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Ask the Experts

Question:

Doctors have given conflicting diagnosis for my brother's mental illness. Some say schizophrenia and others only acute depression. He is currently on treatment for depression.

Is there any definitive test for schizophrenia? We have heard about MRI tests - none have been done on my brother so far. Thank you.

Answered by: Wilfred Van Gorp

Although there is no "definitive" or laboratory based test for a diagnosis of schizophrenia, there are definite procedures which can result in a highly accurate diagnosis if they are followed.

The first step to assist with a differential diagnosis of schizophrenia versus a depression would be a psychiatric examination performed by a licensed, trained and board certified psychiatrist. In addition to this, psychological and neuropsychological testing is often helpful to determine whether the cognitive and personality profile is more consistent with schizophrenia or a depressive condition. Research based "state of the art" structured diagnostic interviews are also often helpful, especially in complex cases.

Finally, imaging can be helpful in ruling out other conditions (such as neurological conditions) that could be responsible for the symptoms, but an MRI or other neuroimaging procedures do not help us confirm a clinical diagnosis.

Using the procedures above, a high level of accuracy can usually be achieved in a diagnosis of schizophrenia versus depression.