Classification of Schizophrenia

Question 1

What are the two types of classification system

Answer 1

DSM-V
ICD-10

Question 2

What are the similarities between the DSM-V and
ICD-10

Answer 2

both requiring persistence of symptoms for at least 1 month

Question 3

What are the differences between the DSM-V and
ICD-10

Answer 3

DSM-V has more specific diagnostic criteria and so requires at least 2 or more of delusions, hallucinations, disorganized speech and catononic behaviour
whereas the ICD-10 takes a broader approach to diagnosis, simply stating that “the clinical picture is dominated by relatively stable, often paranoid delusions, usually accompanied by hallucinations”.
There are different subtypes of schizophrenia - Subtypes are currently recognised in the ICD-10 only, whereas previous editions of the DSM also made these distinctions

Question 4

What are positive symptoms

Answer 4

enhance the typical experience of sufferers, and occur in addition to their normal experiences e.g. hallucinations and delusions.

Question 5

What are Hallucinations

Answer 5

is characterised by a distorted view/ perception of real stimuli or perceptions of stimuli which have no basis in reality

Question 6

What are Negative symptoms

Answer 6

Negative symptoms take away from the typical experience of sufferers, and so represents a ‘loss’ of experience e.g. speech poverty and avolition

Question 6

What are delusions

Answer 6

a set of beliefs with no basis in reality at all e.g. the sufferer may be paranoid that they are being stalked

Question 7

What is speech poverty

Answer 7

occurs when there is an abnormally low level of the frequency and quality of speech

Question 8

What is Avolition

Answer 8

means the inability to cope with the normal pressures and motivations associated with everyday living and day to-day tasks.

Question 9

Who investigated how situational factors affect a diagnosis of schizophrenia.

Answer 9

Rosenhan

Question 10

What were Rosenhan findings

Answer 10

• Psychiatric staff cannot always distinguish sanity from insanity. Any diagnostic method that makes such errors cannot be very reliable or valid.
• This suggests the validity of psychiatric diagnoses was low and the DSM was flawed

Question 11

What is Comorbidity

Answer 11

is where two conditions co-exist in the same individual at the same time

Question 12

How does Comorbidity relate to Schizophrenia

Answer 12

schizophrenia commonly occurs alongside other mental illnesses and the disorders are co-morbid.
Buckley et al found
50% of patients had depression
47% had substance abuse
29% had OCD

Question 13

What is Symptom overlap

Answer 13

Many of the symptoms for schizophrenia are found in other mental illnesses (depression and bipolar disorder)

Question 14

What’s an issue with positive symptom

Answer 14

One issue is that positive symptoms such as the hallucination or hearing voices may be more acceptable in African cultures because of cultural beliefs in communication with ancestors, and therefore people are more ready to acknowledge such experiences.

Question 15

Research that shows a significant variation between cultures when it comes to schizophrenia

Answer 15

Harrison et al.’s (1984) research suggested that those of West Indian origin were over-diagnosed with schizophrenia, by white doctors in Bristol, because of their ethnic background.

Question 16

Criticism of the DSM

Answer 16

Some critics of the DSM diagnostic criteria argue that some diagnostic categories are biased towards pathologizing one gender rather than the other.
When the patients were described as ‘male’ or no information was given about their gender, 56% were given a diagnosis of schizophrenia. However, when the patients were described as ‘female’, only 20% were given a diagnosis of schizophrenia.

Question 17

Gender bias with clinician

Answer 17

clinicians failing to consider that males tend to suffer more negative symptoms than women and have higher levels of substance abuse, or that females have better recovery rates and lower relapse rates. These misconceptions could be affecting the validity of a diagnosis as clinicians are not considering all symptoms.
Clinicians also ignore that there are different predisposing/risk factors between males and females, which give them different vulnerability levels at different points in life. This can possibly explain the gender difference in the onset of schizophrenia.