Schizophrenia

Question 1

Schizophrenia -

Answer 1

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

Question 2

Classification of mental disorder -

Answer 2

The process of organising symptoms into categories based on which symptoms cluster together in people with mental disorders.

Question 3

Positive symptoms of schizophrenia -

Answer 3

Atypical symptoms experienced in addition to normal experiences. They include hallucinations and delusions.

Question 4

Hallucinations -

Answer 4

A positive symptom of schizophrenia. They are sensory experiences of stimuli that have either no basis in reality or are distorted perceptions of things that are there.

Question 5

Delusions -

Answer 5

A positive symptom of schizophrenia. They involve beliefs.that have no basis in reality, for example, that the person with schizophrenia is someone else or that they are the victim of a conspiracy.

Question 6

Negative symptoms of schizophrenia -

Answer 6

Atypical experiences that represent the loss of a usual experience such as clear thinking or ‘normal’ levels of motivation.

Question 7

Speech poverty -

Answer 7

A negative symptom of schizophrenia. It involves reduced frequency and quality of speech.

Question 8

Avolition -

Answer 8

A negative symptom of schizophrenia. It involves loss of motivation to carry out tasks and results in lowered activity levels.

Question 9

Co-morbidity -

Answer 9

The occurrence of two disorders or conditions together, for example a person has both schizophrenia and a personality disorder. Where two conditions are frequently diagnosed together it calls into question the validity of classifying the two disorders separately.

Question 10

Symptom overlap -

Answer 10

Occurs when two or more conditions share symptoms. Where conditions share many symptoms this calls into question the validity of classifying the two disorders separately.

Question 11

What percentage of the world population experiences schizophrenia?

Answer 11

About 1% of the world population experiences schizophrenia.

Question 12

Is schizophrenia more commonly diagnosed in men or women?

Answer 12

Schizophrenia is more commonly diagnosed in men than women.

Question 13

Is schizophrenia more commonly diagnosed in cities or the countryside?

Answer 13

Schizophrenia is more commonly diagnosed in cities than in the countryside.

Question 14

Is schizophrenia more commonly diagnosed in working-class or middle-class people?

Answer 14

Schizophrenia is more commonly diagnosed in working-class people than middle-class people.

Question 15

What are the two major systems for the classification of mental disorders?

Answer 15

The two major systems are the World Health Organisation’s International Classification of Disease edition 10 (ICD-10) and the American Psychiatric Association’s Diagnostic and Statistical Manual edition 5 (DSM-5).

Question 16

How does the DSM-5 differ from the ICD-10 in diagnosing schizophrenia?

Answer 16

In the DSM-5, one of the positive symptoms (delusions, hallucinations, or speech disorganisation) must be present for diagnosis, whereas two or more negative symptoms are sufficient under ICD-10.

Question 17

What are the subtypes of schizophrenia recognised by ICD-10?

Answer 17

ICD-10 recognises paranoid schizophrenia, hebephrenic schizophrenia, and catatonic schizophrenia.

Question 18

What characterises paranoid schizophrenia?

Answer 18

Paranoid schizophrenia is characterised by powerful delusions and hallucinations but relatively few other symptoms.

Question 19

What characterises hebephrenic schizophrenia?

Answer 19

Hebephrenic schizophrenia primarily involves negative symptoms.

Question 20

What characterises catatonic schizophrenia?

Answer 20

Catatonic schizophrenia is characterised by disturbances to movement, leaving the person immobile or overactive.

Question 21

Does DSM-5 recognise subtypes of schizophrenia?

Answer 21

No, DSM-5 has dropped the recognition of subtypes of schizophrenia.

Question 22

What are positive symptoms of schizophrenia?

Answer 22

Positive symptoms are additional experiences beyond ordinary existence, including hallucinations and delusions.

Question 23

What are hallucinations in schizophrenia?

Answer 23

Hallucinations are unusual sensory experiences, such as hearing voices or seeing things that are not there.

Question 24

What are delusions in schizophrenia?

Answer 24

Delusions are irrational beliefs, such as believing one is an important historical figure or being persecuted.

Question 25

What are negative symptoms of schizophrenia?

Answer 25

Negative symptoms involve the loss of usual abilities and experiences, such as avolition and speech poverty.

Question 26

What is avolition?

Answer 26

Avolition is difficulty in beginning or maintaining goal-directed activity, often leading to poor hygiene and lack of persistence.

Question 27

What is speech poverty?

Answer 27

Speech poverty is a reduction in the amount and quality of speech, sometimes accompanied by delayed verbal responses.

Question 28

How does DSM-5 classify speech disorganisation?

Answer 28

DSM-5 classifies speech disorganisation as a positive symptom, where speech becomes incoherent or the speaker changes topic mid-sentence.

Question 29

What is reliability in the context of diagnosing schizophrenia?

Answer 29

Reliability refers to consistency, such as inter-rater reliability, where different assessors agree on their assessments.

Question 30

What did Elie Cheniaux et al. (2009) find about inter-rater reliability in diagnosing schizophrenia?

Answer 30

They found poor inter-rater reliability, with one psychiatrist diagnosing 26 with schizophrenia using DSM and 44 using ICD, and the other diagnosing 13 using DSM and 24 using ICD.

Question 31

What is validity in the context of diagnosing schizophrenia?

Answer 31

Validity refers to the extent to which a diagnosis measures what it is intended to measure.

Question 32

What is criterion validity?

Answer 32

Criterion validity assesses whether different diagnostic systems arrive at the same diagnosis for the same person.

Question 33

What does the Cheniaux et al. study suggest about the validity of schizophrenia diagnosis?

Answer 33

The study suggests poor validity, as schizophrenia is more likely to be diagnosed using ICD than DSM, indicating potential over-diagnosis in ICD or under-diagnosis in DSM.

Question 34

What did Peter Buckley et al. (2009) find about co-morbidity in schizophrenia?

Answer 34

They found that around half of people with schizophrenia also have depression (50%) or substance abuse (47%), with PTSD in 29% and OCD in 23% of cases.

Question 34

What is co-morbidity?

Answer 34

Co-morbidity is the phenomenon where two or more conditions occur together.

Question 35

What is symptom overlap?

Answer 35

Symptom overlap refers to the sharing of symptoms between different conditions, such as schizophrenia and bipolar disorder both involving delusions and avolition.

Question 36

What does symptom overlap suggest about the validity of schizophrenia diagnosis?

Answer 36

Symptom overlap calls into question the validity of both the classification and diagnosis of schizophrenia.

Question 37

What did Julia Longenecker et al. (2010) find about gender bias in schizophrenia diagnosis?

Answer 37

They found that since the 1980s, men have been diagnosed with schizophrenia more often than women, possibly due to gender bias or better functioning in women masking symptoms.

Question 38

What does possible under-diagnosis of schizophrenia in women suggest about the validity of the diagnosis?

Answer 38

It suggests potential issues with the validity of the diagnosis, as symptoms may be overlooked or misinterpreted in women.

Question 39

What is cultural bias in schizophrenia diagnosis?

Answer 39

Cultural bias refers to the over-diagnosis of schizophrenia in certain ethnic groups, such as African Americans and English people of Afro-Caribbean origin.

Question 40

Why might African Americans and Afro-Caribbean people be more likely to be diagnosed with schizophrenia?

Answer 40

This may be due to cultural differences in interpreting symptoms, such as hearing voices, and potential over-interpretation by psychiatrists from different cultural backgrounds.

Question 41

What does the over-diagnosis of schizophrenia in Black British and American people suggest about the validity of the diagnosis?

Answer 41

It suggests potential cultural bias and issues with the validity of the diagnosis, as symptoms may be misinterpreted or over-emphasised based on cultural differences.