introduction to schizophrenia

Question 1

what is schizophrenia

Answer 1

disorder affects thought processes and ability to determine reality.

Question 2

who is schizophrenia most common in

Answer 2

most commonly diagnosed in men, most prevelant in western society and urban areas.

Question 2

what is prevelence of schizophrenia in general population
is schizophrenia a consistent illness

Answer 2

prevelence is around 1% of the world

no the degrees of severity differ between individuals, some people have persistent episodes, others only have one. However is a long term mental illness

Question 2

what are positive symptoms

Answer 2

additions to consciousness

Question 3

what are negative symptoms

Answer 3

decreases in functionality

Question 4

what are 3 examples of positive symptoms, brief summary for each

Answer 4

1. hallucinations - unusual sensory experiences can be visual or auditory
2. delusions - irrational beliefs, commonly involve being persecuted or delusions of grandeaur
3. disorganised speech (DSM ONLY) - person speaks fluently however the speech doesn’t make sense.

Question 5

give 3 examples of negative symptoms, and a brief summary for each

Answer 5

speech poverty - reduction in amount and quality of speech, can result in catatonia

avolition - lack of goal orientated behaviour, reduced motivation, lack of energy and hygeine

flattening effect - lack of emotion

Question 6

what are delusions of grandeaur

Answer 6

belief resulting in them thinking they are a highly important figure. eg religeous figure. (positive symptom)

Question 7

what does reliability mean in diagnosis

Answer 7

if you get same diagnosis for a person whether your using the DSM or ICD. practitioners should interpret the same symptoms in the same way leading to same diagnosis

Question 8

what are some similarities between the DSM and ICD

Answer 8

• both dropped subtypes of schizophrenia as they were inconsistent
• both suggest the no. of symptoms needed and duration of time these symptoms must be present for
• both now say 2 or more persistent symptoms are needed for diagnosis

Question 9

what are some differences between the ICD and DSM
(AO3)

Answer 9

DSM requires 6 months of continuual disturbance or 1 month of active symptoms

ICD requires only 1 month of symptoms persisting for

ICD recognises speech poverty as a negative symptom
DSM see’s speech disorganisation as positive.
Therefore speech disturbances are seen as slightly different.

ICD often yields a higher diagnosis than DSM.

one positive symptom needed for diagnosis in DSM
2 negative symptoms needed for diagnosis

Question 10

what is a valid diagnosis

Answer 10

one where the patient has been accurately diagnosed, the symptoms accurately match the criteria and the appropriate treatment has been given.

Question 11

why is a valid diagnosis so important (AO3)

Answer 11

so individuals can be given treatment options to specifically target their individual symptoms.

Need to accurately diagnose so the NHS can allocate funding appropriately so effective treatments are available.

there is still alot of stigma attached to a diagnosis of schizophrenia. There may be social implications if someone is misdiagnosed. In addition issues if someone who hasn’t got schizophrenia is given powerful antipsychotics.

Question 12

why might the diagnosis of schizophrenia not be valid (AO3)

Answer 12

The ICD and DSM are slightly different in requirements for a diagnosis of schizophrenia. If there are differences it is hard to know which one is correct as they must be measuring something different.

Culture may influence a valid diagnosis, for example. in indonesia it is the cultural norm to speak to dead relatives. A practioner without the cultural context may view this as delusions or hallucinations resulting in a wrongful diagnosis.
African-carribean descent are 9x more likely to recieve diagnosis

Schizophrenia has a high co-morbidity with depression (eg. avoliton) . If two conditions occur together, its questionable whether they are in fact one condition due to the similar symptom overlap. As a result a patient may recieve a diagnosis of depression with the ICD but recieve a diagnosis of SZ with the DSM. This makes diagnosis confusing and prone to error.

Question 13

what evidence is there that schizophrenia has high co-morbidity with other conditions
(AO3)

Answer 13

Buckley et al found around 50% of patients with SZ also had depression, 47% substance abuse. PTSD also occured in 29% of the cases.

Question 14

outline Cheniaux et al’s reasearch (ao3)

Answer 14

had 2 practioners independantly diagnosis 100 patients using both DSM and ICD criteria.

Question 15

what were the findings of Cheniaux et al’s research . What does it suggest (AO3)

Answer 15

68 diagnosed with SZ in ICD
39 diagnosed with SZ with the DSM.
suggests patients may be over or under diagnosed using different systems
Easier to diagnose with ICD, however this research with ICD-10 not ICD-11.

Question 16

why does reliability matter in diagnosis (AO3)

Answer 16

should have same diagnosis if using ICD or DSM. If this is different then either - they do not measure the same thing,

or they are being used by practioners in different way.

This means that u may recieve a diagnose with one system and not the other.

Question 17

However the ICD and DSM are improving in reliability over time, explain

Answer 17

The criteria for diagnosis changes with every updated version of OCD and DSM. The reliability of both as a tool for diagnosing has improved greatly over time. Both the ICD and DSM have become more similar and more reliable between practioners. For example the DSM has very good inter-rater reliability of +0.97 (Osorio).
This is much improved comapared to prior additions and suggests diagnostic criteria is more accurate and the DSM can be used more consistently.