Issues In Diagnosing Schiz

Question 1

Reliability

Answer 1

Can psychiatrists agree on the same diagnosis when independently assessing patients

Question 2

Validity

Answer 2

If psychiatrists can’t agree who has schizophrenia or the outcome than is it an illness that exists at all?

Question 3

3 types of schiz

Answer 3

Undifferentiated schizophrenia
Paranoid schiz

Question 4

Why do types and subtypes make schiz difficult to diagnose

Answer 4

Patients rarely fall neatly into 2 category as there is clear overlap of symptoms

Question 5

Beck 1961

Answer 5

Looked at inter - rater reliability between 2 psychiatrists considering cases of 154 patients
Does this person have schiz?
What type diagnosed?
The reliability agreement was only 54%

Question 6

Cultural differences study

Answer 6

Copeland eat all 1971

Question 7

Copeland et al 1971

Answer 7

Description of a patient given to 134 US psychiatrists
69% of US psychiatrists diagnosed schiz
2% of UK psychiatrists diagnosed schiz

Question 8

Validity of schizophrenia

Answer 8

Is schizophrenia an illness at all

Question 9

Schizophrenia is not a V.A.L.I.D concept
What does this acronym stand for

Answer 9

V - variation in outcomes
A - absence of explanation
L - lack of treatment effectivness
I - individuals diagnosed never fare better
D - disorder overlap

Question 10

Morbidity v co morbidity

Answer 10

Morbidity refers to a medical condition or how common it is
Co morbidity is the phenomenon that2 or more conditions occurs together

Question 11

Why is co morbidity an issue

Answer 11

If con occurs together it calls into question the validity of diagnosis and classification as they might be a single condition.

Question 12

3 disorder schiz is similar to

Answer 12

Depression
OCD

Question 13

BUCKELY 2009 - overlap of illnesses

Answer 13

Half of schizophrenic patients also have a diagnosis of depression
(50%) or substance abuse (47%)
PTSD in 27% of cases
OCD in 23% of cases
Challenges both the classification and diagnosis of schizophrenia

Question 14

Argument of co morbidity

Answer 14

If Half of the schiz patients are also diagnosed with depression maybe we are bad at differentiating between the 2 conditions
In severe depression it might look like severe schiz and vice versa but they are actually a single condition
For example a schiz diagnosis after pregnancy may be post natal depression

Question 15

Kettler 2005

Answer 15

Reported that the positive symptoms of schiz resemble episodes of mania in bipolar disorder whilst the negative symptoms resemble clinical depression
He believes that as many as 50% of cases may be misdiagnosed

Question 16

Who did a study of symptom overlap

Answer 16

Kettler 2005

Question 17

Symptoms of schiz resemeble …

Answer 17

Episodes of temporal lobe epilepsy’s bi polar depression and drug induced psychosis

Question 18

Longnecker 2010 gender bias in diagnosis

Answer 18

He argued that men are more likely to be diagnosed then women
Men may be more genetically vulnerable to dev schizophrenia
More plausible explanation is that there is gender bias

Question 19

Who did study on gender bias

Answer 19

Longnecker 2010

Question 20

Gender bias - females

Answer 20

Female patients tend to be better at functioning in society then men
May explain why women are diagnosed later in life but men are diagnosed earlier on
There are interpersonal functioning may bias practitioners to understand diagnose schizophrenia
Either bc symptoms are masked together y good interpersonal functioning
Or bc the quality of functioning makes then case to mild to warrant a diagnosis

Question 21

Cultural bias in diagnosis

Answer 21

African Americans and English ppl of Afro - Caribbean origin are several times more likely then white ppl to be diagnosed with schiz
If Africa a dn West Indies Rates are not that high it isn’t due to genetic vulnerability
Instead due to cultural bias

Question 22

Cultural bias - African

Answer 22

It could be that hearing g voices is more acceptable in African cultures because of cultural beliefs in communication w ansecstors
Some psychologists argue that white psychologists may over interpret symptoms and distrust honesty of black ppl during diagnosis