<p>No – at least, they shouldn't be required. <a href="http://en.wikipedia.org/wiki/Schizophrenia#Criteria" rel="noreferrer">Wikipedia describes the DSM-5</a> as requiring "delusions, hallucinations, or disorganized speech". Delusions are distinct from hallucinations in that they aren't necessarily perceptual in a conventional sense, though both diverge a person's conscious experience from empirical reality. Disorganized speech is characteristic of <a href="http://en.wikipedia.org/wiki/Disorganized_schizophrenia" rel="noreferrer">disorganized / hebephrenic schizophrenia</a>, regarding which Wikipedia states:</p>

<blockquote>
  <p>The most prominent features of disorganized schizophrenia are not delusions and hallucinations, as they are in paranoid schizophrenia,<sup>[<a href="http://schizophrenia.about.com/od/whatisschizophrenia/f/schiz_diagnosis.htm" rel="noreferrer">5</a>][<a href="http://counsellingresource.com/lib/distress/schizophrenic/schizophrenia-icd/hebephrenic/" rel="noreferrer">6</a>]</sup> although fragmentary delusions and hallucinations may be present.</p>
</blockquote>

<p>This doesn't seem to be the only (partial) exception to the rule you ask about, and <a href="http://apps.who.int/classifications/icd10/browse/2010/en#/F20.1" rel="noreferrer">your source mentions it too</a>: "Affective changes are prominent, delusions and hallucinations fleeting and fragmentary".</p>

CC BY-SA 3.0
2014-04-27T02:36:53.463Z
2014-04-27T02:36:53.463Z
Nick Stauner
<p>According to the <a href="https://ia800900.us.archive.org/0/items/info_munsha_DSM5/DSM-5.pdf" rel="nofollow noreferrer">DSM V</a>, for the diagnosis of schizophrenia, the following is necessary:</p>
<blockquote>
<p>two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated):<br />
(1) Delusions<br />
(2) Hallucinations<br />
(3) Disorganized speech<br />
(4) Grossly disorganized or catatonic behavior<br />
(5) Negative symptoms, i.e., affective flattening, alogia, or avolition.</p>
</blockquote>
<p>where one of the symptoms <strong>must</strong> be delusions, hallucinations, <strong>or</strong> disorganized speech. So, <strong>no</strong>, hallucinations do not need to be present.</p>

CC BY-SA 4.0
2014-05-30T06:54:52.047Z
2023-12-20T15:18:02.203Z
2023-12-20T15:18:02.203Z
anongoodnurse
<p>No. Hallucinations are not necessarily present, although they use to be observed or reported. Hebephrenic schizophrenia does not have hallucinations as a main symptom, and simple schizophrenia doesn't have them at all. The criteria are very clear. </p>

CC BY-SA 3.0
2014-04-28T03:04:44.793Z
Your mention of simple schizophrenia is an interesting contribution, but [not without controversy as a diagnosis](http://en.wikipedia.org/wiki/Simple-type_schizophrenia#Criticisms).
Nick Stauner
CC BY-SA 3.0
2014-04-28T12:45:00.083Z
In fact, exactly as it happens with many other diagnosis. One must know they can be criticized too.
Di Ana
CC BY-SA 3.0
2014-04-28T17:37:36.840Z
I'll rephrase: the controversy regarding the diagnostic validity of simple schizophrenia seems much greater than that surrounding other forms of schizophrenia.
Nick Stauner
CC BY-SA 3.0
2014-04-28T02:50:00.197Z
2014-04-28T02:50:00.197Z
Di Ana
<p>The symptom most people think about when hearing "Schizophrenia" is hallucination. However, <a href="http://apps.who.int/classifications/icd10/browse/2010/en#/F20">ICD-10's entry for schizophrenia</a> seems to list auditory hallucinations as just one of many possible symptoms.</p>

<p>In practice, are hallucinations a <strong>required</strong> symptom for a diagnosis of Schizophrenia, or can a diagnosis be made based on other symptoms?</p>

CC BY-SA 3.0
2014-04-27T21:48:54.993Z
@what I linked to the ICD-10 entry in the question, though it is still unclear to me which (or how many of) the symptoms are _required_. Moreover, _Schizophrenia_ seems to be a larger category with more subtypes under it, making the answer to my question more difficult to find.
IQAndreas
<schizophrenia><hallucinations>
Are hallucinations a requirement for Schizophrenia?
IQAndreas
# Are hallucinations a requirement for Schizophrenia?

(Asked by: username_0 on 2014-04-26)

The symptom most people think about when hearing "Schizophrenia" is hallucination. However, [ICD-10's entry for schizophrenia](http://apps.who.int/classifications/icd10/browse/2010/en#/F20) seems to list auditory hallucinations as just one of many possible symptoms.

In practice, are hallucinations a **required** symptom for a diagnosis of Schizophrenia, or can a diagnosis be made based on other symptoms?

**Tags:** schizophrenia, hallucinations

> **Comments:**
> **username_0**: @what I linked to the ICD-10 entry in the question, though it is still unclear to me which (or how many of) the symptoms are _required_. Moreover, _Schizophrenia_ seems to be a larger category with more subtypes under it, making the answer to my question more difficult to find.  

---

## 3 answers

### Answer by username_1 on 2014-04-27. Score: 5

No – at least, they shouldn't be required. [Wikipedia describes the DSM-5](http://en.wikipedia.org/wiki/Schizophrenia#Criteria) as requiring "delusions, hallucinations, or disorganized speech". Delusions are distinct from hallucinations in that they aren't necessarily perceptual in a conventional sense, though both diverge a person's conscious experience from empirical reality. Disorganized speech is characteristic of [disorganized / hebephrenic schizophrenia](http://en.wikipedia.org/wiki/Disorganized_schizophrenia), regarding which Wikipedia states:

> The most prominent features of disorganized schizophrenia are not delusions and hallucinations, as they are in paranoid schizophrenia,[[5](http://schizophrenia.about.com/od/whatisschizophrenia/f/schiz_diagnosis.htm)][[6](http://counsellingresource.com/lib/distress/schizophrenic/schizophrenia-icd/hebephrenic/)] although fragmentary delusions and hallucinations may be present.

This doesn't seem to be the only (partial) exception to the rule you ask about, and [your source mentions it too](http://apps.who.int/classifications/icd10/browse/2010/en#/F20.1): "Affective changes are prominent, delusions and hallucinations fleeting and fragmentary".


---

### Answer by username_2 on 2014-05-30. Score: 4

According to the [DSM V](https://ia800900.us.archive.org/0/items/info_munsha_DSM5/DSM-5.pdf), for the diagnosis of schizophrenia, the following is necessary:

> two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated):  
> (1) Delusions  
> (2) Hallucinations  
> (3) Disorganized speech  
> (4) Grossly disorganized or catatonic behavior  
> (5) Negative symptoms, i.e., affective flattening, alogia, or avolition.

where one of the symptoms **must** be delusions, hallucinations, **or** disorganized speech. So, **no**, hallucinations do not need to be present.


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### Answer by username_3 on 2014-04-28. Score: 0

No. Hallucinations are not necessarily present, although they use to be observed or reported. Hebephrenic schizophrenia does not have hallucinations as a main symptom, and simple schizophrenia doesn't have them at all. The criteria are very clear.

> **Comments:**
> **username_1**: Your mention of simple schizophrenia is an interesting contribution, but [not without controversy as a diagnosis](http://en.wikipedia.org/wiki/Simple-type_schizophrenia#Criticisms).  
> **username_3**: In fact, exactly as it happens with many other diagnosis. One must know they can be criticized too.  
> **username_1**: I'll rephrase: the controversy regarding the diagnostic validity of simple schizophrenia seems much greater than that surrounding other forms of schizophrenia.  

---

