Introduction To Schizophrenia

Question 1

What is schizophrenia?

Answer 1

A serious mental disorder experienced by about 1% of the world population.

Question 2

Who is schizophrenia more commonly diagnosed with?

Answer 2

Men
City-dwellers
Lower socio-economic groups

Question 3

What can symptoms of schizophrenia interfere with?

Answer 3

Everyday tasks and so many people with schizophrenia often end up homeless or hospitalised.

Question 4

According to the medical approach in order to diagnose a specific disorder what do we need to distinguish?

Answer 4

We need to distinguish one disorder from another by identifying clusters of symptoms that occur together and classifying this as one disorder.

Question 5

How is diagnosis possible?

Answer 5

By identifying symptoms and deciding what disorder a person has.

Question 6

What are the two major systems for classification of mental disorders?

Answer 6

1. ICD-11
2. DSM-5

Question 7

What is one example of how the ICD-11 and DSM-5 differ slightly in classification of schizophrenia?

Answer 7

DSM-5 system says that one of the positive symptoms must be present for diagnosis whereas two or more negative symptoms are sufficient under ICD.

Question 8

Why have DSM-5 and ICD-11 both dropped subtypes?

Answer 8

They tended to be inconsistent.

Question 9

What is meant by positive symptoms of schizophrenia?

Answer 9

Additional experiences beyond those of ordinary existence

Question 10

What are positive symptoms of schizophrenia?

Answer 10

Hallucinations and delusions

Question 11

What are hallucinations?

Answer 11

Unusual sensory experiences

Question 12

What are some hallucinations related to?

Answer 12

Events in the environment whereas others have no relationship to what their senses are picking up from the environment e.g. voices heard often criticising the person hearing them.

Question 13

How can hallucinations be experienced?

Answer 13

In relation to any sense e.g. the person may see distorted facial expressions or occasionally people or animals that aren’t there.

Question 14

What are delusions also known as?

Answer 14

Paranoia

Question 15

What are delusions?

Answer 15

Irrational beliefs which can take a range of forms

Question 16

What are some common delusions?

Answer 16

Believing you are an important historical, political or religious figure e.g. Jesus

Question 17

What do delusions commonly involve?

Answer 17

Believing you are being persecuted perhaps by the government or aliens having superpowers

Question 18

What does another class of delusions concern?

Answer 18

The body e.g. a person may believe they are under external control.

Question 19

How can delusions make someone behave?

Answer 19

In a way that makes sense to them but seems bizarre to others.

Question 20

What is meant by negative symptoms of schizophrenia?

Answer 20

The loss of usual abilities and experiences

Question 21

What are two examples of negative symptoms of schizophrenia?

Answer 21

Speech poverty
Avolition

Question 22

What is schizophrenia categorised by?

Answer 22

Changes in patterns of speech

Question 23

Why is speech poverty seen as a negative symptom?

Answer 23

Emphasis is on reduction in the amount and quality of speech which is sometimes accompanied by delay in verbal responses during conversation

Question 24

What is more emphasis placed on nowadays?

Answer 24

Speech disorganisation which speech becomes incoherent or the speaker changes topic mid-sentence.
This is classified as a positive symptom in the DSM-5 whilst speech poverty is still classed as a negative symptom.

Question 25

What is avolition sometimes called?

Answer 25

Apathy

Question 26

How is avolition described?

Answer 26

Finding it difficult to begin or keep up with goal-orientated activity i.e. actions performed in order to achieve a result.

Question 27

What do people with schizophrenia often have sharply reduced?

Answer 27

Motivation to carry out a range of activities.

Question 28

What did Andreasen identify?

Answer 28

3 signs of avolition:
1. Poor hygiene and grooming
2. Lack of persistence in work or education
3. Lack of energy

Question 29

One strength of the diagnosis of schizophrenia is reliability

Answer 29

Before the DSM-5 reliability for schizophrenia diagnosis was low but this has improved.
Osório et al report excellent reliability for the diagnosis of schizophrenia in 180 individuals using the DSM-5.
Pairs of interviewers achieved inter-rater reliability of +97 and test-retest reliability of +92.
This means we can be reasonably sure that the diagnosis of schizophrenia is constantly applied.

Question 30

One imitation of diagnosis of schizophrenia is validity.

Answer 30

Cheniaux had two psychiatrists independently assess the same 100 clients using the ICD-10 system and DSM-IV criteria and found that 68 were diagnosed with schizophrenia under the ICD system and 39 under the DSM-IV.
This suggests schizophrenia is either over or under-diagnosing according to the diagnostic system.

Question 31

Another limitation of schizophrenia diagnosis is co-morbidity with other conditions

Answer 31

Schizophrenia is commonly diagnosed with other conditions.
A review by Buckley et al found about half of those diagnosed with schizophrenia also had a diagnosis of depression or substance abuse.
This means that schizophrenia may not exist as a distinct condition and is a problem for diagnosis as at least some people diagnosed with schizophrenia may have unusual cases of conditions like depression.

Question 32

A further limitation of schizophrenia diagnosis is the existence of gender bias.

Answer 32

Since the 1980s men have been diagnosed with schizophrenia more commonly than women.
It is likely that this is because women are undiagnosed due to them often having closer relationships and getting support which leads to women with schizophrenia functioning better than men with schizophrenia.
This under diagnosis is a gender bias and means women may not be receiving treatment and services that benefit them.