Schizophrenia Flashcards
What are the 2 classification systems for Schizophrenia and where are they used
ICD-10 = Europe
DSM-5=U.S.A
What are the differences between the ICD-10 and DSM-5?
ICD-10= Recognises the 5 sub-types of Schizophrenia, 2/ more negative symptoms are sufficient for diagnosis.
DSM-5= No longer recognises the 5 sub-types, needs at least one positive symptom ie)hallucination, delusion or speech disorganisation to be present for diagnosis. DSM sees S.P as negative symptom, but focuses of speech disorganisation a positive symptom due to incoherency and change in topics.
Explain the positive symptoms of schizophrenia
Refers to additional experiences
Hallucinations= unusual sensory experiences, usually auditory or visual.
Delusions= paranoia or irrational beliefs, ie) being persecuted, being God (delusions of Grandeur), can lead to aggression, but are most likely to be victims.
Explain the negative symptoms of schizophrenia
Refers to loss of usual abilities and experiences
Avolition/ Apathy= lack of goal-related activity and motivation. Andreason identified 3 characteristics of avolition: lack of energy, poor hygiene + grooming and lack of persistence in work or education.
Speech poverty= changes in pattern of speech. ICD-10= reduction in speech quality so a negative symptom and delay in verbal responses.
Evaluate schizophrenia and its classification
Reliability= poor inter-rater reliability between ICD-10 and DSM-5 shows weakness in diagnosis of Schizophrenia. Ie)Cheniaux et al out of 100- 26 via DSM-5 and 44 via ICD.
Validity= looking at Cheniaux study validity is questioned as ICD-10 either over-diagnosis Schizophrenia or DSM-5 under-diagnosis it.
Co-morbidity= Weakness of diagnosis and classification due to confusion. Are we bad at telling between 2 separate conditions or identifying one overall condition? ie)Buckley et al shows 50% of Schz. also have depression, 47% substance abuse, 29%PTSD and 23%OCD.
System overlap= ie) between Schz. and Bipolar disorder both have neg. symptoms like avolition and positive ones like hallucination, so DSM can diagnose many that ICD-10 diagnose for Schz. with Bipolar. They could also be one disorder if they overlap so close???
What’s the evaluation overlap?
Gender bias in diagnosis= ie) Longenecker et al found that men are more diagnosed that women for schz. from 1980s. Could be due to genetic predisposition, but gender bias is also relevant as fact that women have better inter-functioning (Cotton et al) may act as bias as leads to under-diagnosis by practitioners.
Cultural bias in diagnosis= due to a different culture diagnosing those with afro-caribbean origin as schizophrenic due to positive symptoms like hearing voices being seen as normal in their culture but not in that of the practitioner. ie)Javier Escobar says white psychiatrists over-emphasise symptoms of and distrust diagnosis honesty of black people during diagnosis.
