Schizophrenia Flashcards
What is Sz
best described as a condition where personality loses its unity
classification of mental disorder
The process of organising symptoms into categories based on which symptoms frequently cluster together
What did stafford-clark say about sz
Sz is a generic name for a group of disorders characterised by a progressive disintegration of emotional stability, judgement, contact with and appreciation of reality
What are the classification systems used for sz
-ICD-10
-DSM-5
How do the Diagnostic manuals differ
the manuals differ in their classification of Sz
-DSM-5 patients must have a positive symptom
-ICD-10 patients must have 2+ negative
Positive symptoms
Atypical symptoms experienced in addition to normal experiences
What are positive symptoms
-Hallucinations: unusual sensory experiences that can be related to the environment or have no relationship to what the senses are picking up
-Delusions: irrational beliefs that can take any form and make a person behave in ways that make sense to them but seem bizarre to others
Negative symptoms
Atypical experiences that represent the loss of a usual experience such as clear thinking
What are negative symptoms
-speech poverty: involves reduced frequency and quality of speech
-Avolition: loss of motivation to carry out tasks and results in lowered activity levels
What are different subtypes of sz
-paranoid sz
-hebephrenic sz- involves negative symptoms
-catatonic sz
Which manual recognises different subtypes of sz
ICD-10
What is the prevalence of sz
overall just less than 1% of the world suffer from sz
What age does sz occur
onset of sz mostly occurs between 15 and 45
Who has a higher prevalence rate
males, cities, working class
What is a strength of the diagnosis of Sz (reliability)
-test-retest occurs when a practitioner makes the same diagnosis on separate occasions from the same information
-inter-rater occurs when several practitioners make the same diagnosis of the same patient
-Making a diagnosis with most mental disorders can be a problem as often there are no physical symptoms therefore the practitioner has to diagnose with the patients report
-In 180 cases inter-rater reliability was +0.97 and test-retest reliability was +0.92
What is a limitation of diagnosis of sz (validity)
-concerns how accurate, meaningful and useful diagnosis is
-Validity of a psychotic diagnosis can be assessed by criterion validity
-If someone is diagnosed with sz they should show symptoms of sz
-Cheniaux had 2 psychiatrists independently assess the same 100 clients using ICD and DSM
68 were diagnosed using ICD and only 39 using DSM
-This suggests that sz is either under or over diagnosed and therefore has low criterion validity
What is a counterpoint to low validity of diagnosis of sz
Criterion validity is good for diagnosis as long as the same diagnostic manual is used
What is a limitation of diagnosis of sz (comorbidity)
-Its co-morbidity with other conditions
-if conditions occur together then this calls into question the validity of their diagnosis because they might actually be a single condition
-Sz is commonly diagnosed with other conditions
-a review found that about half of those diagnosed with sz also had a diagnosis of depression or substance abuse
-This is a problem because sz may not exists as a distinct condition
What is a limitation of diagnosis of sz (gender bias)
-after the 1980s more men appear to have been diagnosed with sz than women.
-men may be genetically more vulnerable than women or there is a gender bias in the diagnosis of sz
-Women seem to function better than men with sz which may mean they are being under diagnosed
-this means women may not therefore be receiving treatment and services that might benefit them
What is a limitation of diagnosis of sz (culture bias)
-African americans and english people of afro-caribbean origin are more likely to be diagnosed with sz
-not due to a genetic vulnerability but due to a cultural bias
-African cultures may be more accepting of symptoms such as hearing voices and therefore speak more freely about it to their psychiatrist, leading to more diagnosis
-incidence in the west indies and in great britain is about 1% but afro- caribbean living in GB are 7x more likely to be diagnosed sz.
-This suggest either the stress of living in GB causes sz or invalid diagnosis
What is a limitation of diagnosis of sz (symptom overlap )
there is a considerable overlap of the symptoms in sz and in other conditions.
-I.E bipolar disorder
-This is an issue as Sz is a cluster of different symptoms
what was Gottesman study on
Genetic basis of Sz
what did Gottesman find
Ran a controlled study and found that the risk of an individual developing sz increased in line with genetic similarities to a relative with the disorder
Dz twins and siblings share the same amount of DNA but have a different risk of developing Sz, why
-different shared environments due to age and other social factors