Schizophrenia Flashcards
DSM
= US & Australia - only mental disorders latest version = X subtypes
must have 1 positive & 1 other
ICD
WHO - Eur = all med disorders
only need at least 2 negative symptoms
Positive Symptoms
additional experiences beyond ordinary existence = hallucinations & delusions
Hallucinations
aud/ visual hear voices = crit & unfriendly some also see, smell, taste & feel things not their = sensory expers that = not real / distorted
Delusions
unshakeable belief in something unlikely / bizarre
paranoid d’s - believe = misled / manip / hurt
d’s of grandeur believe have imaginary power / auth e.g., spy / on mission from god
Negative Symptoms
loss of normal function = speech poverty & abolition
Speech Poverty
also = alogia = dec in verbal output / express may = monosyllabic yes / no to ?s or delay in words
Avolition
lack of motivation for plans / negl household chores X hygiene - lack of persist in edu. / work
Reliability: Cheniaux et al (2009)
2 psychs independently assessed 100 ppl using DSM & ICD interrater reliability = poor ICD = 44 ppl DSM = 26 ppl other = 24 + 13
Reliability: Rosenhan
sent friends/ students to be diagnosed - heard voice hollow, empty, thud did match Sz but sent to mental hospital - acted normal & staff didn’t notice
Validity
Extent to which diagnosis = real & distinct & measures what says - criterion val - do dif systems arrive at same diag for same patient - Cheniaux ICD m likely than DSM so either over / under diagnose
Comorbidity
when 2 conditions occur together if 2 a lot = ? val might = 1 condition = prob for Sz 1/2 also diag w/ dep - may = bad at seeing difs if severe dep looks like Sz might be better as 1 = weakness
Comorbidity: Buckley (2009)
around 1/2 also have depression, 47% substance abuse, 29% PTSD & 23% OCD
Symptom Overlap
consid overlap between Sz symps & other conditions e.g., Bipolar also delusions & abolition ?s val of D&C under ICD someone might = Sz but = bipolar under DSM - could = same
Gender Bias: Longnecker (2010)
reviewed studies of prevalence of Sz conc since 1980s men = diag m often than women b4 = no dif men may have gen val
Gender Bias: Cotton (2009)
women fund better m likely to work & have pos fam rela inc func may explain why some aren’t diag where men might be - interpersonal fun might bias psychs so symps = masked
Culture Bias: DSM
created by US for US behav in 1 cup might not = viewed as symps but DSM says is - voices - leads to incorrect treatment & diag - drug side effects
Culture Bias: Escobar (2012)
white psychs over interp symps & distrust patient honesty - Afro-Caribbeans m likely to = diag but not in Africa & West Indies so not gen vol = cup bias - pos symps voices = commun w/ ancestors
Genetics
specific genes = assoc w/ risk of inheritance = polygenic num of studies have identified it as aetiologically heterogenous dif combo can cause
Gottesman
greater gen sim inc risk MZ = 48% DZ 17% comp 9% siblings 6% 1/2 siblings suggests other factors
Ripke et al (2014)
carried out large scale study combo data from genome wide studies not particular genes = 108 sep genetic variations assoc w/ inc risk
Tienari (2000)
looked at 164 adopted children who’s mothers had Sz concor = 67% comp to 2% in adopted children w/ Sz parents
Deterministic
ignores environment nature Vs nurture why is concor not 100% in MZ
Reductionist
Bio Explanation
ignores impact of environ & neurochem