Classification and Diagnosis of Schizophrenia

Question 1

What is schizophrenia?

Answer 1

A severe mental illness where contact with reality and insight are impaired, an example of psychosis.

Question 2

What percentage of the worlds population suffer from schizophrenia?

Answer 2

1%

Question 3

Schizophrenia is more common in which gender?

Answer 3

Men

Question 4

Which class of people is schizophrenia more common in?

Answer 4

Working class

Question 5

What is a positive symptom?

Answer 5

A symptom that is additional, normally you wouldn’t have it.

Question 6

What are hallucinations?

Answer 6

Visual or auditory additions that are not there, but are realistic to the person viewing or hearing them.

Question 7

What are delusions.

Answer 7

Also known as paranoia, delusions are irrational beliefs

Question 8

Give an example of a common delusion.

Answer 8

Sufferers may believe that they are being controlled by someone else.

Question 9

What are negative symptoms?

Answer 9

Symptoms that reduce or remove an ability that should be there in a healthy person.

Question 10

What is avolition?
Give examples of signs of avolition.

Answer 10

Finding it difficult to keep up with goal directed activity and motivation issues. Signs of avolition include lack of energy, poor hygiene etc.

Question 11

What is speech poverty?

Answer 11

Reduction in amount and quality of speech. There might be a delay in the responses given in a conversation. Speech may become incoherent as the speaker changes topic mid-sentence.

Question 12

Explain the strength of there being good reliability in the diagnosis of schizophrenia.
What is reliability?
Osorio reported excellent reliability for diagnosis using the DSM 5 in how many individuals?
What interrater and test retest reliability were achieved when pairs of interviewers assessed schizophrenia in these individuals?
What is the correlation coefficient and how does this support reliability?

Answer 12

Reliability refers to consistency. Although reliability was low prior to the DSM 5, it has now improved. Osorio reported excellent reliability for diagnosis of schizophrenia in 180 individuals using the DSM 5. Pairs of interviewers assessed these people for schizophrenia and achieved interrater reliability of +0.97 and a test retest reliability of +0.92. This means that we can be sure that diagnosis of schizophrenia is consistently applied, as the correlation coefficient for a strong positive correlation is +0.8.

Question 13

Explain the limitation of validity issues within diagnosis and classification of schizophrenia.
100 clients were assessed using which 2 criteria?
Which criteria were 68 clients diagnosed under, and which criteria were 39 diagnosed under?
How can we increase the validity of schizophrenia diagnosis?
Which criteria is the most valid?

Answer 13

Cheniaux conducted research where 2 psychiatrists independently assessed 100 clients using the ICD 10 and DSM 5 criteria. 68 of clients were diagnosed as schizophrenic under the ICD 10 and 39 under the DSM. However, schizophrenia diagnosis may be valid provided that it takes place using a single diagnostic system, as studies have shown excellent agreement between clinicians using two measures, both from the DSM.

Question 14

Explain the limitation of comorbidity in diagnosis of schizophrenia.
What did Buckley find as the co morbidity rates for schizophrenia and depression, substance abuse and OCD?
What could this co morbidity rate be caused by?
Schizophrenia also looks similar to which mental disorders and why can this create confusion?
What does this say about the diagnosis of schizophrenia?

Answer 14

Buckley found that 50% of individuals diagnosed with schizophrenia also have depression. 47% have co morbidity with substance abuse and 23% are comorbid with OCD. It could be that the findings for research are due to psychiatrist’s not being able to tell the difference between the 2 conditions. In terms of classification, it may be that if very severe depression looks like schizophrenia (and vice versa), then they may be better seen as a single condition. This illustrates the difficulties that co morbidity can create in achieving a valid diagnosis of schizophrenia.

Question 15

Explain the limitation of issues with gender bias in schizophrenia diagnosis.
Why do females appear to function better than males?
Why might fewer women be diagnosed with schizophrenia (think high functioning)
Men experience more of which type of schizophrenia symptom?
Why do these misconceptions affect validity of diagnosis of schizophrenia?

Answer 15

It appears that female patients typically function better than males as they are more likely to seek help for their problems. This high functioning may explain how some women have not been diagnosed with schizophrenia where men have been, because they are able to hide symptoms more easy. Gender bias also occurs due to clinicians failing to consider that males suffer more negative symptoms than women and have higher levels of substance abuse. These misconceptions could be affecting the validity of diagnosis as clinicians are not considering all symptoms.

Question 16

Explain the limitation of there being significant overlap between schizophrenia and other disorders.
Compare the overlap between schizophrenia and bipolar disoder.
As there is an overlap, which criteria is each disorder more likely to be diagnosed under?
What might this actually suggest about schizophrenia and bipolar being independent disorders?
What does this suggest about diagnosis and classification of schizophrenia?

Answer 16

Schizophrenia and bipolar disorder involve positive symptoms like delusions and negative symptoms like avolition. Using the ICD, a patient might be diagnosed as schizophrenic, however, many of the same patients would receive a diagnosis of bipolar disorder under the DSM criteria. This is a result of overlap of symptoms. It even suggests that schizophrenia and bipolar disorder may not even be separate conditions, but one. This questions the validity of both classification and diagnosis of schizophrenia.

Question 17

Explain the limitation of validity of diagnosis being reduced by cultural bias.
Which culture is x10 more likely to be diagnosed with schizophrenia?
Why are positive symptoms more acceptable in these cultures?
How might psychologists of a different background view these symptoms?
How might white psychologists display prejudice towards these people?
How does this lead to overdiagnosis of schizophrenia and affect validity of diagnosis?

Answer 17

African Americans and English people of Afro-Caribbean origin are ten times more likely than white British people to be diagnosed with schizophrenia. One issue is that positive symptoms such as hearing voices may be more acceptable in African cultures as they believe it is their ansestors trying to contact them. When reported to a psychiatrist from a different cultural background, these experiences are likely to be seen as weird and irrational. Furthermore, research has pointed out that many white psychiatrists over interpret symptoms and distrust the honesty of black people during diagnosis> The overdiagnosis of schizophrenia from certain groups suggests that the validity of the diagnosis should be questioned.