Diagnosis and classification of schizophrenia

Question 1

What are positive symptoms of schizophrenia?

Answer 1

Experiences/behaviours that are additional to normal behaviours

Question 2

What are negative symptoms of schizophrenia?

Answer 2

A withdrawl or lack of function that you would usually expect to see in a healthy person.

Question 3

Give 2 examples of positive symptoms of schizophrenia.

Answer 3

Hallucinations, Delusions

Question 4

What is a hallucination?

Answer 4

These are unusual sensory experiences. E.g voices commenting on the person, criticising them.

Question 5

What is a delusion?

Answer 5

Delusions are irrational, unshakable belifs in something that is untrue which others know to be false. These belifs can take a range of forms such as the patient believing that they are a religious figure. People may believe that they are under external control.

Question 6

What are the two types of delusions?

Answer 6

Delusions of grandeur, Delusions of persecution

Question 7

What are delusions of grandeur?

Answer 7

Someone thinking they are special or different from everyone else e.g thinking they are Jesus Christ or Napoleon.

Question 8

What are delusions of persecution?

Answer 8

Thinking that they are being tracked or followed by secret agencies.

Question 9

What are two examples of negative symptoms of schizophrenia?

Answer 9

Avolition, Speech poverty

Question 10

What is avoloition?

Answer 10

A total lack of motivation. Finding it difficult to keep up with goal-directed activity such as hygeine, work or education.

Question 11

What is speech poverty?

Answer 11

When there is a reduction in the amount and quality of speech. There may be a delay in the persons verbal responses during communication.

Question 12

What are the two major systems for the classification of schizophrenia?

Answer 12

The DSM-V and the ICD-10

Question 13

What is the DSM-V?

Answer 13

The DSM-V is a diagnostic classification system used in the USA which suggests that for a patient to be diagnosed with schizophrenia,they must be experiencing 1 or more negative symptoms.

Question 14

What is the ICD-10?

Answer 14

A diagnostic classification system used worldwide which suggests for a patient to be diagnosed with schizophrenia they must be experiencing 2 or more negative symptoms and these must last over a month.

Question 15

Differences between DSM and ICD.

Answer 15

DSM American
ICD worldwide.
DSM 1 or more negative symptoms
ICD 2 or more negative symptoms for over one month
DSM no subtypes
ICD range of subtypes.

Question 16

Why does having two classification systems for schizophrenia pose a challenge during diagnosis?

Answer 16

Patients in USA more likely to be diagnosed as they only need to be experiencing one negative symptom however everywhere else needs 2 or more. Also, negative symptoms of schizophrenia can also be related to other mental conditions.

Question 17

Reliability in diagnosis of Schizophrenia.

Answer 17

The level of consistency of diagnosis by different psychiatrists. If different psychiatrists cannot agree on the same diagnosis using the same manual than the diagnosis is unreliable.

Question 18

Research evidence for reliability of schizophrenia diagnosis.

Answer 18

E.g Cheniaux et al. (2009) had two psychiatrists diagnose the same group of 100 patients using both the DSM and ICD.
One diagnosed 26 out of 100 patients with schizophrenia using the DSM and 44 out of 100 using the ICD.
The other diagnosed 13 out of 100 with schizophrenia using the DSM and 24 out of 100 using the ICD. This showed poor reliability and consistency and this is a weakness of diagnosis of schizophrenia as people wrongly diagnosed will receive the wrong treatment which could negatively impact them.

Question 19

Co-morbidity of schizophrenia.

Answer 19

Co-morbidity is the phenomenon that two or more conditions occur together. E.g PTSD and schizophrenia.

Question 20

Why does co-morbidity pose a challenge for the classification and diagnosis of schizophrenia?

Answer 20

A doctor may miss that there is another mental condition going on and so may only diagnose them with one condition therefore may give them medication which will not relieve their symptoms.

Question 21

Symtom overlap of schizophrenia.

Answer 21

There is considerable overlap between the symptoms of schizophrenia and other conditions. E.g bipolar and schizophrenia both have symptoms such as avoloition this means one person may be diagnosed with schizophrenia and another bipolar using the same manual.

Question 22

Explain gender bias in schizophrenia.

Answer 22

Men have been diagnosed with schizophrenia more than women which may simply be that men are more genetically vulnerable to developing schizophrenia however another explination is the stereotype that ‘women function better than men’ which explains why some women have not been diagnosed with schizophrenia when men with the same symptoms have been. Practitioners under diagnose schizophrenia in women.

Question 23

Cultural bias in schizophrenia

Answer 23

African Americans and English people of Afro-carribean origin are several times more likely to be diagnosed with schizophrenia and this is often as a result of cultural bias. Symptoms such as hearing voices may be acceptable in African cultures due to belifs in communication with the dead so when reported to a psychiatrist from a different culture, these experiences are likely to be seen as bizzare and irrational.

Question 24

Research evidence for gender bias in schizophrenia.

Answer 24

Loing and Powell randomly selected 290 males and females and asked psychiatrists to read a description of a patient and diagnose them. When they were described as Male or no gender info was given, 56% were given a diagnosis. When they were described as female only 20% were diagnosed.

Question 25

Define schizophrenia.

Answer 25

Schizophrenia is a severe mental disorder where contact with reality and insight are impaired, an example of psychosis.

Question 26

What percentage of the population experience schizophrenia?

Answer 26

1%

Question 27

Research evidence for comorbidity of schizophrenia.

Answer 27

Buckley et al. (2009) found that 50% of schizophrenic patients had depression.
77% of schizophrenic patients had substance abuse.
29% of schizophrenic patients had PTSD.
27% of schizophrenic patients had OCD.

Question 28

Validity in schizophrenia.

Answer 28

The extent to which the diagnosis of schizophrenia is correct and accurate. If schizophrenic patients are diagnosed with a different disorder or not diagnosed at all this means that the diagnostic tool lacks validity.

Question 29

Research evidence for validity in schizophrenia.

Answer 29

Rosenhan- 8 pseudopatients went to 12 different hospitals and reported having auditory hallucinations (they hadn’t) in attempt to be admitted to a mental institution. When they arrived at the institutions, they acted completely normal yet 7 pseudopatients were diagnosed with schizophrenia and one manic depression. This shows that psychiatrists cannot accurately tell the difference between sane and insane individuals, thus the diagnosis of schizophrenia lacks validity.