Introduction Flashcards
(21 cards)
What is Schizophrenia?
A severe mental disorder where contact with reality and insight are impaired
How much of the population does Schizophrenia affect?
1%
How are most commonly diagnosed with Schizophrenia?
Men
City dqeller
Low socio-economic groups
How is diagnosis and classification linked?
In order to diagnose a specific disorder we need to distinguish one disorder from another
What are the major systems for the classification of mental disorder?
ICD-10
DSM-5
What is the difference between the classification on schizophrenia?
DSM-5 - One of the positive symptoms must be present for diagnosis
ICD-10 - Two or more negative symptoms have to be sufficient
What are positive symptoms?
Additional experiences beyond those of ordinary existence
What are hallucinations?
Unusual sensory experiences
Some related to events in environments, some no relationship to what sense are picking up from environment
Experiences in relation to any sense
What are delusions?
Irrational beliefs
Important historical, political or religious figures
Commonly involve persecution, gov or aliens or having superpowers
Under external control
May behave in ways that make sense to them but seem bizarre to others
What are negative symptoms?
Loss of usual abilities and experiences
What is speech poverty?
Changes in patterns of speech
Emphasis is on reduction in the amount and quality of speech
Sometimes accompanied by a delay in persons verbal responses during conversation
What is speech disorganisation?
Speech becomes incoherent
Speaker changes topic mid sentence
Classified as positive symptom in DSM-5
What is avolition?
Described as finding it difficult to begin or keep up with goal directed activity
Sharply reduced motivation to carry out range of activities
What are Andreasens three signs of avolition?
Poor hygiene and grooming
Lack of persistence in work or education
Lack of energy
How is good reliability a strength of diagnosis and classification?
Inter-rater reliability
A psychiatric diagnosis is said to be reliable when different diagnosis clinicians reach same diagnosis for the same individual
Test-retest reliability
When clinicians reach same diagnosis for same individual on two occasions
Prior to DMS-5 reliability was low - now improved
Osoria et al
Excellent reliability for diagnosis of schizophrenia
180 individuals using DMS-5
Pairs of interviews achieved interrater reliability of +0.97 and test retest of +0.92
Can be reasonably sure diagnosis of schizophrenia is consistently applied
How is low validity a limitation of diagnosis and classification?
Cheniaux et al
Two psychiatrists independantly assess same 100 clients
Using ICD-10 and DSM-IV criteria
68 diagnoses with Schizophrenia under ICD and 39 under DSM
Schizophrenia is either over or under diagnosed according to diagnostic system
Criterion validity is low
What is a counterpoint to low validity?
Osario et al
Excellent agreement between clinicians when using two measures to diagnose schizophrenia
Both derived from DSM system
Criterion validity is actually good
Takes place within a single diagnostic system
How is co-morbidity a limitation of diagnosis and classification?
If conditions occur together a-lot of time then this calls into question the validity of diagnosis as they might actually be a single condition
Schiz commonly diagnosed with other conditions
Eg Depression or substance abuse
Schiz may not exists as a distinct condition
Some people diagnosed with schizophrenia may have unsual cases of conditions like depression
How is gender bias an issue in diagnosis and classification?
Since 1980 - men diagnosed more than women
Women are less vulnerable than men - maybe due to genetic factors
Women are under-diagnosed as have closer relationships and hence get support
Women with schizophrenia often function better than men
Under diagnosis due to gender bias
Women not receiving treatment and services that might benefit them
How is cultural bias an issues in diagnosis and classification?
Different meanings in different cultures
Haiti - hearing voices is communications from ancestors
British ppl of African Caribbean origin 9x more likely to receive a diagnoses as white British people
Diagnosis in clients by psychiatrists from a different cultural background
Over-interpretation of symptoms in black British people
British African Caribbean people may be discriminated against by a culturally biased diagnostic system
How is symptom overlap a limitation of diagnosis and classification?
Overlap of symptoms of schizophrenia and other conditions
Schiz and BPD involve positive symptoms and negative symptoms
May not be two different conditions but variation of a single condition
Schiz is hard to distinguish from BPD
Means schizophrenia may not exist as a distinct condition
Hard to diagnose
Classification and diagnosis are flawed
