Introduction to schizophrenia

Question 1

Description and summary of schizophrenia

Answer 1

• serious mental disorder
• around 1% of the world’s population suffer from it
• more commonly diagnosed in men
• more commonly diagnosed in people in cities as opposed to the countryside
• more commonly diagnosed in working-class people rather than the middle-class
• many who suffer from it end up homeless or hospitalised due to the severe interference it had on everyday life

Question 2

Classification - DSM-V and ICD-10

Answer 2

• The ICD-10 is used in the UK, set up by the WHO
• the DSM-V is used in the US, set up by the APA
• classification of schizophrenia in the 2 differs slightly
• DSM-V requires 1 positive symptom for a diagnosis
• ICD-10 requires 2 negative symptoms for a diagnosis
• ICD-10 refers to a number of subtypes as well:
• paranoid schizophrenia, hebephrenic schizophrenia, catatonic schizophrenia

Question 3

Subtypes of schizophrenia

Answer 3

paranoid schizophrenia

• powerful delusions and hallucinations
• not many other symptoms

hebephrenic schizophrenia
- mostly negative symptoms e.g. avolition, speech poverty

catatonic schizophrenia
- sufferer is left immobile or overactive

Question 4

Positive symptoms

Answer 4

Hallucinations

• sensory experiences
• sometimes related to environmental events, and other times not
• could be voices, being critical
• can be experienced in relation to any of the senses

Delusions

• irrational beliefs that can take a range of forms
• known as paranoia
• a common one is a sufferer thinking that they are Jesus
• sufferers may believe they are under the control of an external force
• typically delusions do. to lead to aggression but some can

Question 5

Negative symptoms

Answer 5

Avolition

• a sufferer will find it difficult to engage in goal-directed activity
• known as apathy
• sharp reduction in motivation to carry out activities
• Andreason (1982) suggested 3 signs of avolition:
• poor hygiene and grooming, lack of persistence at school or work, lack of energy

Speech poverty

• changes in speech patterns
• reduction in quality or amount of speech
• delay in verbal responses when in conversation
• speech disorganisation

Question 6

Course of the disorder

Answer 6

• it was previously believed that recovery was impossible
• however, recent studies show that 2/3 people make a substantial recovery
• depression and schizophrenia often go hand in hand
• between 10-15% of people with schizophrenia commit suicide

Question 7

(-) EVAL - reliability

Answer 7

• an important measure of consistency is inter-rater reliability
• this is the extent to which different assessors agree on their findings
• as for diagnoses, this is the extent to which two or more mental health professionals decided on the same diagnosis for the same patients
• Cheniaux et al. (2009) got 2 psychiatrists to independently diagnose 100 patents using the DSM-V then using the ICD-10
• one of the psychiatrists diagnosed 26 with schizophrenia using the DSM and 44 with the ICD
• the other one diagnosed 13 with the DSM and 24 with the ICD
• this shows poor inter-rater reliability
• this is a weakness of the diagnosis and classification of schizophrenia

Question 8

(-) EVAL - validity

Answer 8

• for something to have validity, we want to be measuring what we intend to measure
• criterion validity asks if different assessment systems come to the same diagnosis for the same patient, and is a standard way of assessing validity
• Cheniaux et al. (2009) shows that there is a big different between how many are diagnosed when using the ICD or DSM
• the ICD is much more likely to diagnose schizophrenia
• this could mean that DSM under-diagnoses or the ICD over-diagnoses

Question 9

(-) EVAL - co-morbity

Answer 9

• morbidity refers to a medical condition or how common it is
• co-morbidity is therefore when two or more conditions occur at the same time
• it is concern for validity of diagnosis and classification if conditions occur at the same time a lot
• Buckley et al. (2009) concluded that around 50% of patients diagnosed with schizophrenia have also been diagnosed with depression, 46% with substance abuse, 29% with PTSD and 23% with OCD
• the fact that half of schizophrenia patients are also diagnosed with depression means that we are bad at telling the difference between the two conditions
• they may also be a single condition due to very similar symptoms

Question 10

(-) EVAL - symptom overlap

Answer 10

• there is quite a lot of overlap of symptoms between schizophrenia and other disorders such as bipolar
• patients may be diagnosed with schizophrenia under the ICD but diagnosed with bipolar under the DSM