Classification and diagnosis of sz

Question 1

What does the ICD stand for?

Answer 1

The international classification of disease

Question 2

What does the DSM-5 stand for?

Answer 2

The diagnostic and statistical manual

Question 3

How ICD classify schizophrenia?

Answer 3

Where people have 2 or more negative symptoms for one month or longer

Question 4

Which classification system recognises subtypes of schizophrenia such as paranoid schizophrenia?

Answer 4

ICD-11

Question 5

How does the DSM-5 classify schizophrenia?

Answer 5

One positive symptom must be present for at least one month for diagnosis

Question 6

What is a positive symptom?

Answer 6

An additional experience beyond those of ordinary existence

Question 7

What is a negative symptom?

Answer 7

A loss of usual abilities and experiences

Question 8

What is a hallucination?

Answer 8

An unusual sensory experience that have no basis in reality and can affect any of the senses. For example, auditory hallucinations or visual hallucinations

Question 9

What is a delusion?

Answer 9

Irrational/false beliefs that have no basis in reality, they can make people with schizophrenia behave in ways that make sense to them but may be bizarre to others

Question 10

What are the two examples of delusions?

Answer 10

Delusions of persecution and delusions of control

Question 11

What is a delusion of persecution?

Answer 11

A delusion of persecution is a false belief that you are being harassed e.g by the government

Question 12

What are delusions of control?

Answer 12

A false belief that you are being controlled by something external e.g by aliens

Question 13

What is abolition?

Answer 13

A severe loss of motivation to carry out everyday tasks and difficulty to begin or keep up with goal-directed activity.

Question 14

Andreason identified three signs of avolition which are…

Answer 14

Poor hygiene and grooming, lack of persistence in work or education and lack of energy

Question 15

What is speech poverty?

Answer 15

A reduction in the amount and quality of speech, this is sometimes accompanied by a delay in the sufferers’ verbal responses during conversation or a lack of fluency

Question 16

What is the definition of diagnosis?

Answer 16

The identification of the nature of an illness or other problem by examination of the symptoms i.e someone reporting hearing voices

Question 17

What is the definition of classification?

Answer 17

The action or process of classifying something i.e the classification of disease according to symptoms. For example a symptom of sz is hallucinations

Question 18

Who conducted AO1 research into the reliability and validity in classification and diagnosis in sz?

Answer 18

Cheniaux

Question 19

What did Cheniaux do?

Answer 19

They asked two psychiatrists to diagnose the same 100 patients using the DSM and ICD

Question 20

What does reliability refer to?

Answer 20

Reliability refers to whether we can gain consistent results when classifying and diagnosing sz

Question 21

What is validity?

Answer 21

The extent to which we are accurately identifying sz symptoms in individuals

Question 22

What is reliability in the context of sz?

Answer 22

The extent to which the ICD and DSM consistently agree on how schizophrenia should be classified

Question 23

In Chienaux’s study, one psychiatrist diagnosed __ people using the DSM as having schizophrenia whilst the other psychiatrist diagnosed __ as having schizophrenia

Answer 23

26, 13

Question 24

Using the ICD one psychiatrist __ people with schizophrenia and the other psychiatrist diagnosed __

Answer 24

44, 24

Question 25

What does the inconsistencies in diagnosis in Chienaux's study show?

Answer 25

It shows poor inter-rater reliability as one psychiatrist diagnosed almost double the amount than the other psychiatrist

Question 26

What is validity in the context of schizophrenia?

Answer 26

It is the extent to which the ICD and DSM accurately identify the symptoms of schizophrenia

Question 27

What can validity also be?

Answer 27

It can also be the extent to which two or more health professionals accurately diagnose schizophrenia

Question 28

What was the validity of classifying and diagnosing sz like in Chienaux's study?

Answer 28

As one psychiatrist diagnosed almost double the number of patients using the ICD than the DSM

Question 29

What is system overlap?

Answer 29

System overlap is where two or more conditions share similar symptoms. For example, both schizophrenia and depression involve negative symptoms such as avolition

Question 30

What is co-morbidity?

Answer 30

Co-morbidity is where two illnesses/conditions occur at the same time. Schizophrenia is commonly diagnosed with other conditions such as depression and/or OCD as they share common symptoms of lowered motivation and mood

Question 31

Why is co-morbidity an issue?

Answer 31

This is an issue because it means that schizophrenia may not exist as a distinct condition which may lead to misdiagonsis

Question 32

What is gender bias in relation to schizophrenia?

Answer 32

Since the 1980s men have been diagnosed with schizophrenia more often than women.

Question 33

Why have men often been diagnosed with schizophrenia more than women?

Answer 33

It may be because men are more genetically vulnerable to developing schizophrenia than women.

Question 34

What is different in women with schizophrenia which makes them less likely to be diagnosed?

Answer 34

Females with schizophrenia typically function better than men, being more likely to work and have good family relationships

Question 35

What is culture bias in terms of schizophrenia?

Answer 35

English people of African origin are much more likely to be diagnosed with schizophrenia in the UK.

Question 36

What about schizophrenia rates in Africa proves it is not due to genetic vulnerability?

Answer 36

Rates in the West Indies and Africa are not high so it cannot be due to genetic vulnerability

Question 37

Why are African people more likely to be diagnosed in the UK?

Answer 37

Higher diagnosis rates in the UK may be because some behaviours classed as positive symptoms of schizophrenia are normal in African cultures e.g hearing voices is part of ancestor communication