Diagnosis and classification of schizophrenia Flashcards
Define schizophrenia
A severe mental illness where contact with reality and insight are impaired, an example of psychosis
What is the difference in diagnosis between genders?
More commonly diagnosed in men than women
What is the difference in diagnosis between classes?
More commonly diagnosed in working class than middle class
What is the difference in diagnosis between urban and rural living areas?
More commonly diagnosed in urban than rural
How do the DSM-5 and ICD-10 differ in their classification and diagnosis of schizophrenia?
DSM-5 requires at least one positive symptom for diagnosis, whereas ICD-10 only needs 2 or more negative symptoms. ICD-10 also recognises range of subtypes of schizophrenia, such as paranoid, hebephrenic and catatonic
What is meant by a positive symptom of schizophrenia?
Additional experiences beyond those of ordinary existence, including hallucinations and delusions.
What is meant by a negative symptom of schizophrenia?
The loss of usual abilities and experiences, such as avolition and speech poverty
What are hallucinations and delusions?
Hallucinations- a false perception of objects or events involving your senses
Delusions- a belief held with complete conviction even though its based on a mistaken, strange or unrealistic view
What are avolition and speech poverty?
Avolition- lack of motivation or ability to do tasks or activities that have an end goal
Speech poverty (alogia)- causes you to speak less, say fewer words, or only talk in response to others
Advantage of diagnosis and classification
Allows doctors to communicate more effectively about a patient and use similar terminology when discussing them. They can predict the outcome of the disorder and recommend related treatment to help the patient.
Self fulfilling prophecy?
Scheff (1966) suggest that classification labels the individual, and this can have many adverse effects, such as self fulfilling prophecy, or lower self esteem.
Reliability
Jakobsen et al (2005) tested inter rater reliability in diagnosing schizophrenia with the ICD-10 on 100 danish patients with history of psychosis, concordance rate of 98% so high reliability.
However, Cheniaux et al (2009) found low inter rater reliability between two psychiatrists, one diagnosed 26 out of 100 using DSM and 44 with ICD, other diagnosed 13 with DSM and 24 with ICD.
Bias?
Cultural bias- Watters (2010) offers cross cultural analysis of mental illness, suggests that western conception about causes and treatments of mental illnesses has been applied to other cultures, often forcing inappropriate and harmful set of ideas.
Gender bias- Loring and Powell (1988) found that some behaviour that was regarded as psychotic in males was not in females
Validity
Rosenhan (1973)- 8 confederates acted as pseudo patients, going to 12 different hospitals, claimed that had suffered from hallucinations, but then stopped pretending symptoms, behaved normally and wrote observations. Staff diagnosed 11 pseudo patients with schizophrenia and one with manic depression, 35 patients detected sanity, average hospital stay was 19 days. Although shows lack of validity, may be because it is safer to diagnose healthy person as schizophrenic, rather than vice versa.
