Flashcards in SCHIZOPHRENIA-issues with classifcation Deck (21):
what is reliability?
extent to where psychiatrists can agree on same diagnosis when independantly assessing patient
what do some psychiatrists do?
Some parts of the world may use diagnostic tool DSM and others ICD
what are the reliability issues? (6)
both different diagnostic criterias
no physical cause
interpretations of symptoms= subjective
diagnostic criteria on dsm 1 symptom required if delusions ‘ bizarre’
rosenhan main study
what is meant by both different diagnostic criterias?
ICD= 7 subtypes and DSM= 5 subtypes. although updated = diagnosis not consistent between different parts of world who are dependant on tools = 1 could say normal while other schizo
synopsis of both different diagnostic criterias?
cultural bias & ethical concerns
why is both different diagnostic criterias cultural bias and ethical concerns?
cultural-on identification tool and where patient is= inconsistent . ethical- because if diagnosed as schizo when not could affect area of lives such as employment or how people percieve them and even on the basis of being stigmatised and msitreated
what does both different diagnostic criterias also highlight?
schiz not understood well enough to even diagnose
what is meant by no physical cause?
placed on patient to report symptoms which are not always accurately described due to condition, hindering reliability
what is meant by interpretations of symptoms= subjective?
down to person doing diagnosis and importance placed on individs ability on diagnosis. vary btw health profressional. skill experience and knowledge affect reliability.
study for interpretation of symptoms?
what happened in whaley?
found inter rater reliabilty bte health professional low as 0.11 - findings- diagnosis rarely consistent btw them and dsm tool unreliable and inaccurate diagnosis
what is study for diagnostic criteria on dsm 1 symptom required if delusions ‘ bizarre’ which is difficult to always agree on?
what happened in mojtabi?
senior psych ask to differentiate between bizarre and no bizarre delusions- they produced inter reliabilty corellations of 0.40 (even diagnostic requirements lack reliability to distinguish btw schiz and non schiz symptoms - using bizarre to diagnose
synposis for mojtabi?
reductionist and attempt to over simplyfly something we dont understand
what is rosenhan issue?
rosenhan main study - (highlighted unreliability for diagnosis) normal people went to psych hospitals to claim hearing voices, they were all diagnosed with schiz and admitted. throughout stay noone realised normal highlighting unreliabilty of diagnosis raising ethical issue. follow up study rosenhan informed hosp sending fake p resulted in 21 % detection rate highlights diagnos unrelaibale meaning current undertsanding of schiz lacking validity.
what is bentall et al? (validity)
bentall et al review of research into symptoms causes and outcomes of schiz and concluded that schiz not useful sceientific category
what is schneider issue? (validity)
made first rnk symtoms not valid thouhg as sympotms overlaop other disorder such as depression.
what happened in ellason & ross
point out that people with dissociative Identity disorder (DID) actually have more Schizophrenic symptoms than
people diagnosed with it.
what does ellason & ross highlight?
issues of Comorbidity as symptoms may appear to fit in with Schizophrenia however may be due to a combination
of other illnesses that resemble it making diagnosis unreliable and treatment difficult.
what happened in copeland et al?
highlighted cultural differences in diagnosis and how this varies greatly between countries. Giving a description
of a patient to US psychiatrists and British Psychiatrists; 69% of those from the US diagnoses the patient with
Schizophrenia while only 2% of british psychiatrists