Diagnosis and Classification of Schizophrenia

Question 1

How many people experience schizophrenia?

Answer 1

1%

Question 2

What are the two methods of diagnosing schizophrenia?

Answer 2

• ICD - 10
• DSM - 5

Question 3

How does the ICD - 10 diagnose?

Answer 3

-It requires two or more negative symptoms

Question 4

How does the DSM - 5 diagnose?

Answer 4

• Requires one positive symptoms

Question 5

What are positive symptoms?

Answer 5

• These are additional experience beyond the ordinary existence

Question 6

What are the two types of positive symptoms?

Answer 6

• Delusions
• Hallucinations

Question 7

Describe hallucinations.

Answer 7

• These are unusual sensory experiences
• Some hallucinations are related to the environment or have no relationship to our environment
• They can be experienced in relation to any sense, for example distorted facial expressions or people who aren’t there

Question 8

Describe delusions.

Answer 8

• These are irrational beliefs
• common ones include historical or political figures
• They may involve being prosecuted or believing that their body is under external control

Question 9

What are negative symptoms?

Answer 9

• These are the loss of usual abilities and experiences
• Examples include speech poverty and avolition

Question 10

Describe speech poverty.

Answer 10

• Schizophrenia is characterised by changes in patterns of speech
• This is seen as a negative symptom as it involves the reduction in the amount and quality of speech and may cause delays in conversation
• People also may have speech disorganisation ( a positive symptom in DSM-5) when speech becomes incoherent or changing in topics mid way through sentences

Question 11

Describe avolition.

Answer 11

• This is also known as apathy
• A lack of motivation in keeping up with goal directed activity
• They may lack motivation to carry out a range of activities
• Therefore people may have poor hygiene, grooming, lack of persistence in work or education or a lack of energy

Question 12

What are the strengths of diagnosis and classification of schizophrenia?

Answer 12

• Good reliability

Question 13

What are the weaknesses of diagnosis and classification of schizophrenia?

Answer 13

• Low validity
• Co - morbidity
• Gender bias
• Culture bias
• Symptom overlap

Question 14

Describe good reliability?

Answer 14

• One strength is that the diagnosis of schizophrenia is consistent
• A psychiatric diagnosis is reliable if different clinicians reach the same diagnosis for the same individual ( inter - rater reliability) or if the same clinician reaches the same diagnosis for the same individual on two occasions ( test - retest reliability)
• Flavia Osorio reported excellent reliability for the diagnosis of 180 individuals using the DSM - 5
• Pairs of interviewers achieved inter - rater reliability of +0.97 and test retest of +0.92
• This shows that there is consistent diagnosis

Question 15

Describe low validity?

Answer 15

• A limitation is the validity
• This concerns if we are assessing what we intend to
• One way to assess the diagnosis is criterion validity
• Ellie Cheniaux found that two psychiatrists independently assessed the same 100 clients using the ICD-10 and DSM -5 and found 68 were diagnosed with schizophrenia under the ICD and 39 under DSM
  Counterpoint = Osorio reported that there was excellent agreement between clinicians when they used two measures to diagnose schizophrenia both derived from the DSM system. This means that there is good validity using one system

Question 16

Describe co - morbidity?

Answer 16

• Another limitation is that there is co - morbidity with other conditions
• If conditions occur at the same time, it calls into question whether it is one single condition
• Schizophrenia is commonly diagnosed with other conditions
• For example, Buckley found that 50% of individuals with schizophrenia also have depression, 47% have co - morbidity with substance abuse and 23% for OCDs

Question 17

Describe Gender bias?

Answer 17

• A further limitation is the existence of gender bias
• there is a 1.4:1 ratio with Fischer and Buchanan and men are more commonly diagnosed than women
• This is because women have closer relationships with more support and therefore are more functional then men
• This leads to the underdiagnose of women and poor treatment

Question 18

Describe culture bias?

Answer 18

• A further limitation is culture bias
• Hearing voice or delusions can be seen as having better communications with ancestors or having gifts
• Black brits are up to nine times as likely to recieve a diagnosis as white British people
• This means that culture bias affects diagnosis and over - interpretation or discrimination in African/Caribbean british people

Question 19

Describe symptom overlap?

Answer 19

• A final limitation is symptom overlap with other conditions
• For example, schizophrenia and BPD both have positive symptoms (delusions) or negative symptoms (avolition)
  -This means BPD and Schizophrenia may be variations of a single condition and therefore they are hard to distinguish