Classification: Symptoms & Diagnosis

Question 1

What is schizophrenia?

Answer 1

• a psychotic disorder characterised by the loss of contact with reality
• many diggerent manifestations e.g. Lunacy, madness or insanity

Question 2

Rule of quarters

Answer 2

• 25% will fully recover from the first episode
• 25% will be substantially improved but still show symptoms
• 25% will improve somewhat but will relapse
• 25% will have little to no improvement with treatment

Question 3

Positive Symptoms

Answer 3

Distortion of normal functions
- Hallucinations: bizarre, unreal perceptions of the environment
-> sensory hallucinations - visual, auditory, olfactory, tactile
- Delusions: bizarre beliefs which seem real to the person with psychosis but are not
-> paranoia, delusions of grandeur
- Disorganised speech: abnormal thought processes where a disorganised mindset shows up in speech
-> derailment, word salad
- Grossly disorganised behaviour: inability to initiate or complete a task
-> bizarre behaviour, catatonic behaviour

Question 4

Negative symptoms

Answer 4

Lack of normal function
- Alogia: lessening of speech fluency and productivity
-> less fluency, less complex syntax
- Avolition: reduction of interests and desires, unable to persist in goal-oriented behaviour
-> lack of desire
- Affective flattening: reduction in the range and intensity of emotional expression
-> body/facial movement, para-linguistic features
- Anhedonia: a loss of interest or pleasure to almost all pleasurable activities and stimuli
-> pervasive, social inabilities

Question 5

Diagnostic tools and differences

Answer 5

• DSM-5: book outlining the classification of all mental disorders
  -> Schizophrenia only requires one other symptom if delusions are bizarre or if hallucinations are auditory
  -> Symptoms persist for at least 6 months
• ICD-10: system used by physicians to classify and code all diagnoses, symptoms and procedures
  -> Sz requires two symptoms to be present at all times
  -> Symptoms persist for at least 1 month

Question 6

Reliability of classification & diagnosis

Answer 6

:( Regrier et al (2013): inter-rater reliability of 0.46
:) Osorio et al (2019): high inter-rater reliability of 0.97
:( Motjabi & Nicholson (1995): reliability correlation of 0.4
:( Whaley (2001): low correlation of 0.11

Question 7

Validity of classification & diagnosis

Answer 7

:( Cheniaux et al (2009): ICD-10 - 68 diagnosed, DSM-5 - 39 diagnosed
:( Pinto & Jones (2008): cultural minorities 9x more likely to be diagnosed
:( Broveman et al (1970): mentally healthy behaviour is based off men
:( Cotton et al (2009): under-diagnosis of women

Question 8

Symptom Overlap

Answer 8

:) Swets et al (2014): 12% of Sz also sufficient for OCD
:) Ella & Ross (1995): DID have more Sz symptoms

Question 9

Co-morbidity

Answer 9

:) Buckley et al: half of schizophrenics also have depression
** Weber et al (2009)**: Sz sufferers also had a mental problem e.g. addiction