1. Schizophrenia Flashcards
What is schizophrenia?
A severe mental disorder where contact with reality and insight are impaired, an example of psychosis.
What % of the population have it?
1% of the population
Where is schizophrenia more common?
More common in men than in women More common in cities than in the countryside More common in working rather than middle-class people
What are the 2 main systems for classifying schizophrenia?
- World Health Organisation - International Classification of Disease (ICD-10)
- American Psychiatric Associations - Diagnostic & Statistical Manual (DSM-5)
How do the systems differ in classifying schizophrenia?
In the ICD-10 system at least one positive and negative symptom must be present whereas in DSM-5 one positive symptom alone is enough for a diagnosis of schizophrenia
What is another difference between ICD-10 and DSM-5?
ICD-10 recognises a range of subtypes of schizophrenia while DSM-5 no longer does
What are the subtypes of schizophrenia according to ICD-10?
Paranoid Schizophrenia - powerful hallucinations and delusions (but not much else)
Hebephrenic Schizophrenia - involves primarily negative symptoms
Catatonic Schizophrenia - disturbance to movement leaving the sufferer immobile or overactive
What are positive symptoms?
Atypical symptoms experienced in addition to normal experiences. They include hallucinations and delusions.
What are hallucinations?
Sensory experiences of stimuli that either have no basis in reality or are distorted perceptions of things that are there.
What are delusions?
Beliefs that have no basis in reality.
What are negative symptoms?
Atypical experiences that represent the loss of of a usual experience. They include avolition and and speech poverty.
What is avolition?
This is when someone suffers a loss of motivation to carry out tasks and results in lowered activity levels.
What is speech poverty?
This is a reduction in the quality and frequency of speech.
How can hallucinations be further subdivided?
They can be related or unrelated to events in the environment. They can also be experienced in relation to any sense.
What are delusions also known as?
Paranoia. They are irrational beliefs that can take a range of forms.
What are common delusions and what may they lead to?
They involve being an important historical or political figure or being persecuted by someone - may lead to sufferers thinking their body is under external control so behave aggressively.
What is avolition also known as and how is it shown?
Also called apathy, avolition is shown by poor hygiene, inconsistency in work and a decrease in energy.
How is speech poverty shown?
It is shown by a decrease in coherent speech, delays in responses and poor quality and quantity of speech.
What are the 5 evaluation points for the methods used to diagnose and classify schizophrenia?
Reliability (-) Validity (-) Co-morbidity (-) Symptom Overlap (-) Cultural Bias (-)
How is reliability a problem?
Poor inter-rater reliability between the ICD-1O and DSM-5. Cheniaux et al. - 2 independent psychiatrists diagnose 100 patients using ICD-10 and DSM-5. 1 = 26 using DSM & 44 using ICD. 2 = 14 using DSM and 24 using ICD.
How is validity a problem?
Criterion validity is when different assessment systems arrive at the same diagnosis for the same patient. Cheniaux et al. shows one of ICD and DSM over or under diagnoses - poor criterion validity
How is co-morbidity a problem?
This is when 2 different conditions are diagnosed together. Buckley et al. - 50% of schizophrenics have depression, 47% substance abuse, 29% post-traumatic stress, 23% OCD. Lowers the validity of classifying the 2 disorders separately.
How is symptom overlap a problem?
Both schizophrenia and bi-polar disorder have positive symptoms - this questions the classification validity of schizophrenia. Also, some patients may be classified as schizophrenic under ICD but bi-polar under DSM - poor diagnostic reliability.
How is cultural bias in diagnosis a problem?
African American people are more willing to accept hearing voices to someone else bc it is more culturally appropriate and acceptable to them, getting in touch with ancestors. It is seen as bizarre to us so we judge them and don’t report it ourselves - therefore it appears there are higher prevalence rates in African Americans.
