Diagnosis & Classification

Question 1

What is schizophrenia?

Answer 1

a severe mental illness where contact with reality and insight are impaired

Question 2

DSM5

Answer 2

one positive symptom must be present for at least 6 months

Question 3

ICD10

Answer 3

2+ negative symptoms

Question 4

What are positive symptoms?

Answer 4

atypical symptoms experienced in addition to normal experiences - hallucinations and delusions

Question 5

What are hallucinations?

Answer 5

Sensory experiences of stimuli that have no basis in reality, or are distorted perceptions of things that are e.g. auditory: hearing things that are not really there

Question 6

What are delusions?

Answer 6

beliefs that have no basis in reality e.g. grandeur (importance e.g. God), paranoia, persecution, control (external)

Question 7

What are negative symptoms?

Answer 7

atypical experiences that represent the loss of usual experience e.g. thinking normal levels of motivation - avolition, speech poverty

Question 8

What is avolition?

Answer 8

loss of motivation to carry out tasks e.g. work, and results in lowered activity levels

Question 9

What is speech poverty?

Answer 9

reduced frequency/quality of speech

Question 10

What is comorbidity?

Answer 10

the occurrence of two illnesses/conditions together - calls us to question the validity of classifying the two separately

Question 11

AO3 of comorbidity

Answer 11

Buckley: 50% depression and scz
47% scz and substance abuse
- one single condition?
- separate conditions with symptoms of both?

Question 12

What is symptom overlap?

Answer 12

2+ conditions share symptoms - questions validity of classifying the two separately

Question 13

AO3 symptom overlap

Answer 13

Ketter: misdiagnosis due to symptom overlap can lead to years of delay in recovery which results in further degeneration and increased suicide rates

Question 14

What is the validity referring to?

Answer 14

whether the classification system measures what it aims to

Question 15

What is the predictive validity?

Answer 15

how similar individuals diagnosed are

Question 16

What is aetiological validity?

Answer 16

how similar patients causes are

Question 17

What is raw predictive validity?

Answer 17

how useful diagnostic tools are for predicting the right treatment

Question 18

What is the construct validity?

Answer 18

shared common features of patients

Question 19

AO3 validity for schizophrenia

Answer 19

• no single symptom (doubt construct validity) and diagnosis is subjective
• same treatment may have different outcomes (Birchwood and Jackson: 20% recover, 10% suicide)
• more likely diagnosed with ICD than DSM

Question 20

What is the reliability referring to?

Answer 20

how far the classification system produces same diagnosis for a particular set of symptoms - different clinicians should meet the same diagnosis

Question 21

AO3 for reliability

Answer 21

Beck: 4 psychiatrists agree how to use DSM for 153 patients - only 54% agreement due to: different information given by patients, different judgement, mostly inadequacies in classification system
Soderberg: 81% concordance rate using a later DSM

Question 22

Gender bias in diagnosis

Answer 22

Longenecker: more men diagnosed since 80s, thought because women tend to function better, so are less likely to be diagnosed - problem as the same symptoms give different diagnosis

Question 23

Culture bias in diagnosis

Answer 23

rates of diagnosis vary among ethnic groups, African Americans more likely to be diagnosed than white Americans with similar symptoms. Admit hallucinations more easily for example. Stress possibly due to racism, higher chance of poverty