In DSM-IV, if you hear voices, you can be diagnosed with schizophrenia even if this is the only “psychotic” symptom. This has been controversial for a while, because many people hear voices without being actually psychotic. Not only other conditions – such as dissociative identity disorder – are characterized by voice-hearing, but voice-hearing may be a normal symptom related to stress.
Thankfully, the DSM-V workgroup is recommending that someone must have two or more characteristic symptoms of schizophrenia for a substantial period of time in order to be diagnosed. These two symptoms must include at least one core symptom, which are determined to be delusions, hallucinations and disorganized speech. In addition, people must display a significant deterioration in their social or occupational functioning. This criterion was considered for elimination, but the workgroup thankfully decided against this. Again, this protects functioning voice-hearers from a false diagnosis.
Of course, there is the newly considered diagnosis of attenuated psychosis syndrome, which includes symptoms suggesting a person is at risk of a psychotic disorder. This diagnosis may cause voice-hearers to be pathologized after all, which is a very sad thing.