Schizophrena

Question 1

A01
What is schizophrenia

Answer 1

• a severe mental illness where contact with reality and insight is impaired
• 1% of population have it
• onset is typically in late adolescent and early childhood
• uses the DSM-5 or ICD-11

Question 2

A01
What are the two classification systems for metal disorders

Answer 2

DSM-5 and ICD-11

Question 3

A01
How does the DSM-5 classify schizophrenia

Answer 3

• requires two or more of the following symptoms to be apparent for a six month period, at least one must be a positive symptom (hallucinations, delusions, disorganised speech) and negative symptoms

Question 4

A01
What are positive symptoms

Answer 4

• experiences that are added in addition to normal experiences

Question 5

A01
What are hallucinations

Answer 5

• hearing voices, seeing things or even smelling things all of which don’t exist

Question 6

A01
What are delusions

Answer 6

• irrational beliefs about themselves or the world

Question 7

A01
What is disorganised speech

Answer 7

• result of abnormal thought processes and see’s the sufferer struggle to organise and filter their thoughts which show up in their speech

Question 8

A01
What are negative symptoms, give examples

Answer 8

• loss of normal experiences and abilities e.g:
  1) avolition- inability to make decisions, lack of energy, enthusiasm and loss of interest in personal hygiene, sociability and affection
  2) anhedonia: loss of interest or pleasure in activities or the lack of reactivity to normally pleasurable stimuli
  3) speech poverty: lessened speech fluency and productivity which is believed to reflect slowed or blocked thoughts

Question 9

A01
What are the differences between DSM-5 and ICD-10

Answer 9

• DSM: all people diagnosed as suffering from schizophrenia must have the symptoms present for at least 6 months
• ICD requires the signs to be apparent for one month
• ICD only need to show at least 2 negative symptoms

Question 10

A01
How does the ICD compare to the DSM-5

Answer 10

• firstly with the symptoms only needing to be present for one month as opposed to six with the DSM, suffers do not have so much time in which they may be at risk to themselves and others
• they also only have to live without help for 1 month before receiving diagnosis and therefore appropriate treatment

Question 11

A01
What is meant by reliability in diagnosis

Answer 11

• measures consistency, how consistent the results are using the same measuring tools

Question 12

A01
What is meant by validity in diagnosis

Answer 12

• measure what you intend to measure (i.e how accurate the diagnosis for schizophrenia) this means each time the classification system is used to diagnose a behaviour/set of symptoms is SHOULD produce the same outcome
• e.g anhedonia is also present in depression, symptoms overlap

Question 13

A01
What are the weaknesses of the classification for schizophrenia diagnosis

Answer 13

1) inter rated reliability- Beck et al- agreement on diagnosis for 153 patients was only 54%, often due to vague criteria for diagnosis and inconsistencies in techniques to gather data
- many ppl may have been diagnosed incorrectly

2) reliability- Cheniaux et al had 2 psychiatrists independently diagnose 100 patients using both DSM and ICD criteria
- inter rater reliability was poor, 1st psychiatrist diagnosed 26 with schitz according to DSM and 44 according to ICD
- 2nd psychiatrist diagnosis end 13 according to DSM and 24 according to ICD
- this is a weakness of diagnosis, reliability is poor and down to human judgement

Question 14

A01
What is meant by co-morbidity

Answer 14

• presence of 2 different disorders at the same time. It may be that the disorders are actually one disorder, and perhaps should be seen as one condition

Question 15

A01
What is meant by symptom overlap

Answer 15

• when two or more disorders share the some of the symptoms needed for classification. Schizophrenia and bipolar disorder share many symptoms (delusions and avolition) meaning that the same patient could receive two different diagnosis
• therefore problem of validity, are we really measuring what we intended to measure because of overlapping of symptoms
• are we actually measuring schitz or another condition

Question 16

A01
What is research support for co-morbidity

Answer 16

1) Research support- Buckley found up to 50% of patients diagnosed with schizophrenia also fit into the diagnosis for depression and 29% for PTSD and 23% for OCD
- poses a challenge for the validity of schizophrenia as a disorder itself because if we are unable to distinguish it from, other disorders, the reliability of diagnosis by clinicians will also be inconsistent

Question 17

A01
Explain gender bias in schizophrenia diagnosis

Answer 17

• suggested that women’s experience of schizophrenia is taken less seriously and undiagnosed compared to men
• Cotton suggests this is due to women’s better social coping strategies leading to being less likely to seek treatment

Question 18

A01
Explain culture bias in schizophrenia

Answer 18

• people with Afro-Caribbean heritage in the uk and African Americans more likely to be diagnosed with SZ compared to the 1% of the general population
• westerns definitions of mental illness are applied to non western cultures, a specific example is how hearing voices would be seen as auditory hallucination in the UK but as a religious experience in the West Indies

Question 19

A01
What is the biological explanation for schizophrenia

Answer 19

• twin studies are used
• Gottesmans reviewed cases of sz in families and found evidenced that sz run in the family
• MZ twins- 48% whereas DZ twins- 17% this suggests that sz has a genetic component
• polygenic (many genes involved)