Comorbidity and symptom overlap

Question 1

What are examples of symptom overlap?

Answer 1

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

Question 2

How can you overcome the problem of symptom overlap and comorbidity?

Answer 2

Using context

Question 3

How can context be used to guide diagnosis?

Answer 3

Current and past context

Question 4

What is an example of current context?

Answer 4

Delusions and simultaneous loss of pleasure - SZ and not bipolar

Question 5

How can past context be used?

Answer 5

Cycle of delusions and loss of pleasure - bipolar not SZ

Question 6

What is current context?

Answer 6

Other symptoms

Question 7

What is past context?

Answer 7

History of symptoms

Question 8

What is co-morbidity?

Answer 8

When a person has 2 or more disorders at the same time

Question 9

What is the issue with co-morbidity?

Answer 9

One or more disorders could be missed, ad this could lead to misdiagnosis and inappropriate treatment

Answer 10

One or more disorders could be missed, ad this could lead to misdiagnosis and inappropriate treatment

Question 11

What is evidence for co-morbidity?

Answer 11

No. of pateints with SZ who also met symptoms for other disorders - depression - 50%, PTSD - 50% and OCD - 23%

Question 12

Why are there such high rates of co-morbidity?

Answer 12

Disorders can cause each other and disorders can have the same cause

Question 13

Why is co-morbidity often missed?

Answer 13

Doctors are reluctant to diagnose 2 disorders and one illness hides the other

Question 14

What is possible evidence for gender bias?

Answer 14

40% more males are diagnosed with schizophrenia than females

Question 15

What is the impact of gender bias?

Answer 15

Underdiagnosis and lack of treatment

Question 16

What may be the reason for gender bias?

Answer 16

One criteria in diagnosis is ‘decline in functioning’

Question 17

How would ‘decline in functioning’ lead to gender bias in diagnosis?

Answer 17

Women appear to function better than men by downplaying difficulties and doctors believe due to gender stereotypes

Question 18

What is research evidence for gender bias?

Answer 18

Hoye changed the gender pronoun when describing patient’s symptoms and overall diagnosis rate was 75%

Question 19

What was the purpose of Hoye’s experiment?

Answer 19

Testing the 40% gap, if it not due to gender bias, it would be 75% for both

Question 20

What were Hoye’s findings into gender ias?

Answer 20

Rates for male diagnosis was 81% and 69% for females, if it was truly due to gender bias it would be 88% and 62%

Question 21

What are conclusions from gender bias research?

Answer 21

Some difference in diagnosis is from the stereotype than women function better

Question 22

What may be the cause for difference in rates regardless of gender bias?

Answer 22

Women receive better social support or have better coping mechanisms

Question 23

What is cultural bias in diagnosis of SZ?

Answer 23

Those of african-carribean decent are 3x more likely to have a diagnosis of SZ

Question 24

Why may there be cultural bias in diagnosis?

Answer 24

Doctors cannot distinguish behaviour that is normal in different cultures from symptoms of SZ

Question 25

What is an example of a cultural belief that may be misunderstood as a delusion?

Answer 25

In non-western cultures, communication with the dead is common

Question 26

How may the manuals e leading to cultural bias in diagnosis?

Answer 26

They provide inadequate information to judge whether behaviour is normal in context of patient’s culture

Question 27

low are pateints contributing to cultural bias in diagnosis?

Answer 27

They are more willing to report experiences, not realising they will e seen as abormal

Question 28

What is evidence for cultural bias in diagnosis?

Answer 28

Teplin reviewed studied where they changed the ethnicity race and where pateints where rediagnosed without knowing race

Question 29

What were Teplin’s findings of cultural bias?

Answer 29

3/5 studied where race was changed found bias and 7/8 studies found bias when race was unknown

Question 30

What were conclusions of cultural bias studies?

Answer 30

There was over-diagnosis when the pateints was from a minority group

Question 31

What is an alternative explanation for other cultures having higher diagnosis rates?

Answer 31

Factors than increase risk of SZ are higher in minority groups - diathesis stress

Question 32

What could be potential diathesis leading to higher rates of SZ in minority groups?

Answer 32

They made have genes that predispose them to schizophrenia

Question 33

What is the issue with the alternative diathesis of minority groups?

Answer 33

Relative migrants which remain in country of origin do not have increased rates of schizophrenia

Question 34

What is an alternative stressor for those in minority groups?

Answer 34

Prejudice and other stressors are more common

Question 35

What is the strength of alternative stressors for minority groups?

Answer 35

Prejudice and such stressors are associated with schizophrenia