Paper 3 - Schizophrenia Flashcards
What does schizophrenia translate to?
Introduction to schizophrenia
- Means SPLIT MIND
- Nothing to do with a split personality
- SPLIT from REALITY
Introduction to schizophrenia
Perecentages of likelihood of developing schizophrenia
Introduction to schizophrenia
- Identical twins - 48%
- Fraternal twins - 17%
- Parents - 6%
- Grandchildren - 5%
Introduction to schizophrenia
Define Positive Symptoms
Introduction to schizophrenia
Additional experiences beyond those of ordianry existence
Introduction to schizophrenia
Define Negative Symptoms
Introduction to schizophrenia
The loss of usual abilities and experiences
Introduction to schizophrenia
Examples of Positive Symptoms
Introduction to schizophrenia
- Hallucinations
- Delusions
Introduction to schizophrenia
Examples of Negative Symptoms
Introduction to schizophrenia
- Avolition - Lack of motivation to do everyday tasks
- Speech Poverty - Reduced frequency and quality of speech
Introduction to schizophrenia
What is used to diagnose someone with schizophrenia?
Introduction to schizophrenia
- ICD 11 - International Classification of Disease (Negative symptoms)
- DSM 5 - Diagnostic Statistical Manual (Negative + Positive symptoms)
- ICD recognises subtypes e.g. Paranoid, Hebephrenic, Catatonic
- NHS uses ICD 11
Introduction to schizophrenia
Hebephrenic Schizophrenia
Introduction to schizophrenia
- Disorganised behviour without purpose
- Disorganised thoughts - others may find difficult to understand you
- Usually develops between 15-25
Introduction to schizophrenia
Paranoid Schizophrenia
Introduction to schizophrenia
- Most common
- Prominent hallucinations/delusions
- May develop at later age than other types
- Speech + emotions may be unaffected
Introduction to schizophrenia
Catatonic Schizophrenia
Introduction to schizophrenia
- More rare
- Unsusual movements, often switch between over-actvitity and stillness
- May not talk at all
Introduction to schizophrenia
Define external reliability
Diagnosing Schizophrenia
Consistency of results from a test when done again
Diagnosing Schizophrenia
Define Inter-Rater Reliability
Diagnosing Schizophrenia
Consistency of ratings by different people
Diagnosing Schizophrenia
External Reliability - Schizophrenia
Diagnosing Schizophrenia
Consistency of diagnosis of the same patient (over time) given no chnages in symptoms
Diagnosing Schizophrenia
Inter-Rater Reliability - Schizophrenia
Diagnosing Schizophrenia
Consistency of diagnosisof the same patient given by different psychiatrists
Diagnosing Schizophrenia
Problems with reliability of diagnosis - Cheniaux et al (2009)
Diagnosing Schizophrenia
- Method - 2 psychiatrists independently diagnosed 100 patients using DSM 4 and ICD 10 criteria
- Results - Schizophrenics diagnosed by psychiatrist 1 = DSM - 13 and ICD - 24
Different = Poor external validity - Psychiatrist 2 = DSM - 26 and ICD - 44
- DSM - poor inter-rater reliability
Diagnosing Schizophrenia
Jakobsen et al (2005)
Diagnosing Schizophrenia
- 100 Danish patients with history os psychosis - assessed using both manuals + found a near perfect agreement (kappa = 0.87)
- High external rleiability of clinical diagnosis of schizophrenia
Diagnosing Schizophrenia
Validity of schizophrenia
Diagnosing Schizophrenia
Extent to which schizophrenia is actuallly a syndrome with specific characteristics signs and symptoms.
Diagnosing Schizophrenia
Validity of diagnosis
Diagnosing Schizophrenia
Are we correctly diagnosing people who have the disorder?
Diagnosing Schizophrenia
How well a diagnosis applies to different:
Diagnosing Schizophrenia
- People (Cultural/Population)
- Places (Ecological)
- Times (Historic/Temporal)
Diagnosing Schizophrenia
PEEL Paragraph - Problems with external reliability of diagnosis
Diagnosing Schizophrenia
P - Overlapping symptoms with other disorders
E - Contrasting symptoms with depression. E.g. Flat affect and lack of hygiene are also symptoms of depression aswell as schizophrenia
E - Sometimes patients can be diagnosed as schizophrenic using one classfication system
L - This calls into question whether SZ is being reliability diagnoses as it presents similarly to other disorders
Diagnosing Schizophrenia
PEEL Paragraph - Problems with internal vailidity of diagnosis
Diagnosing Schizophrenia
P - Disorder is often comorbid
E - Comorbidity means more than one illness /disease occuring in one person at the same time
E - Buckley et al 2009 - studied patients with diagnosed SZ. Looked at comorbidity rates with other disorders:
50% - Depression
47% - Substance abuse
29% - PTSD
23% - OCD
L - Reduces validity because psychiatrists cannot tell which symptoms are attributed to which disorder
Diagnosing Schizophrenia
Candidate gene
Biological Causes
Gene whose chromosomal locatiom is associated with a particular disease/other phenotype
Biological Causes
Dopamine
Biological Causes
Neurotransmitter which plays a role in how we feel pressure
Biological Causes
Aetiologically Heterogenous
Biological Causes
Number of different combinations of genes can lead to illness
Biological Causes
