Classification of Schizophrenia

Question 1

who is more likely to have schizophrenia?

Answer 1

• 1% of the UK have it
• 1st symptoms around 15-45 y/o
• men most likely to have it
• men also have earlier symptoms

Question 2

positive symptoms

Answer 2

• experiences that are in addition to normal experiences

Question 3

negative symptoms

Answer 3

• loss of normal experiences and abilities

Question 4

examples of positive symptoms

Answer 4

• hallucinations
• delusions

Question 5

examples of negative symptoms

Answer 5

• avolition
• speech poverty

Question 6

how to diagnose symptoms

Answer 6

• using DSM-5 (the diagnostic and statistical manual)
• using ICD (international classification of disease)
• 2 symptoms need to be present for at least a month
• at least 1 needs to be positive

Question 7

what is a hallucination?

Answer 7

• additional sensory experiences
• seeing distortions in objects that look like faces
• hearing critical voices

Question 8

what is a delusion?

Answer 8

• irrational beliefs about themselves or the world
• feelings of persecution
• ’ the government’
• feelings of grandeur
• ‘president’

Question 9

What is avolition?

Answer 9

• a lack of purposeful, willed behaviour
• no energy
• no sociability affection
• no personal hygiene

Question 10

what is speech poverty?

Answer 10

• brief verbal communication style
• lack of quality and quantity of verbal responses
• can be a positive symptom if speech is excessively disorganized, with suffers wondering off the point

Question 11

what is reliability?

Answer 11

• how consistent the results are using the same measuring tool

Question 12

what is inter-rater reliability?

Answer 12

• measure of how two observers agree

Question 13

what is test-retest reliability?

Answer 13

-the same doctor giving the same diagnosis, over time with the same symptoms

Question 14

Inter-rater reliability in terms of SZ diagnosis

Answer 14

• 54% concordance rate between doctors assessments
• low inter-rater reliability in the diagnosis of SZ
• many people have been diagnosed incorrectly
• potentially lead to the inappropriate treatments

Question 15

what is validity in terms of SZ?

Answer 15

• the diagnoses of SZ can be questioned in individual cases
• question as to whether SZ is actually a unique syndrome
• has its own characteristics, symptoms and causes

Question 16

what is co-morbidity in terms of SZ?

Answer 16

• SZ often diagnosed with other disorders
• could be leading to inaccurate diagnosis of SZ, when it could be a severe case of depression
• as these diagnoses usually occur together, they may not be separate disorders

Question 17

co-morbidity rates for SZ

Answer 17

• depression 50%
• drug abuse 47%
• PTSD 29%
• OCD 23%
• this complicates treatments plans
• suggests the original diagnosis of SZ may be wrong if the disorders share symptoms

Question 18

what is symptom overlap with SZ

Answer 18

• Bipolar also has hallucinations and delusions as positive symptoms
• if the two disorders are so similar it means they may not be so distinct
• as a result, they should be redefined

Question 19

Gender and the diagnosis of SZ (men)

Answer 19

• women and men equally likely to be diagnosed but women 5 years later
• average diagnosis age for a man is 25
• men more likely to have drug abuse as a co morbidity
• men have more negative symptoms and worse social functioning
• women are more likely to display negative symptoms

Question 20

Gender bias when diagnosing SZ (women)

Answer 20

• women’s experience of SZ is taken less seriously and undiagnosed
• cotton: womens better coping strategies leading to being less likely to seek treatments

Question 21

Culture on the diagnosis of SZ

Answer 21

• people with afro-carribean heritage are 9x more likely to be diagnosed than the 1% of the general population

Question 22

culture bias on the diagnosis of SZ

Answer 22

• as SZ rates are 1% in the country of origin, the rise in diagnostic rates are likely due to cultural bias
• Fernando: ‘category failure’
• western definitions of mental illness applied to non-western cultures
• e.g. hearing the voices of the angels= auditory hallucination in the UK, but in the west indies= religious experience

Question 23

Evaluation strength: research support

Answer 23

• lorning and Powell: sent 290 psychiatrists 2 identical case files
• 2 case studies changed to W male, B male, W female, B female or not identified
• over diagnosis of black case studies and under diagnosis of female case studies
• most accurate diagnosis was when the gender and race of the psychiatrist was the same as the case study
• shows gender and culture bias