Schizophrenia Flashcards
(43 cards)
Define schizophrenia
A severe mental illness where contact with reality and insight are impaired, an example of psychosis
What are the 2 major systems for classifying mental disorders
ICD-10
DSM-5
What are the 3 sub-types of schizophrenia recognised by ICD-10?
Paranoid - delusions & hallucinations
Hebephrenic - primarily negative symptoms
Catatonic - disturbance to movement - overactive/immobile
State a difference of classification between DSM-5 and ICD-10
In DSM-5 one positive symptom must be present where as for ICD-10 two or more negative symptoms must be present
What are positive symptoms of schizophrenia
Hallucinations and delusions
What are hallucinations
Unusual sensory experiences, for example voices to or commenting on the sufferer
What are delusions
Aka paranoia, = irrational beliefs. Takes a range of forms
Give examples of negative symptoms
Loss of usual abilities and experiences - avolition & speech poverty
What is avolition
‘Apathy’ - difficult to begin or keep a goal = reduced motivation
What are the 3 identified signs of avolition by Andreason (1982)
Poor hygiene and grooming, lack of persistence in work/education and lack of energy
What is speech poverty
Changes in patterns of speech. Negative in ICD-10
Speech disorganisation = positive in DSM-5
Evaluation - why is inter-rated reliability poor?
Inter-rater reliability = the extent to which 2 or more mental health professionals arrive at the same diagnosis. Cheniaux et al (2009) had 2 psychiatrists independently diagnose 100 patients using DSM or ICD criteria. One psychiatrist diagnosed 26 with schizophrenia according to DSM and 44 according to ICM, the other diagnosed 13 according to DSM and 24 according to ICD
Why does diagnosis of validity have poor validity?
Cheniaux et al - patients are more likely to be diagnosed with schizophrenia using ICD than DSM. Suggests schizophrenia may be over diagnosed in ICD or under diagnosed in DCM.
Explain why co-Morbidity is a weakness is diagnosing schizophrenia
Buckley et al (2009) concluded that 50% of patients diagnosed with schizophrenia have also been diagnosed with depression or 47% substance abuse. Post-traumatic stress disorder occurred in 29% and OCD in 23%. May be bad a telling the different between schizophrenia and depression or they may be same condition.
Explain how symptom overlap is a negative of diagnosing schizophrenia
Schizophrenia and bipolar disorder involve positive symptoms like delusions and negative symptoms like avolition. Questions the validity. Under ICD may be diagnosed with schizophrenia where as others may be diagnosed with bipolar disorder under DSM. Suggests they may not be 2 different conditions but 1.
Describe gender bias in schizophrenia diagnosis
Longenecker et al (2010) reviewed studies of prevalence of schizophrenia and concluded that since 1980s men have been diagnosed with schizophrenia more than women. May be because men are more genetically vulnerable. Or may be gender bias - females function better than men and are more likely to work and have good family relationships (Cotton et al). High functioning may explain some women are not diagnosed with schizophrenia when men with similar symptoms might have been.
Describe cultural bias in diagnosis
African Americans and English people of Afro Caribbean origin are several times more likely than white people to be diagnosed with schizophrenia. May be because hearing voices is more acceptable in African cultures due to cultural beliefs in communication with ancestors and are therefore more likely to acknowledge such experiences. Escobar (2012) - white psychiatrists may tend to over interpret symptoms and distrust the honesty of black people during diagnosis.
What are the 3 psychological therapies for schizophrenia?
Cognitive Behaviour Therapy (CBT)
Family therapy
Token economies
What is CBT?
5-20 sessions - aim = helping patients identify irrational thoughts and try change them. May involve argument/discussion of how likely patients beliefs are to be true
How does CBT help schizophrenia?
Patients can be helped to make sense of how their delusions and hallucinations impact on their feelings and behaviour. Understanding where symptoms come from can be hugely helpful for some patients. Delusions can be challenged so the patient can learn their beliefs are not based on reality
What is family therapy?
Aims to improve the quality of communication and interaction between family members. Some therea islets see family as root cause of condition. Most therapists concerned with reducing stress within family that might contribute to patients risk of relapse. Aims to reduce levels of expressed emotion.
How does family therapy help according to Pharoah et al (2010)?
Strategies:
Forming therapeutic alliance between family members
Reduce stress of caring for someone with schizophrenia
Improving ability of family to anticipate and solve problems
Reduction of anger and guilt in family members
Helping family members achieve balance between caring for individual with sz and maintaining own life
Improving families beliefs and behaviour towards sz.
Pharoah suggested these strategies work by reducing levels of stress and expressed emotion whilst increasing patients chance of complying with medication.
What are token economies?
Reward systems used to mange the behaviour of patients with sz, in those who have adapted patterns of maladaptive behaviour through spending long time in psychiatric hospitals. Does not sure sz but improves quality of life,
Explain how tokens are used in a token economy system
Tokens given to patients who perform desirable behaviour that has been targeted for reinforcement e.g getting dressed in the morning or making their bed. Immediacy of reward is important as it prevents ‘delay discounting’
