introduction to schizophrenia Flashcards
what is diagnosis and classification
interlinked
medical approach- in order to diagnose specific disorder we need to distinguish one disorder from other- identify clusters of symptoms that occur together and classify as one dirsorder
world health organisations international classification of disease (icd-10)
american psychiatric associations diagnostic and statistical manual (dsm-5)
what are positive symptoms
hallucinations- unusual sensory experiences, some related to events in environment whereas other bear no relationship to what senses are pciking up from environment, can be experienced in relation to any sense
delusions- irrational beliefs, involve being important historical political or religious figure and being persecuted, may believe that they are under external control, can make a person behave in ways that make sense to them but bizarre to others
what are negative symptoms
speech poverty- changes in patterns of speech, reduction in amount and quality of speech, accompanied by delay in persons verbal responses during conversation, disorganisation speech becomes incoherent or speaker changes topic mid sentence
avolition- finding it difficult to begin or keep up with goal directed activity, reduced motivation to carry out range of activities, adnreasen- identified three signs- poor hygiene and grooming, lack of persistence in work or education and lack of energy
what is good reliability (evaluation)
reliability
psychiatric diagnosis said to be reliable when different diagnosing clinicianms reach same diagnosis for same individual- inter rater reliability and when same clinician reaches same diagnosis for same individual on two occassions- test retest reliability
osorio report reliability for diagnosis of schizophrenia in 180 people using dsm-5
pairs of interviewers achieved inter rater reliability of .+97 and test retest reliability +.92
means reasonably sure diagnosis of schizophrenia consistently applied
what is low validity
validity
criterion validity
cheniaux- had two psychiatrists independently assess same 100 clients using icd-10 and dsm-iv criteria, found 68 diagnosied with schizophrenia under icd and 39 under dsm
suggests schizophrenia either over or underdiagnosed according to diagnostic system, criterion validity low
osorio study- agreement between clinicians when used two measures to diagnose both derived from dsm system
criterion validity is good provided it takes place within single diagnostic system
what is co-morbidity (evaluation)
comorbidity
conditions occur together- calls into question validity of diangosis and classification- might be a single condition
commonly diagnosed with other conditions
one review found half diagnosed with schizophrenia had diagnosis of depression or substance abuse
may not exist as distinct condition
problem for diagnosis as at least some people with diagnosed with schizophrenia may have unusual cases of conditions like depression
what is gender bias in diagnosis
gender bias
men diagnosed more commonly than women
women less vulnerable than men- genetic factors
women underdiagnosed bevause they have closer relationships and get support
leads to women often functioning better than men
women may not be receiving treatment and services that might benefit them
what is culture bias in diagnosis
culture bias
some symptoms (hearing voices etc) have different meanings in different cultures
haiti- voices communication from ancestors
british people of african caribbean origin are up to nine times as likely to receive diagnosis as white british people
people living in african caribbean countries are not
culture bias in diagnosis of clients by psychiatrists from different cultural background
appears to lead to overinterpretation of synptoms in black british people
british african caribbean discriminated against by culturally biased diagnostic system
what is system overlap
system overlap with other conditions
between symptoms of schizophrenia and symptoms of other conditions (bipolar)
classification suggests that schizophrenia and bipolar may not be different conditions but variations of single condition
diagnosis- hard to distinguish from bipolar
schizophrenia may not exist as distinct condition abd hard to diagnose
flawed both diagnosis and classification
