Classification of Schizophrenia Flashcards
(23 cards)
AO3 (1) classification of schizophrenia
- One limitation of a diagnosis of schizophrenia is low reliability
- For example, Cheniaux et al. (2009) had two psychiatrists independently diagnose 100 patients using both DSM and ICD criteria
- This is a weakness because the inter-rater reliability was poor. One psychiatrist diagnosed 26 with SZ using DSM and 44 using ICD.
- However it can be argued Osorio et al study reported there was excellent agreement between clinician when they used two measures to diagnose SZ both derived from the DSM system. DSM and ICD are becoming more aligned with each other, and removing the sub types of SZ
Criterion validity for diagnosing SZ is solid provided it takes place within a single diagnostic system - Despite this, there is a lack of inter-rater reliability and lack of trust in the medical profession. There is no consistency of diagnosis
AO3 (2) classification of schizophrenia
- Another limitation is gender bias in the diagnosis of SZ
- Longnecker et al (2010) reviewed studies of the prevalence of SZ and concluded that since the 1980s men have been diagnosed more often than women. Cotton et al (2009) found females better than men
- This may explain why some women escape diagnosis because their better interpersonal functioning may bias practitioners to under diagnose SZ
- However, it can be argued first onset occurs in males between 18-25 years, females 25-35. Difference may be related to differences in the types of stressors both sexes experience at different ages and age related variations in the female menstrual cycle which may be overlooked during diagnosis. Patients fall within these age brackets doctor training to look for symptoms
OR
Out of date research ( was done in 2009), now much more awareness of mental illness treatment, reduces temporal validity - This is a problem because men and women with similar symptoms may experience differing diagnoses
AO3 (3) classification of schizophrenia
- A final limitation is cultural bias in the diagnosis of SZ
- For example African Americans and English people of African origin are much more likely to be diagnoses with SZ in the UK. Rates in the West Indies and Africa are not high, so this is not due to genetic vulnerability
- This is a weakness because higher diagnosis rates in the UK may be because some behaviours classed as positive symptoms of SZ are ‘normal’ in African cultures (e.g. hearing voices as part of ancestor communication)
- However, it can be argued that doctors are much better trained to recognise cultural differences/backgrounds. More doctors from various cultural backgrounds easier to diagnose accurately?
Cultural differences – more research into SZ – because of diagnosis of people of colour. Recognising culture is a factor in diagnosis
Escobar (2012) has suggested that, because psychiatric profession is dominated by European people, psychiatrists might be over-interpreting symptoms and distrusting the honestly of people of colour during diagnosis. Recruit doctors from multi cultural backgrounds to limit cultural bias/better training - This highlights an issue in the validity of diagnosis because it suggests that individuals from some cultural backgrounds are more likely to be diagnosed
What is schizophrenia?
A severe psychotic disorder marked by severely impaired thinking, emotions, and behaviors, with impaired contact with reality and insight.
What does the term “schizophrenia” mean literally?
From Greek, “schizo” means split and “phrena” means mind—referring to a split between thought processes and reality.
What are the two main types of symptoms in schizophrenia?
Positive symptoms (additions to normal experience) and negative symptoms (losses or reductions in normal experience).
Give two examples of positive symptoms of schizophrenia.
Hallucinations and delusions.
What are hallucinations in schizophrenia?
Sensory experiences of stimuli that have no basis in reality or distorted perceptions of real stimuli (e.g., hearing voices).
What are delusions in schizophrenia?
False beliefs with no basis in reality, such as paranoia or delusions of grandeur.
What is speech poverty?
A negative symptom characterized by reduced frequency and quality of speech.
What is avolition?
A negative symptom involving a lack of motivation and reduced purposeful activity.
What is the difference between DSM-V and ICD-10 in diagnosing schizophrenia?
DSM-V requires at least 2 or more symptoms like delusions or hallucinations for 1 month; ICD-10 requires a broader approach focusing on stable paranoid delusions and hallucinations.
What are some subtypes of schizophrenia recognized by ICD-10?
Positive schizophrenia (prominent delusions and hallucinations) and mixed schizophrenia (both positive and negative symptoms).
What is co-morbidity?
The occurrence of two illnesses or conditions together in the same person.
What is symptom overlap?
When two or more conditions share symptoms, questioning the validity of separate classifications.
What percentage of the world population suffers from schizophrenia?
About 1%.
Name common features of schizophrenia.
Incoherent or illogical thoughts, bizarre behavior and speech, delusions, and hallucinations.
What is anhedonia?
The reduced ability or inability to feel pleasure, often social or physical.
What are the DSM-IV diagnostic criteria for schizophrenia?
At least 2 of the following for 1 month: delusions, hallucinations, disorganized speech, grossly disorganized/catatonic behavior, negative symptoms.
What is a common cause of auditory hallucinations in schizophrenia?
Excess dopamine receptors in Broca’s area.
What is a persecutory delusion?
A false belief that one is being harmed or persecuted by others.
What is the difference between speech poverty in ICD-10 and DSM?
ICD-10 sees speech poverty as reduced amount and quality; DSM emphasizes speech disorganization (incoherent speech) as positive symptom, speech poverty as negative.
What signs indicate avolition?
Poor hygiene, lack of persistence in work/education, and lack of energy.
