schizophrenia- classification and diagnosis

Question 1

How prevalent is schizophrenia?Who does it most affect?

Answer 1

-serious mental disorder, affects 1% of population
-more common in males deem city in lower socio-economic groups

Question 2

how is sz diagnosed?

Answer 2

identify symptoms and use classification system to identify disorder

Question 3

classification of sz

Answer 3

identify symptoms that go together as part of a disorder

Question 4

what are the two main classifications used for sz?

Answer 4

DSM-5
ICD-10

Question 5

how does the DSM-5 classify sz?

Answer 5

ONE POSITIVE symptom must be present (delusions, hallucinations or speech disorganisation)

Question 6

how does the ICD-10 classify sz?

Answer 6

two or more negative symptoms are sufficient for diagnosis (abolition and speech poverty)

Question 7

what are positive symptoms of sz?

Answer 7

atypical symptoms experienced in addition to normal experiences

Question 8

what does it mean by negative symptoms of sz?

Answer 8

loss of usual abilities and experiences

Question 9

two examples of positive symptoms of sz

Answer 9

-hallucinations
-delusions

Question 10

what are hallucinations?

Answer 10

unusual sensory experiences that have no basis in reality or distorted perceptions of real things. experienced in relation to any sense i.e. hearing voices or seeing people who aren’t there

Question 11

what are delusions?

Answer 11

beliefs that have no basis in reality- make a person w/ sz behave in ways that make sense to them but are bizarre to others
i.e. beliefs ab being a very important person or the victim of a conspiracy

Question 12

two examples of negative symptoms of sz

Answer 12

-speech poverty
-avolition

Question 13

what is avolition?

Answer 13

-severe loss of motivation to carry out everyday tasks (work, hobbies, personal care)
-results in lowered activity levels and unwillingness to carry out goal-directed behaviours

Question 14

what is speech poverty?

Answer 14

-reduction in the amount and quality of speech. may include delay in verbal responses in conversation
-DSM emphasises speech disorganisation and incoherence as a positive symptom

Question 15

ao3 of sz: good reliability

Answer 15

-reliable diagnosis is consistent between clinicians (inter-rater) and between occasions (test-retest)
-Osório et al. (2019) report excellent reliability for sz diagnosis (DSM-5)- inter-rater agreement of +97 and test-retest reliability of +92
-means diagnosis of sz is consistently applied

Question 16

ao3 of sz: low validity

Answer 16

-criterion validity involves seeing whether different procedures used to assess the same individuals arrive at the same diagnosis
-Cheniaux et al. (2009) two psychiatrists independently assess the same 100 clients 68 were diagnosed with sz with ICD and 39 with DSM
-means sz is either over, or under diagnosed, criterion validity low

Question 17

ao3 of sz: co-morbidity w/ other conditions

Answer 17

-if conditions ofter co-occur then they might be a single condition. sz is commonly diagnosed w/ other conditions
-for example, buckley et al. (2009) concluded that sz is co-morbid w/ depression (50% of cases), substance abuse (47%) or OCD (23%)
-sz may not exist as a distinct condition

Question 18

ao3 of sz: gender bias

Answer 18

-men diagnosed w/ sz more than often than women, in ratio of 1.4:1 (fisher and Buchanan (2017)
-this could be bc men are more genetically vuberble or more women have better social support, masking symptoms
-means women w/ sz not diagnosed so miss out on helpful treatment

Question 19

ao3 of sz: culture bias

Answer 19

-some symptoms e.g. hearing voices, accepted in some cultures, e.g. Afro- Caribbean societies ‘hear voices’ from ancestors
-Afro-Carribean British men ten times more likely to receive a diagnosis as white British men, probably due to over interpretation of symptoms by uk psychiatrists
-means afro-carribean men living in uk appear to be discriminated against by a culturally-biased system