Diagnosis And Classification Of Schizophrenia

Question 1

What is schizophrenia?

Answer 1

A severe mental illness where contact with reality and insight are impaired, it involves major disturbances in thought, emotion and behaviour. It is a psychosis, and is the most common psychotic disorder, affecting around 1% of the population.

Question 2

Between what ages is schizophrenia most often diagnosed?

Answer 2

It is most often diagnosed between the ages of 15 and 35.

Question 3

Which gender is it more often diagnosed in?

Answer 3

Males

Question 4

What is classification of a mental disorder?

Answer 4

The process of organising symptoms into categories based on which symptoms cluster together

Question 5

What are the two major systems for classification of mental disorders?

Answer 5

• The American Psychiatric Association’s Diagnostic and Statistical Manual edition 5 (DSM-5) - is an American classification system of over 200 mental disorders grouped into their common features
• The World Health Organisations International classification of Disease edition 10 (ICD-10) - is the classification system used in Europe

Question 6

How do these manuals differ slightly in their classification of schizophrenia?

Answer 6

In the DSM-5 system, one of the positive symptoms (delusions of hallucinations) must be present for a diagnosis. Whereas in the ICD-10, two or more negative symptoms are sufficient.

Question 7

What are the three criterions in the DSM of characteristics necessary for diagnosis of schizophrenia?

Answer 7

Criterion A - positive symptoms (delusion, hallucinations, disorganised speech etc) and negative symptoms

Criterion B - SOCIAL/ OCCUPATIONAL DYSFUNCTION- for a significant portion of time since the onset, one or more major areas functioning such as work, interpersonal relationships or self-care are markedly below the level achieved prior to onset

Criterion C - DURATION - continuous signs of disturbance for at least 6 months. There must be at least 1 month of symptoms from criterion A.

Question 8

Define positive symptoms of schizophrenia and give 2 examples

Answer 8

Positive symptoms of schizophrenia are atypical additional symptoms beyond those of normal experience.

They include behaviours involving loss of touch with reality including hallucinations and delusions.

Question 9

What are hallucinations?

Answer 9

Hallucinations are unusual sensory experiences that either have no basis in reality or are distorted perceptions of things that are there

Question 10

What are the two types of hallucination?

Answer 10

• Auditory hallucinations

* Visual hallucinations

Question 11

Define auditory hallucinations

Answer 11

Hearing voices that other people cannot hear (no basis in reality) either talking to the person or commenting on the person’s behaviour. They are often highly critical, insulting or obscene.

Question 12

Define visual hallucinations

Answer 12

Seeing distorted faces (distorted perception of what is there) or animals or objects that are not there.

Question 13

Define delusions

Answer 13

Delusions are irrational beliefs that have no basis in reality. Delusions can make sufferers behave in ways which make sense to them but seem bizarre to others.

Question 14

Name the three types of delusions

Answer 14

• Delusions of grandeur
• Delusions of persecution
• Delusions concerning the body

Question 15

What are delusions of grandeur? Give an example

Answer 15

These are inflated beliefs about the person’s power and importance. For example, the person may believe they are someone else such as an important religious figure I.e. Jesus

Question 16

What are delusions of persecution? Give an example

Answer 16

These often involve the belief that they are being followed or spied on I.e. They are victim of a conspiracy by the government

Question 17

What are delusions concerning the body?

Answer 17

Sufferers may believe they or part of them is under external control I.e. That they are being controlled by aliens

Question 18

Define negative symptoms of schizophrenia

Answer 18

Negative symptoms involve the loss of usual abilities and experiences, such as the loss of clear thinking or normal levels of motivation.

Question 19

Name the two negative symptoms of schizophrenia

Answer 19

• Avolition

* Speech poverty

Question 20

What is avolition?

Answer 20

This involves a loss of motivation to carry out tasks and lowered activity levels. It involves finding it difficult to begin or keep up with a goal directed activity (actions performed to achieve a result) e.g. Sitting in the house all day nothing instead of getting ready to go to work.

Signs of avolition include; poor hygiene and grooming, lack of persistence in work or education, and a lack of energy.

Question 21

What is speech poverty?

Answer 21

This involves a reduction in the amount and quality of speech. This is sometimes accompanied by a delay in the sufferer’s verbal responses during conversation. Patient’s with this symptom usually produce fewer words in a given time which is thought to be due to a difficulty spontaneously producing words due to slowing or blocked thoughts.