Classification of SZ

Question 1

What are some key facts about schizophrenia?

Answer 1

More common in men than women

Likelihood of diagnosis is 1 in 100

3 – 5 times more likely in afrocarribean cultures in the UK (Nazroo and Buckley’s research)

More commonly diagnosed in cities than in the countryside

Interferes severely with every day tasks many sufferers end up homeless or institutionalised. (failure to function adequately)

Question 2

What is schizophrenia?

Answer 2

Severe mental illness where contact with reality and insight is impaired.

It does not have a defining characteristic - issue because it makes it harder to diagnose/treat

It’s a cluster of symptoms which can be unrelated.

DSM V and ICD 10 have differing ways of defining and diagnosing SZ.

Question 3

What’s classification of mental disorders?

Answer 3

The process of organising symptoms into categories based on which symptoms cluster together in people with mental disorders.

Question 4

What’s the DSM classification of Schizophrenia?

Answer 4

One positive symptom must be present to be diagnosed

Question 5

What’s the ICD 10 classification of Schizophrenia?

Answer 5

Two positive symptoms must be seen to be diagnosed

Recognises a range of subtypes of Schizophrenia;
Paranoid Schizophrenia
Catatonic Schizophrenia
Hebephrenic Schizophrenia

Question 6

What is paranoid schizophrenia?

Answer 6

Features delusions, especially delusions of persecution (the belief people are plotting against them) and hallucinations, particularly hearing voices.

Paranoid schizophrenics are usually agitated, angry, argumentative and suspicious of others

35–40% of people are diagnosed with this type

Question 7

What is catatonic schizophrenia?

Answer 7

May spend long periods immobile (catatonia), staring blankly or uncontrolled excitement and motor movements

10% of people are diagnosed with this type

Question 8

What is hebephrenic schizophrenia?

Answer 8

Symptoms include disorganised behaviour such as not washing, disorganised speech – language disturbances, mood swings, hallucinations and delusions, flattened effect, confusion and incoherence

10% of people are diagnosed with this types

Question 9

What are positive symptoms of schizophrenia?

Answer 9

Atypical symptoms experienced in addition to normal experiences. They include hallucinations and delusions.

Question 10

What are hallucinations?

Answer 10

A positive symptom of schizophrenia.

They are sensory experiences of stimuli that have either no basis in reality or are distorted perceptions of things that are there.

Auditory
Visual
Olfactory
Smelling something that isn’t there.
Hallucinations can occur in any of the senses.

Question 11

What are delusions?

Answer 11

A positive symptom of schizophrenia.

They involve beliefs that have no basis in reality, for example, that the person with schizophrenia is someone else or that they are the victim of a conspiracy.

Irrational beliefs - common delusions are that the individual is a religious figure.

Question 12

What are negative symptoms of schizophrenia?

Answer 12

Atypical experiences that represent the loss of a usual experience such as clear thinking or
‘normal’ levels of motivation.

Question 13

What is avolition?

Answer 13

Negative symptom of schizophrenia.

Low motivation sometimes referred to as apathy

Andreason (1982) this is observable when the patient doesn’t seem to be washing or grooming themselves.

Question 14

What is speech poverty?

Answer 14

Delay in response in conversation

Reduction in the quality and frequency of speech

Question 15

What is co-morbidity?

Answer 15

The occurrence of two disorders or conditions together, for example a person has both schizophrenia and a personality disorder. Where two conditions are frequently diagnosed together it calls into question the validity of classifying the two disorders separately.

Question 16

What is symptom overlap?

Answer 16

Occurs when two or more conditions share symptoms. Where conditions share many symptoms this calls inte question the validity of classifying the two disorders separately.

Question 17

What’s gender bias?

Answer 17

there is evidence that gender is presented in a biased way. This bias leads to differential treatment of males and females, based on stereotypes and not real differences.

Question 18

What’s culture bias?

Answer 18

the tendency to judge people in terms of one’s own cultural assumptions.

Question 19

What’s reliability?

Answer 19

a measure of whether something stays the same, i.e. is consistent. The results of psychological investigations are said to be reliable if they are similar each time they are carried out using the same design, procedures and measurements. (inter-rater reliability)

Question 20

What’s validity?

Answer 20

refers to whether a measure actually measures what it claims to be measuring.

Question 21

What’s reliability in terms of schizophrenia?

Answer 21

Reliability is the extent to which a finding is consistent.

It is the extent to which psychiatrists can agree on the same diagnosis when
independently assessing patients (inter-rater reliability). In order for a classification system to be reliable, the same diagnosis should be
made each time. Therefore different psychiatrists should reach the same decision when assessing a patient.

Question 22

What’s validity in terms of schizophrenia?

Answer 22

Validity is the extent to which we are measuring what we are intending to measure.

In the case of an illness like schizophrenia we have to consider the validity of the diagnostic tools; for example, do different assessment systems arrive at the same diagnosis for the same patient? (i.e. the ICD 10 and the DSM 5)

Question 23

What are some limitations of classification and diagnosis of schizophrenia?

Answer 23

Validity:
Cheniaux et al (2009)
100 patients
2 psychiatrists
DSM criteria – 26 diagnosed
ICD – 44 diagnosed
Questions the validity of diagnosing and classifying SZ
SZ more likely to be diagnosed using the ICD than the DSM. – over / underdiagnosed.
Diagnosis is Subjective (based on the psychiatrists opinion)

Comorbidity:
Buckley (2009)
Depression – 50%
PTSD – 47%
OCD – 23%
Substance abuse disorder – 47%
Classification and diagnosis issues.

Question 24

What are some other limitations of classification and diagnosis of schizophrenia?

Answer 24

Culture Biases in Diagnosis
Escobar (2012) has pointed out that White psychiatrists may tend to over-interpret the symptoms of Black people during diagnosis.
Such factors as cultural differences in language and mannerisms, difficulties in relating between black patients and white therapists, and the myth that black people rarely suffer from affective disorders may be causing this problem.
Nazroo supported in saying Afrocarribean are 3 – 5 x more likely to be diagnosed in the UK than any other minority.

Gender Biases in Diagnosis
Research conducted on men - men are genetically more vulnerable to developing SZ.
Coping methods of men and women.