• Negative symptoms (diminished emotional expression or avolition). 2. For a significant portion of the time since the onset of the disturbance, level of functioning in one or more major areas, such as work, interpersonal relations, or self-care, is markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, there is failure to achieve expected level of interpersonal, academic, or occupational functioning). 3. Continuous signs of the disturbance persist for at least six months. This six-month period must include at least one month of symptoms (or less if successfully treated) that meet Criterion 1 (active-phase symptoms) and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or by two or more symptoms listed in Criterion 1 present in an attenuated form (examples: odd beliefs, unusual perceptual experiences). 4. Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either (1) no major depressive or manic episodes have occurred concurrently with the active-phase symptoms, or (2) if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness. 5. The disturbance is not attributable to the physiological effects of a substance (examples: a drug of abuse, a medication) or another medical condition. 6. If there is a history of autism spectrum disorder or a communication disorder of a childhood onset, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations, in addition to the other required symptoms of schizophrenia, are also present for at least one month (or less if successfully treated). Binge eating disorder 1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following: • Eating, in a discrete period of time (example: within any two-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances. • A sense of lack of control overeating during the episode (examples: a feeling that one cannot stop eating or control what or how much one is eating). 2. The binge eating episodes are associated with three (or more) of the following:
• Eating much more rapidly than normal. • Eating until feeling uncomfortably full.
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