A nurse is reviewing the DSM-5 diagnostic criteria for schizophrenia. Which of the following symptoms must be present for a client to be diagnosed with schizophrenia? (Select all that apply.)

Choice A reason:
Recent marriage is generally considered a protective factor against suicide rather than a risk factor. Marriage can provide emotional support and stability, which can reduce the risk of suicidal behavior. However, the quality of the relationship and other individual factors should also be considered.
Choice B reason:
Age greater than 55 is a recognized risk factor for suicide, particularly among men. Older adults may face multiple stressors such as chronic illness, loss of loved ones, and social isolation, which can increase the risk of suicide. It is important to monitor and support older adults who may be at risk.
Choice C reason:
Having a bachelor’s degree is not typically associated with an increased risk of suicide. In fact, higher educational attainment is often linked to better mental health outcomes and access to resources. However, individual circumstances and stressors should always be considered.
Choice D reason:
Male gender is a significant risk factor for suicide. Men are more likely to die by suicide compared to women, although women may attempt suicide more frequently. This gender disparity is attributed to various factors, including the methods used and societal expectations around expressing emotions.
Choice E reason:
A diagnosis of schizophrenia is a known risk factor for suicide. Individuals with schizophrenia may experience severe symptoms, including delusions and hallucinations, which can contribute to suicidal thoughts and behaviors. It is crucial to provide comprehensive care and support to individuals with this diagnosis to mitigate the risk of suicide.

Choice A reason:

“That is very interesting. We are not sure why people start to isolate themselves.” This response is vague and does not provide the client with useful information. It may leave the client feeling uncertain and unsupported.

Choice B reason:

“Before symptoms of schizophrenia begin, people often isolate themselves. This is an early warning.” This response is informative and helps the client understand that social withdrawal can be an early sign of schizophrenia. It provides a clear explanation and validates the client’s experience.

Choice C reason:

“Do you think of yourself as more of an introvert? That makes a difference with how you socialize.” This response shifts the focus to the client’s personality rather than addressing the specific concern about social withdrawal related to schizophrenia. It may not provide the clarity the client is seeking.

Choice D reason:

“Were you avoiding your friend so that you could hear the voices more clearly?” This response is speculative and could be perceived as judgmental. It does not address the underlying issue of social withdrawal as an early symptom of schizophrenia.