Diagnosis and classification Flashcards
What does reliability of a diagnosis mean?
Diagnosing the same way as another psychiatrist
What is validity of diagnosis?
Making a correct diagnosis
How do you establish reliability of a diagnosis?
If two psychiatrists agree on a diagnosis
How do you establish validity of diagnosis?
You can’t, cause there are no core symptoms of schizophrenia, and there is no objective test to verify diagnosis
Why may a misdiagnosis of schizophrenia occur?
Overlapping symptoms, comorbidity and gender/culture it’s
What is a false positive diagnosis?
When someone is diagnosed with schizophrenia when they dont have it
What is a false negative diagnosis?
When someone is not diagnosed with schizophrenia when they have it
What are consequences of a false positive diagnosis?
Treatment for schizophrenia when they dont have it, including side effects of drugs
What are consequences of a false negative diagnosis?
Not treated for schizophrenia when they dont have it, so they get worse
Why did the old DSM have low reliability?
Lack of diagnostic criteria, lack of precision/structure and open to subjective judgement
Why did the reliability of the DSM increase?
Clearer criteria and procedures, more precision/structure and types of symptoms,duration and severity
What is an appropriate target for inter-rater reliability?
0.8
What was found when inter-rate reliability of SZ diagnosis?
Reliability of 0.4
What is an experiment about reliability of DSM?
Osario - testing if reliability could e increased y improving time, training and conditions for diagnosis
What was
What was Osario’s method?
Structured interview from DSM used, with 20h of training and 60-90 minutes allowed for the interview with a partner, where one led and one could ask extra questions
What was Osario’s findings?
Inter-rater reliability was 0.97
Why are classifications of schizophrenia unreliable?
The DSM and ICD do not agree with what they define schizophrenia to be, they have different diagnostic criteria
What is evidence for differences in diagnostic rates?
Cheniaux compared diagnosis with ICD to DSM
What did Cheniaux find?
Doctors mad 2x as many diagnosis used ICD than DSM
What can you conclude from Cheniaux findings?
DSM produces false negatives, and ICD produces false positives
