Classification of Schizophrenia

Question 1

How many people does Schizophrenia affect?

Answer 1

Affects about 0.3-0.7% of the population at some point in their lives.

Question 2

Who is diagnosed more males or females for Schizophrenia?

Answer 2

Males are diagnosed 40% more than females.

Question 3

What are the there possible durations of schizophrenia?

Answer 3

Approximately 1/3 of sufferers have a single, fairly brief episode.

1/3 follow repetitive episodes throughout their life.

1/3 experience a constant schizophrenic state.

Question 4

Who lists various types of schizophrenia?

Answer 4

DSM-5

Question 5

What are the three better known types of schizophrenia listed by DSM-5?

Answer 5

Paranoid

Disorganised

Catatonic

Question 6

What are positive symptoms?

Answer 6

Refer to an excess or distortion of a normal function or to a new function.

Question 7

What are negative symptoms?

Answer 7

Refer to a lessening or loss of normal functions.

Question 8

What are the positive symptoms of Schizophrenia?

Answer 8

Delusions

Hallucinations

Experiences of control

Disordered thinking

Question 9

What is the positive symptom of Schizophrenia Delusions?

Answer 9

‘false’ beliefs which appear true to the schizophrenic.

There are three types.

Question 10

What are the three types of delusions?

Answer 10

Delusions of grandeur

Paranoid delusions

Religious delusions

Question 11

What are Delusions of grandeur?

Answer 11

A belief that one possesses a special personal identity or special powers/abilities.

Question 12

What are paranoid delusions?

Answer 12

A belief that one is being followed, monitored or conspired against by a group who mean to do harm.

Question 13

What are Religious delusions?

Answer 13

A belief that one is in communication with or is a supernatural being e.g. a god, a demon, a superhero

Question 14

What are hallucinations as a positive symptom of schizophrenia?

Answer 14

Usually aural ‘hearing voices’ proving a negative critical commentary on the person or commanding them to do or not do certain things. Can also be visual seeing things or tactile feeling things.

Question 15

What are experiences of control as a positive symptom of schizophrenia?

Answer 15

A belief that one is under the control of an outside force which has invaded one’s mind and body: e.g. through implanted transmitters etc.

Question 16

What is disordered thinking as a positive symptom of schizophrenia?

Answer 16

Incoherent or random speech. Feeling that thoughts have been inserted or withdrawn from the mind.

Question 17

What are the negative symptoms of schizophrenia?

Answer 17

Speech poverty

Avolition

Affective flattening

Catatonia

Question 18

What is the negative symptom of schizophrenia speech poverty?

Answer 18

Difficulty with speaking, reduced speech output and verbal fluency.

Question 19

What is the negative symptom of schizophrenia avolition?

Answer 19

Loss of motivation and the will or desire to participate in activities or do things.

Question 20

What is the negative symptom of schizophrenia Affective flattening?

Answer 20

A reduction in the range and intensity of emotional expression.

Immobile and unresponsive facial expressions often accompanied by poor eye contact and little body language or movement.

Question 21

What is the negative symptom of schizophrenia Catatonia?

Answer 21

Assuming a rigid posture and remaining immobile in a trance-like state.

Question 22

What does reliability refer to in Schizophrenia?

Answer 22

Refers to the consistency of the diagnosis, i.e. different psychiatrists diagnosing the individual should all agree that schizophrenia is the correct diagnosis and the same diagnosis should be given over time.

Question 23

How is Schizophrenia diagnosed?

Answer 23

After a lengthy clinical interview, however, there is no objective test e.g. blood test for the disorder.

Question 24

What evidence suggests that there were problems with the reliability of diagnosis of schizophrenia some years ago?

Answer 24

Copeland 71 gave a description of a patient to 134 and 194 psychiatrists.

69% of the US psychiatrists diagnosed schizophrenia whereas only 2% of the British psychiatrists gave the same diagnosis. This indicates very poor reliability.

Question 25

What has been done to address the previous lack of reliability in the diagnosis of schizophrenia?

Answer 25

Diagnostic and Statistical manual (DSM) has been revised through several additions.

Question 26

What evidence suggests that there is still a poor reliability in the diagnosis of schizophrenia?

Answer 26

Whaley ‘01 found inter-rater reliability correlations in the diagnosis of schizophrenia as low as 0.11.

Question 27

What does validity refer to in Schizophrenia?

Answer 27

Validity refers to how accurate and true the diagnosis is, i.e. a diagnosis is valid if a schizophrenic is diagnosed with schizophrenia and not another disorder.

Question 28

What is Predictive validity?

Answer 28

Refers to the extent to which the diagnosis of schizophrenia can predict the likely outcome of the illness the prognosis.

It is usually the case that there should be a predictable course that a disorder will take. However, this is not the case with schizophrenia. Thus diagnosis has low predictive validity.

Question 29

What was the a study to see how validity of the diagnosis of schizophrenia was in psychiatric hospitals?

Answer 29

Rosenhan’s 73 sent ‘normal’ people to a number of psychiatric hospitals claiming that they were hearing unfamiliar voices in their heads. They were all admitted into the hospitals and diagnosed with schizophrenia or manic-depression.

On entry they all stopped faking their symptoms and acted normally, yet were still treated as being mentally ill by staff.

Thus, psychiatrists and staff were, apparently, unable to make a valid diagnosis of schizophrenia.

Question 30

Who claimed that British psychiatrists hold conscious or unconscious stereotypes about race which affect diagnosis?

Answer 30

Fernando

Question 31

What was the study, studying if culture bias affected whether someone was diagnosed with schizophrenia?

Answer 31

Loring ‘88 gave 290 psychiatrists a transcript of a patient interview and told half of them that the patient was black and the other half white.

Black males were more likely to be diagnosed with paranoid schizophrenia. This indicated that certain people are more likely to be diagnosed based on cruet other than the presented symptoms, in this case, race.

Question 32

What can culture bias in schizophrenia diagnosis explain?

Answer 32

Why there are disproportionately large numbers of ethnic minorities in the UK and USA forcibly placed in institutions.

Question 33

How can gender bias affect schizophrenia diagnosis?

Answer 33

Males may be more likely to be involuntarily committed to a mental institution as psychiatrists label them as being more likely to be violent/criminal.

Whereas women are more likely to commit themselves to a mental institution as it is more socially acceptable fr women to seek help for emotional/psychological problems.

Question 34

What study shows that gender bias can affect schizophrenia diagnosis?

Answer 34

Broverman ‘70 found that psychiatrists in the USA tended to think of mentally healthy behaviour in terms of stereotypically male traits, therefore, females were more likely to be judged as mentally ‘unhealthy’.

Question 35

What is co-morbidity?

Answer 35

Two illnesses occurring at the same time.

Question 36

How does co-morbidity affect the reliability of Schizophrenia diagnosis?

Answer 36

It is complicated by the fact that schizophrenia is often co-morbid with depression, anxiety and substance abuse.

For example, co-morbid depression occurs in 50% of schizophrenics and co-morbid substance abuse occurs in 47%.

Thus, it is very difficult to draw aline between schizophrenia and other disorders, and questions whether a single, simple classification of schizophrenia is valid and useful.

Question 37

What is symptom overlap?

Answer 37

This is when there is an overlap between the symptoms of two conditions.

Question 38

How can symptom overlap question the validity of both the classification and diagnosis of schizophrenia?

Answer 38

There is considerable overlap between the symptoms of schizophrenia and other conditions.

For example, schizophrenia and bipolar disorder both share positive symptoms like delusions and negative symptoms like avolition.

This lack of distinction calls into question the validity of both the classification and the diagnosis of schizophrenia.