schizophrenia Flashcards
schizophrenia AO1
what is schizophrenia characterised by?
what required by the DSM-5?
What’s required by the ICD-10?
-Schizophrenia is characterised by thought, languages and behavioural disturbances.
-most common mental health disorder as found in all cultures and parts of population.
-1% of people in all populations develop schizophrenia.
DSM-5
diagnosis requires at least two of the four key symptoms listed below (delusions, hallucinations or disorganised speech/ thought.
the person must have at least one month of active symptoms and six months of disturbance to everyday functioning.
ICD-10
less focus on dysfunction and six months of disturbance is not necessary. six subtypes.
what is meant by positive symptoms?
give three examples.
addition of new behaviour that wasn’t experiences before schizophrenia
hallucinations
delusions
paranoid thinking
what is meant by negative symptoms?
give three examples.
where normal functioning is not present, such as loss of emotion, speech or motivation
thought insertion
-person believes their thoughts do not belong to them and have been implanted by an external source.
-experience ‘blurring’ between self and others.
Hallucinations
-involuntary and vivid perceptual experiences that occur in the absence of external stimuli.
-visual, olfactory, somatosensory (bodily feelings)
-Auditory are most common in schizophrenia (experienced as hearing voices, distinct from own inner voice/ thoughts.
delusions
-fixed beliefs that are not amenable to change in the light of conflicting evidence (DSM-5).
-May relate to everyday life, or may be ‘bizzare’
-many forms, e.g persecutory (someone is trying tho harm you, referential (environmental cues have personal meanings) and/or grandiose (you are exceptional).
disorganised thought
inferred from speech - derailment (unrelated ideas) or tangentiality (going off on a different topic).
-difficulty to follow the persons train of thought.
‘word salad’ - random stringing together of words
‘neologism’ - bending words to create new words.
-mixing up words is common so this is only classed as symptomatic if it leads to dysfunctional communication.
Features
characteristics of a diagnosis, in terms of prevalence and prognosis.
age
gender
race
lifetime prevalence
prognosis
-Lifetime prevalence is 0.3-0.7% (varies with ethnicity, nationality and geographic origin in immigrants)
-onset is slightly earlier in males (early-to mid-20s) than females (late 20s) and males have poorer prognosis.
-both genders have equal chance of diagnosis. Males have worse prognosis, more negative symptoms and psychotic episodes.
-African Americans, increased diagnosis.
-prognosis is variable and hard to predict- a minority recover, most experience chronic, episodic impairment and some show progressive deterioration. Positive symptoms reduce over time but negative symptoms often remain.
strength
reliable
Who found a good kappa value of 0.46?
Who found a very high kappa value of 0.86?
what percentage of clinicians lacked confidence in their diagnosis?
schizophrenia can be reliably diagnosed
-schizophrenia diagnosis is highly constant (this is true of diagnosis made with both DSM-5 and ICD-10).
-Kappa value was 0.46 (‘good’) in field trials of the DSM-5 (Regier et al. 2013) while Sartorius et al. 1995 found a very high kappa value of 0.86. only 3.8% of clinicians ‘lacked confidence’ in their diagnoses using the ICD-10.
-This is important because is suggests that the descriptors for schizophrenia are sufficiently detailed to allow clinicians to distinguish this condition from others with shared symptoms and features.
what kappa value did Regier et al 2013 find?
0.46 (‘good’)
what kappa value did sartorious et al 1995 find?
0.86 (very high)
suggest a counter argument
What’s a problem with diagnosing schizophrenia?
What can hallucinations be a symptom of?
name another symptom that is also part of major depression or bipolar disorder.
this said, diagnosing schizophrenia is not easy as it shares symptoms with various other disorders. For example, hallucinations can be experienced by people with depression and post-traumatic stress disorder.
Hallucinations can also be caused by drug withdrawal, metabolic disorders, stress and sleep deprivation. Catatonic behaviour can be symptomatic of major depression or bipolar disorder.
weakness
what’s a problem with cultural differences?
name and example. (Rastafarians/ play on words)
what could this be seen as?
what does this demonstrate?
cultural differences can make diagnosis difficult
-identifying disorganised thinking can be hard if the client is from a different cultural background from the clinician.
-For example, Rastafarians use neologisms (new words) which are play on English words (e.g down press for oppress). could be seen as a sign of disorganised thought when interviewing someone showing signs of mental distress.
-This demonstrates that an accurate diagnosis of schizophrenia requires an awareness of and sensitivity to cultural and linguistic differences.
culture does not effect diagnosis
scientific model
who was conducted in Korea to test this?
DSM was developed in the USA and is widely used by other cultures. This is valid if mental disorders are specifically defined with specific features and symptoms. Culture should not affect diagnosis because we use a scientific model to diagnose.
mental disorders are scientifically defined illnesses.
Lee 2006 was conducted In Korea deliberately to see if the DSM-IV-TR was valid in a non-western culture, and it was found it was (for ADHD).
What did Lee 2006 do?
Lee 2006 was conducted In Korea deliberately to see if the DSM-IV-TR was valid in a non-western culture, and it was found it was (for ADHD).
