Classification of SZ

Question 1

What is Schizophrenia?

Answer 1

does not have a single defining characteristic it appears to be a collection of unrelated symptoms

Question 2

What classification system is used in the UK for sz?

Answer 2

• ICD11
• 2 or more negative symptoms for one month or longer are sufficient for diagnosis eg avolition and speech poverty
• also recognises subtypes of sz paranoid sz is characterised by powerful delusions and hallucinations whereas catatonic sz involves problems w patients movement eg immobile for long periods of time

Question 3

What Classification is used in USA?

Answer 3

• DSM5
• one + symptom must be present for at least 1 month for diagnosis
  -does not categorise sz further into subtypes

Question 4

What are + symptoms of sz?

Answer 4

An additional experience beyond those of ordinary existence

Hallucinations - unusual experiences that have no basis in reality that can affect any sense

eg auditory hallucinations (hearing voices that are not present) or visual hallucinations (seeing objects that are not present)

Question 5

Describe Delusions

Answer 5

Irrational/false beliefs that have no basis in reality they can make people with sz behave in ways that make sense to them but may be bizarre to others

eg delusions of persecution - false belief that you are being harassed eg by govn

delusions of control - false belief that you are being controlled by something external eg aliens

Question 6

What are the - symptoms of sz?

Answer 6

A loss of usual abilities and experiences

• Avolition
  severe loss of motivation to carry out everyday tasks and difficulty

Andreason identified 3 signs of avolition poor hygiene and grooming lack of persistence in work/education and lack of energy

Question 7

Describe Speech poverty

Answer 7

A reduction in the amount of quality of speech this is sometimes accompanied by a delay in sufferers verbal responses during conversation or a lack of fluency

Question 8

Define Diagnosis (2)

Answer 8

The identification of the nature of an illness or other problem by examination of symptoms

ie someone reporting hearing voices

Question 9

Define Classification (2)

Answer 9

The action or process of classifying something the classification of disease according to symptoms

ie a symptom of sz is hallucinations

Question 10

Give ao1 for reliability

Answer 10

reliability refers to consistency
this refers to whether we gain consistency results when classifying sz therefore the extent to which diff classification systems agree upon how sz should be classified and the extent to which 2 or more health pofessionals would agree on the same diagnosis regardless of time period or culture measured by inter rater reliability

Question 11

Give ao1 for Validity

Answer 11

refers to accuracy the extent which we are measuring what we intend to measure (sz)

eg are classification symptoms accurately outlining the signs and symptoms of sz and health professionals accurately diagnosing sz ?

Question 12

What did Cheniaux do?

Answer 12

asked 2 psychiatrists to diagnose the same 100 patients using DSM and ICD

1 diagnosed 26 according to DSM and 44 according to ICD
the other diagnosed 13 according to DSM and 24 to ICD

> shows poor inter rater reliability as one psychiatrist diagnosed almost double the number of patients using ICD than DSM which also calls in to q the validity of diagnosis

Question 13

Define system overlap

Answer 13

two or more conditions share similar symptoms

eg sz and depression involve negative symptoms such as avolition

Question 14

Define co-morbidity

Answer 14

two illnesses/conditions occur at same time

sz is commonly diagnosed w other conditions such as D/OCD as share same common symptoms lowered motivation/mood

problem as it means sz may not exist as a distant condition which may lead to diagnosis

Question 15

Define Gender Bias

Answer 15

since 1980’s men have been diagnosed w sz more often than women

men more genetically v to dev sz than women

however cud be bc females with sz typically function better than men being more likely to work and have good family rs

Question 16

Define culture bias

Answer 16

English ppl of African origin much more likely to be diagnosed w sz in UK

higher diagnosis rates in UK may be bc some bh classed as + symptoms off sz are normal in African cultures ‘shaman’ hearing voices as part of ancestors communication’

Question 17

Give a problem of R and Val of classification

Answer 17

P - System Overlap

E - 2>more conditions share similar symptoms eg both sz and D involve - symptoms such as avolition

E - this ? val + reliability of classification and diagnosis of sz bc I may be diagnosed w wrong disorder this is an issue as some doctors may not be diagnosing sz correctly and therefore I may not receive appropriate treatment

L - weakens val and reliability in classification as it negatively affects its accuracy and consistency

Question 18

Give a further problem w reliability and val

Answer 18

P - co-morbidity

E - where two illnesses/conditions occur at same time
eg buckle concluded that 50% patients diagnosed w sz also have diagnosis w OCD

E - this ? validity and reliability of classfication and diagnosis oof sz because two conditions may be better seen as one and drs may diagnose the wrong condition

Question 19

Give a final issue

Answer 19

P - Gender Bias in diagnosis

E - 1980’s men>women may be bc men more genetic v to developing sz than women

E - however cud be bc females w sz typically function better than men being more likely to work and have good family rs therefore their symptoms may be masked by good interpersonal skills (Cotton)

L - this ? as women who share similar symptoms as men may not receive same diagnosis as their symptoms seem mild