Clinical characteristics; issues in diagnosis

Question 1

Classification

Answer 1

Th act of distributing things into classes or categories of the same type

Question 2

Diagnosis

Answer 2

Identification of disease by its sign and symptoms

Question 3

The two most widely use classification systems

Answer 3

• The international classification for disease (ICD)

- The diagnostic and statistical manual of mental disorders (DSM)

Question 4

ICD

Answer 4

• Used by the World Health Organisation (WHO)
• Currently on its 10th edition
• IDC 11 is planned for 2018
• It includes 21 chapter, of which only one is devoted to mental disorders (chapter 5)

Question 5

DSM

Answer 5

• Produced by the American Psychiatric Association and is the dominant manual in the US
• DSM-5 is the current version

Question 6

What was dropped from DSM 5?

Answer 6

-The sub categories for schizophrenia

Question 7

Why has the DSM continuously been revised?

Answer 7

• Things have changed with time, e.g. in DSM-3 homosexuality was classed as a mental illness
• Cultures have changed
• More research has been conducted

Question 8

The GAF

Answer 8

• The General Assessment of Functioning scale in the DSM-5, this measures how well patients have been functioning and it has been dropped from the DSM.
• Doctors state that the DSM should use the equivalent, the WHODAS (World Health Organisation Assessment Schedule)

Question 9

Symptoms of schizophrenia

Answer 9

DSM criteria: Two or more of the following, each present for a significant portion of time during a 1-month period. ‘Continuous signs of disturbance’ for at least six months.
ICD criteria: Symptoms must be present for six months prior to the session.

Question 10

Delusions

Answer 10

Fixed false beliefs resistant to change in the light of contrary evidence. These include delusions of persecution, reference or grandeur, thought withdrawal, thought insertion and delusions of control.

Question 11

Hallucinations

Answer 11

Perception- like experiences without an external stimulus. Most commonly auditory, but in other sense modalities, e.g., visual or olfactory. They need to be distinguished from normal religious experience.

Question 12

Disorganised thinking (speech)

Answer 12

Disorganised thought inferred from speech. Involves (switching of topics), irrelevance and incoherence / ‘word salad’.

Question 13

Grossly disorganised or catatonic behaviour

Answer 13

• Disorganised behaviour includes unpredictable agitation or ‘silliness’.
• Catatonic behaviour is a marked decrease in reactivity to the environment, including rigid posture, lack of verbal or motor responses.

Question 14

Negative symptoms

Answer 14

• Diminished emotional expression; reduction in eye contact, facial expressions, hand movements
• Avolition; decrease in motivated self- initiated purposeful activities
• Level of functioning in one or more major areas, such as work, interpersonal relations or self-care must have diminished.

Question 15

Two main types of symptoms:

Answer 15

• Type 1: Characterised by positive symptoms. This means something is in some way added to the sufferer’s personality.
• Type 2: Characterised by negative symptoms. This means something is taken away from the sufferer’s personality.

Question 16

“Outline the clinical characteristics of schizophrenia”

Answer 16

Good answers:

• Defines symptoms clearly
• Gives examples of symptoms
• Clarifies number/ type of symptom (type 1 or 2)

Avoid:

• Out of date info
• Lists of symptoms
• Not relevant info e.g. long intros or history of Sz.