LS1 - Issued With Classification And Diagnosis Flashcards
Schizophrenia
A serious mental psychotic disorder characterised by a profound disruption of cognition and emotion.
Where Is Schizophrenia Seen More?
Men more than women
Cities rather than the countryside
Working class than middle class people
Psychotic Disorder
Serious mental issues causing abnormal thinking and perceptions, meaning people lose touch with reality and even themselves.
Diagnosing Schizophrenia
The DSM 5 - Used in America
The ICD 11- Used in Europe and other parts of the world
DSM 5 Requirements
You need to show at least 2 or more positive symptoms (or one positive one negative) for a period of a month to be diagnosed with SZ
ICD 11 Requirements
You need to show one positive and one negative (or two negative) symptoms for at least one month to be diagnosed with SZ.
Types Of Schizophrenia
Type 1
Type 2
Type 1 Schizophrenia
Characterised more by positive symptoms, and usually has better prospects for recovery.
Type 2 Schizophrenia
Characterised more by negative symptoms, and usually poorer prospects for recovery.
Positive Symptoms
Hallucinations
Auditory Hallucinations
Visual Hallucinations
Olfactory Hallucinations
Tactile Hallucinations
Delusions
Disorganised Speech
Hallucinations
Sensory experiences of stimuli that have no basis in reality or distorted perceptions of things that are there
Auditory Hallucinations
Hearing voices making comments or talking to them in their head.
Visual Hallucinations
Seeing things which are not real e.g. distorted facial expressions on people
Olfactory Hallucinations
Smelling things that aren’t real e.g. smelling disinfectant which isn’t there
Tactile Hallucinations
Touching things that aren’t there e.g. bugs crawling on your skin.
Delusions
Irrational, bizarre beliefs that seem real but aren’t e.g. being an important political figure.
Negative Symptoms
Speech Poverty (Alogia)
Avolition
Speech Poverty (Alogia)
The reaction in the quantity/quality of speech, sometimes accompanied by a delay in the sufferer’s verbal responses to a conversation. This can also mean less complex speech.
Avolition
Finding it difficult to begin or keep up with actions performed in order to achieve a result. This suggests sharply reduced motivation to carry out a range of activities e.g. poor hygiene, grooming, a lack of persistence in work and a lack of energy.
Issues Associated With The Classification And Diagnosis of SZ
Reliability
Validity
Co-Morbidity
Symptom Overlap
Gender Bias
Cultural Bias
Reliability
Consistency of a measuring instrument (ICD or DSM) e.g. inter-rater reliability. Researchers found a low inter-rater reliability for DSM and ICD, meaning they’re not very reliable, but a lower reliability when using the DSM.
Validity
Assessed using criterion validity, when different assessment systems arrive at the same diagnosis for the patient, and we see the ICD diagnose more than the DSM meaning there’s poor validity.
Rosenhan Validity Study
8 pseudo patients were admitted into psychiatric hospital by using auditory hallucinations, once there they all behaved normally, and only one was discharged with remission.
Co-Morbidity
When 2 or more mental disorders occur together, meaning we can question the validity of diagnosis for SZ, as we can’t distinguish the difference between disorders very well.
Buckley Et Al (Co-Morbidity)
Concluded that around half SZ patients have been diagnosed with depression or substance abuse. OCD and PTSD were also common when diagnosing.
Symptom Overlap
There is considerable overlap between symptoms of SZ and other conditions. This questions the validity of the classification systems under ICD someone might have SZ but under DSM they have another disorder.
Ellison And Ross Symptom Overlap
They pointed out people with DID actually have more SZ symptoms than people with SZ, meaning that they would also have one other diagnosis.
DID
Dissociative Identity Disorder
Gender Bias In Diagnosis
Longenecker et al reviewed studies and found men are more likely to be diagnose than women, suggesting men are genetically vulnerable to developing SZ or there’s a gender bias towards men.
Culture Bias In Diagnosis
African American/English people of Afro Caribbean origin are 9 times more likely to be diagnosed with SZ, because positive symptoms like auditory hallucinations may be acceptable in African concepts/beliefs.
Advantages Of Classification And Diagnosis
Communication Shorthand
Treatment
Biological Abnormalities
Communication Shorthand (+)
A patient with a mental disorder often has numerous symptoms. It is simpler to incorporate these symptoms into a single diagnosis making communication between health professionals much easier.
Treatment (+)
Treatments are often specific to certain disorders e.g. symptoms of SZ respond well to certain anti-psychotic drugs but not anti-anxiety drugs. Meaning a reliable diagnosis can point to a better therapy.
