Schizophrenia: Categories, Symptoms And Diagnoses Flashcards
What does psychosis mean?
A term used to describe a severe mental health problem where the individual loses contact with reality (unlike neurosis where the individual is aware they have problems).
What does relapse mean?
When a patient returns into a state of psychosis, usually when they stop medication. About 25% of SZ sufferers will not have another psychotic episode of the illness; 50-65% will improve, but continue to have bouts about the illness. The remainder will have persistent difficulties
What are the subtypes in ICD-10 classification proposed by WHO?
Disorganised, Catatonic, Paranoid, Residual, Undifferentiated
What is the DSM-V classification of SZ proposed by NICE
SZ is a chronic mental illness with positive symptoms (delusions, hallucinations, disorganised speech and behaviour), negative symptoms, and cognitive impairment. DSM-V dropped subtypes though they were once recognised
What is the disorganised schizophrenia subtype and it’s symptoms?
(Disorganisation of behaviour and speech) Where the persons behaviour is generally disorganised and not goal directed. Symptoms include thought disturbances, (including delusions and hallucinations), an absence of expressed emotion, incoherent speech, large mood swings and a loss of interest in life-social withdrawal. It is usually diagnosed in adolescence / young childhood.
What is the catatonic schizophrenia subtype and its symptoms?
(Motor movements and repetition) Where the patient has severe motor abnormalities, such as unusual gestures or use of body language. Sometimes they gesture repeatedly, using complex sequences of finger, hand and arm movements, which appear to have some meaning to them. Type often involves doing opposite to what is asked or repeating everything that is said. The main symptom is patients staring blankly for hours, almost totally immobile. Sometimes involves Echolalia (involuntary parrot like repetition (echoing) of a word or phrase just spoken) and Echopraxia (involuntary repetition or imitation of the body movements of another person)
What is the paranoid schizophrenia subtype and its symptoms?
(Delusional and more alert) Where patients have delusions of various kinds (persecution and grandeur); however the patient remains emotionally responsive. They are more alert than patients with other types of SZ. People who are diagnosed with Paranoid SZ tend to be argumentative
What is the residual schizophrenia subtype and its symptoms?
(Mild symptoms) Where people who although have had an episode of SZ during the past 6 months and still exhibit symptoms, they are not strong enough to merit putting them in other categories.
What is the undifferentiated subtype and its symptoms?
(Catch all) A Broad “catch all” category which includes patients who do not clearly belong within any other category. They show symptoms of SZ but do not fit into the other types
What are the positive symptoms of SZ?
Hallucinations, delusions, disorganised speech, grossly disorganised or catatonic behaviour
What are the negative symptoms of SZ?
Avolition (loss of interest), speech poverty, affective flattening (emotions aren’t expressed outwardly), anhedonia (lack of motivation)
What are the secondary symptoms of SZ?
Depression, loss of employment, breakdown of relationships
How many symptoms must you have to be diagnosed with SZ by the DSMV criteria?
One of each, positive, negative, secondary
How many symptoms must you have to be diagnosed with SZ by the ICD-10 criteria?
Two of each, but focus is more on positive symptoms
What is the definition of a positive symptom of SZ?
Symptoms that are rare in normal, everyday experiences, (in addition to), they reflect an excess or distortion of normal function I.e. delusions and hallucinations.
What is the definition of a negative symptom of SZ?
Symptoms that are much less dramatic and can be experienced in everyday life, loss of / failure to show normal behaviour i.e. loss of energy, reduced personal hygeine
What is the definition of a secondary symptom of SZ?
Difficulties living with the disorder, such as depression
What does the mental health act (1983) say about patients who refuse treatment?
Someone with SZ may not realise they are ill and can refuse treatment when they need it, as a result they can be admitted to hospital against their will and given treatment without their consent under this act. This should only happen if their health is at risk, or if they are a danger to themselves or others
What was Rosenhan (1973) study?
(Being sane in insane places) 7 friends and students (3 women 4 men), twelve psychiatric hospitals in five states, didnt wash or brush their teeth, faked a hallucination to get inside then acted normal inside. Aims to test psychiatric labels and to see what it was like to be a patient. Findings were that nurses didn’t realise sanity of research patients
What are the negative evaluations of Schizophrenia classification and diagnosis?
Diagnosis of SZ lacks validity as psychiatrists cannot distinguish between real and pseudo-patients, being diagnosed with SZ is a sticky label with long term consequences, low degree of accuracy from psychiatrists. Co-morbidity affects reliability & validity, the occurrence of two illnesses or conditions occurring simultaneously can cause a diagnosis of only one not both, e.g. SZ or Depression, although SZ can have depression. Symptom overlap which can cause wrong diagnoses, so validity issues with classification and diagnosis e.g. SZ vs Bipolar under ICD. Culture bias, overdiagnoses in other cultures, particularly with people with afro-carribean origin several more times likely to be diagnosed than white people (Researchers belive the main reason for this is due to overlooked or misinterpretations of symptom expression.
What are the positive evaluations of Schizophrenia classification and diagnosis?
Evidence does generally suggest an improvement in reliability of diagnosis as classifications have been updated, meaning practitioners are provided with a common language, permitting communication of research ideas and findings which ultimately lead to a better understanding of the disorder and the development of better treatments
