Comorbidity and symptom overlap Flashcards
What are examples of symptom overlap?
Delusions are a symptom of mania in bipolar, hallucinations are a symptom of drug-induced psychosis and loss of pleasure is a symptom of depression
How can you overcome the problem of symptom overlap and comorbidity?
Using context
How can context be used to guide diagnosis?
Current and past context
What is an example of current context?
Delusions and simultaneous loss of pleasure - SZ and not bipolar
How can past context be used?
Cycle of delusions and loss of pleasure - bipolar not SZ
What is current context?
Other symptoms
What is past context?
History of symptoms
What is co-morbidity?
When a person has 2 or more disorders at the same time
What is the issue with co-morbidity?
One or more disorders could be missed, ad this could lead to misdiagnosis and inappropriate treatment
One or more disorders could be missed, ad this could lead to misdiagnosis and inappropriate treatment
What is evidence for co-morbidity?
No. of pateints with SZ who also met symptoms for other disorders - depression - 50%, PTSD - 50% and OCD - 23%
Why are there such high rates of co-morbidity?
Disorders can cause each other and disorders can have the same cause
Why is co-morbidity often missed?
Doctors are reluctant to diagnose 2 disorders and one illness hides the other
What is possible evidence for gender bias?
40% more males are diagnosed with schizophrenia than females
What is the impact of gender bias?
Underdiagnosis and lack of treatment
What may be the reason for gender bias?
One criteria in diagnosis is ‘decline in functioning’
How would ‘decline in functioning’ lead to gender bias in diagnosis?
Women appear to function better than men by downplaying difficulties and doctors believe due to gender stereotypes
What is research evidence for gender bias?
Hoye changed the gender pronoun when describing patient’s symptoms and overall diagnosis rate was 75%
What was the purpose of Hoye’s experiment?
Testing the 40% gap, if it not due to gender bias, it would be 75% for both
What were Hoye’s findings into gender ias?
Rates for male diagnosis was 81% and 69% for females, if it was truly due to gender bias it would be 88% and 62%
What are conclusions from gender bias research?
Some difference in diagnosis is from the stereotype than women function better
What may be the cause for difference in rates regardless of gender bias?
Women receive better social support or have better coping mechanisms
What is cultural bias in diagnosis of SZ?
Those of african-carribean decent are 3x more likely to have a diagnosis of SZ
Why may there be cultural bias in diagnosis?
Doctors cannot distinguish behaviour that is normal in different cultures from symptoms of SZ
What is an example of a cultural belief that may be misunderstood as a delusion?
In non-western cultures, communication with the dead is common
How may the manuals e leading to cultural bias in diagnosis?
They provide inadequate information to judge whether behaviour is normal in context of patient’s culture
low are pateints contributing to cultural bias in diagnosis?
They are more willing to report experiences, not realising they will e seen as abormal
What is evidence for cultural bias in diagnosis?
Teplin reviewed studied where they changed the ethnicity race and where pateints where rediagnosed without knowing race
What were Teplin’s findings of cultural bias?
3/5 studied where race was changed found bias and 7/8 studies found bias when race was unknown
What were conclusions of cultural bias studies?
There was over-diagnosis when the pateints was from a minority group
What is an alternative explanation for other cultures having higher diagnosis rates?
Factors than increase risk of SZ are higher in minority groups - diathesis stress
What could be potential diathesis leading to higher rates of SZ in minority groups?
They made have genes that predispose them to schizophrenia
What is the issue with the alternative diathesis of minority groups?
Relative migrants which remain in country of origin do not have increased rates of schizophrenia
What is an alternative stressor for those in minority groups?
Prejudice and other stressors are more common
What is the strength of alternative stressors for minority groups?
Prejudice and such stressors are associated with schizophrenia
