Issues in the diagnosis of Schizophrenia Flashcards
Prevalence of Schizophrenia?
- affects 1% of population
- symptoms appear between 15-45
- Men more susceptible than women
- Men tend to be diagnosed mid 20s
- Women tend to be diagnosed early 30s
Prognosis of Schiz?
- Symptoms most severe during first 5 years after onset
- 40% recover from positive symptoms
- 20% make full recovery, diagnosed early
- 40% have it for life
What are positive symptoms?
Give two examples
- Symptoms normal people don’t experience
- Delusions & Hallucinations
- referred to as Category A symptoms
What are negative symptoms?
Give two examples
- Symptoms normal people experience that schiz patients do not
- Avolition & Alogia (speech poverty)
How does the DSM classify a schiz patient mainly?
- symptoms must persist for 6 months
- this period must include 1 month of two symptoms
- one of the two has to be positive
What is the relationship to Autism the DSM outlines?
- If there is history of Autism in the patient, diagnosis of Schiz. is only made if there are delusions/hallucinations & other symptoms for at least 1 month (or less if successfully treated
Describe Hallucinations as a positive symptom?
- Sensory experiences, seeing distortions, hearing critical voices
- Can include olfactory (phantom odours) which are smells
Describe Delusions as a positive symptom?
- Irrational beliefs
- Feelings of persecution (from the government)
- Feelings of grandeur (thinking they’re royalty)
Describe Avolition as a negative symptom?
- lack of purposeful behaviour
- No energy, lack of social activity, lack of personal hygiene
- Generally apathetic towards people
- won’t go outside
Describe speech poverty as a negative symptom?
- lack of quantity & quality of verbal responses
- Disorganised verbal communication can become positive symptom
What’s a positive implication of being diagnosed with a disorder?
- appropriate treatment
- placed on road to recovery
- family at ease
What’s are 3 negative implications of being diagnosed with schizophrenia?
- stigma of schizophrenia
- labelling theory and self-fulfilled prophecy
- employment/housing
In reliability of Schiz diagnosis what two types of reliability arise & what are they?
- Inter-rater reliability
- two+ clinicians make identical diagnosis of the SAME patient with SAME information
- Test-retest reliability (external reliability)
- clinicians make the same diagnosis of the patient on separate occasions with SAME information
What factors could influence a low rate of agreement between clinicians?
- bias (gender, race)
- subjective guidelines
- vague symptoms
A03 Reliability of diagnosis
Beck et al 1963?
(153 patients)
- Beck reviewed 153 patients diagnosed by 2 different psychiatrists
- Diagnosis concordance rate only 54%
- Suggests low inter-rater reliability in diagnosis
- Suggests many misdiagnosed leading to incorrect treatments
A03 Reliability of diagnosis
Farmer 1988?
(PSE)
- Found standardised interview known as Present State Examination (PSE) increases reliability
- PSE focuses on frequency & severity of symptoms
- therefore diagnosis can be made reliable as all patients are asked the same things