diagnostic Codes
ICD-10-AM diagnostic codes commonly associated with the Schizophrenia (F20).
Frequently Asked Questions
Does DSM-5-TR still use schizophrenia subtypes?
No. DSM-5-TR eliminated the subtypes (paranoid, disorganised, catatonic, undifferentiated, residual) as they showed poor reliability across clinicians and limited predictive validity. ICD-10-AM retains the subtypes. ICD-11 has also removed them.
What is the EPPIC model?
Early Psychosis Prevention and Intervention Centre (EPPIC) was developed at Orygen in Melbourne. It provides a model for early intervention in first-episode psychosis, emphasising rapid access to treatment, low-dose medication, psychological therapy, and vocational support during the critical early period.
References
- World Health Organization. ICD-10-AM.
- RANZCP. Clinical Practice Guidelines for the Management of Schizophrenia and Related Disorders.
- American Psychiatric Association. DSM-5-TR. 2022.
This tool calculates scores based on published guidelines for professional reference. It does not provide clinical diagnoses. Scores are provided as reference information only and should be interpreted by a qualified practitioner in the context of a comprehensive assessment.
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