Classification and Diagnosis Flashcards Preview

Schizophrenia > Classification and Diagnosis > Flashcards

Flashcards in Classification and Diagnosis Deck (27):
1

Positive symptom

reflect an excess of normal functions

2

Negative symptom

reflect a loss of normal functions

3

Delusion

bizarre beliefs, seem real can be paranoid in nature. delusion of grandeur/ persecution

4

Experiences of control

under control of external force that has invaded mind

5

Hallucinations

bizarre, unreal perceptions of environment

6

Disordered thinking

thoughts inserted/ withdrawn from mind

7

Affective flattening

reduction in range and intensity of emotional expression

8

Alogia

poverty of speech

9

Avolition

inability to initiate in goal-directed behaviour

10

Validity

extent diagnosis represent something distinct from other disorders and ICD/DSM measures what it claims to

11

Reliability

consistency of diagnosis

12

Inter-rater reliability - DSM-III (1980)

designed to be more reliable
Carson (1991): claimed it fixed the problem, should lead to greater agreement

13

Test-retest reliability - Wilks et al. (2003):

2 forms of cognitive screening tests given to patients over varying intervals, 1-134 days
correlation of scores across 2 test periods was .84

14

Co-morbidity

extent 2+ conditions co-occur

15

Co-morbidity - Buckley et al. (2009)

estimate depression occurs in 50% of patients
47% have lifetime diagnosis of co-morbid substance abuse
difficulties in diagnosis and treatment

16

Validity - Positive or negative symptoms?

assessed 489 admissions to psychiatric unit in Germany
found positive symptoms more useful for diagnosis then negative

17

Prognosis

diagnosed, rarely share symptoms, no evidence of same outcomes
varies: 20% recover previous level functioning, 10% achieve significant and lasting improvement, 30% improve with intermittent relapses
little predictive validity

18

Inter-rater reliability - little evidence

that DSM is used with high reliability
correlations in diagnosis .11

19

Unreliable symptoms - US

50 psychiatrists, differentiate non- and bizarre
inter-rater reliability correlation .40
diagnosis based on 'bizarre' delusions not reliable method of distinguishing( non-)schizophrenic patients

20

Comparing DSM and ICD

Cheniaux et al. (2009): inter-rater relaibility above .50
SZ more frequently diagnosed according to ICD-10

21

Cultural differences - Copeland (1971)

US and British psychiatrist given patient description
69% US diagnosed SZ, 2% British

22

Co-morbidity and medical complications

Weber et al. (2009): evidence of co-morbid physical disorder (e.g. diabetes, asthma)
if untreated, poorer prognosis

23

Co-morbidity and suicide risk

attempted suicide rose from 1% to 40% for those with at least 1 co-morbid mood disorder

24

Symptoms - DID

symptoms found in mood disorders
Ellason and Ross: people with dissociative identity disorder have more symptoms of SZ

25

Ethnicity and misdiagnosis

rates 8x higher for African-Caribbean
result poor housing, unemployment
or diff. mannerisms - misdiagnosis

26

Rosenhan - psychiatric hospital

normal people, sent to hospital, voices,
diagnosed and admitted, not recognised as normal
follow-up, warned of pseudopatients, 0 sent
21% detection rates

27

Self-fulfilling prophecy

labelled with diagnosis, develop symptoms