Schizophrenia-Classification of Schizophrenia

Question 1

define schizophrenia

Answer 1

is a brain
disorder that distorts the
way a person thinks, acts,
expresses emotions,
relates to others and
perceives reality.

Question 2

Statistics

Answer 2

1% of the population have the disorder, onset of first symptoms is around 15-45 years-
men are more likely to develop the disorder, with males also having an earlier onset

Question 3

What are the two major symptoms for the classification of mental disorders such as SZ?

Answer 3

ICD-10
DSM-IV

Question 4

DSM-IV

Answer 4

It is the most widely used diagnostic tool in psychiatric institutions throughout America and some parts of Europe.

Question 5

ICD-10

Answer 5

Used in the UK and many other European countries

Question 6

According to the ICD-10 , how many classification of SZ are there and why?

Answer 6

There are five classifications of schizophrenia according to the ICD-10 because of the range of symptoms shown, so SZ in not a unitary phenomenon

Question 7

The 5 classifications of ICD-10 according to ICD-10?

Answer 7

CRUDP
Disorganised SZ
Catatonic SZ
Paranoid SZ
Residual SZ
Undifferentiated SZ

Question 8

Disorganised schizophrenia:

Answer 8

meaning silly mind.

Symptoms include disorganised behaviour such as:
not washing
disorganised speech - language disturbances
mood swings
hallucinations and delusions
flattened effect
confusion and incoherence
(10% of people are diagnosed with this type).

Question 9

Catatonic schizophrenia:

Answer 9

May spend long periods immobile (catatonic stupor)
staring blankly or uncontrolled excitement and motor movements
(10% of people are diagnosed with this type).

Question 10

Paranoid schizophrenia:

Answer 10

Features delusions, especially delusions of persecution (the belief people are plotting against them) and hallucinations, particularly hearing voices.
Paranoid schizophrenics are usually agitated, angry, argumentative and suspicious of others
(35-40% of people are diagnosed with this type).

Question 11

Residual schizophrenia:

Answer 11

This consists of people who are experiencing mild symptoms
(20% of people are diagnosed with this type).

Question 12

Undifferentiated schizophrenia:

Answer 12

This is a broad category and includes people which do not fit clearly into the other categories (20% of people are diagnosed with this type).

Question 13

Prevalence

Answer 13

The onset is typically in late adolescence and early adulthood, onset - Men: 18–25 years; women: 25–35 years

Men are more likely to suffer than females

Question 14

Positive symptoms:

Answer 14

Atypical symptoms experienced in addition to normal experiences. These include hallucinations and delusions.

Question 15

Negative Symptoms:

Answer 15

Atypical symptoms that represent a loss of usual experiences such as clear thinking or ‘normal’ levels of emotion

Question 16

Asociality

Answer 16

defined as a reduction in social initiative due to decreased interest in forming close relationships with others.

Question 17

Delusions of persecution

Question 18

Blunted affect

Answer 18

person with blunted affect who receives news of a loved one’s passing may respond with complete indifference; they may verbalize their sadness, but keep a straight face, or they may give an emotionless reply such as, ‘Okay

lacks emotion

Question 19

Delusions of grandeur

Answer 19

Patients with delusions of grandeur believe that they are wonderful, successful, more important than others, or even miraculous.

Question 21

Avolition

Question 22

Echolalia

Answer 22

meaningless repetition of words just spoken by another person, occurring as a symptom of mental conditions.

Question 23

Anhedonia

Answer 23

the inability to feel pleasure

Question 24

Delusions

Question 26

What is schizophrenia?

Answer 26

Schizophrenia is a serious mental disorder affecting about 1% of the population, characterized by disruptions in thought, perception, and behaviour.

Question 27

What groups are more commonly diagnosed with schizophrenia?

Answer 27

Schizophrenia is more commonly diagnosed in men than women, in urban areas than rural areas, and among working-class rather than middle-class people.

Question 28

What impact can schizophrenia symptoms have on individuals’ lives?

Answer 28

Symptoms can severely interfere with daily tasks, often resulting in homelessness or hospitalization for affected individuals.

Question 29

How is schizophrenia classified?

Answer 29

Schizophrenia is a cluster of symptoms with no single defining characteristic and is classified by systems like ICD-10 and DSM-5.

Question 30

What is ICD-10?

Answer 30

The International Classification of Disease, 10th Edition, is a system by the World Health Organization that classifies mental disorders, including schizophrenia.

Question 31

What is DSM-5?

Answer 31

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, is a classification system by the American Psychiatric Association for diagnosing mental disorders.

Question 32

How do DSM-5 and ICD-10 differ in diagnosing schizophrenia?

Answer 32

DSM-5 requires at least one positive symptom (like delusions or hallucinations) for diagnosis, while ICD-10 allows for a diagnosis with only negative symptoms.

Question 33

What are positive symptoms of schizophrenia?

Answer 33

Positive symptoms involve additional experiences beyond ordinary reality, including hallucinations and delusions.

Question 34

What are hallucinations?

Answer 34

Hallucinations are a positive symptom where individuals experience unusual sensory perceptions, like hearing voices or seeing things that aren’t actually present.

Question 35

What are delusions?

Answer 35

Delusions are irrational beliefs that are a positive symptom of schizophrenia, such as believing oneself to be a famous figure or thinking one is being persecuted.

Question 36

How might delusions affect behavior in schizophrenia?

Answer 36

Delusions can make behaviors seem bizarre to others, although most individuals are more likely to be victims than perpetrators of violence.

Question 37

What are negative symptoms of schizophrenia?

Answer 37

Negative symptoms involve a loss of usual abilities or experiences, like reduced motivation (avolition) and impaired speech (speech poverty).

Question 38

What is avolition?

Answer 38

Avolition, also known as apathy, is a negative symptom where a person finds it difficult to start or maintain goal-directed activities, like work or personal hygiene.

Question 39

What are the three signs of avolition according to Andreason (1982)?

Answer 39

Poor hygiene and grooming, lack of persistence in work or education, and lack of energy.

Question 40

What is speech poverty?

Answer 40

Speech poverty is a negative symptom where speech is reduced in amount and quality, often with delays in verbal responses during conversation.

Question 41

What is speech disorganization?

Answer 41

Speech disorganization is a positive symptom in DSM-5, where speech becomes incoherent or the person frequently changes topics mid-sentence in a confusing way.

Question 42

What are schizophrenia subtypes recognized by ICD-10?

Answer 42

ICD-10 includes types like paranoid schizophrenia, which mainly involves negative symptoms, and catatonic schizophrenia, marked by movement disturbances.

Question 43

What happened to schizophrenia subtypes in DSM-5?

Answer 43

DSM-5 removed the specific subtypes of schizophrenia that were previously included in earlier versions of the DSM.

Question 44

Classification of mental disorder

Answer 44

The process of getting symptoms into categories based on which symptoms cluster together in people with mental disorders.

Question 45

Positive symptoms of schizophrenia -

Answer 45

Atypical symptoms experienced in addition to normal experiences. They include hallucinations and delusions.

Question 46

Hallucinations -

Answer 46

A positive symptom of schizophrenia. They are sensory experiences of stimuli that have either no basis in reality or are distorted perceptions of things that are there.

Question 47

Hallucinations -

Answer 47

A positive symptom of schizophrenia. They are sensory experiences of stimuli that have either no basis in reality or are distorted perceptions of things that are there.

Question 48

Delusions -

Answer 48

A positive symptom of schizophrenia. They involve beliefs that have no basis in reality, for example, that the person with schizophrenia is someone else or that they are the victim of a conspiracy.

Question 49

Negative symptoms of schizophrenia -

Answer 49

Atypical experiences that represent the loss of a usual experience such as clear thinking or ‘normal’ levels of motivation.

Question 50

Speech poverty -

Answer 50

A negative symptom of schizophrenia. It involves reduced frequency and quality of speech.

Question 51

Avolition -

Answer 51

A negative symptom of schizophrenia. It involves loss of motivation to carry out tasks and results in lowered activity levels.

Question 52

Co-morbidity -

Answer 52

The occurrence of two disorders or conditions together, for example a person has both schizophrenia and a personality disorder. Where two conditions are frequently diagnosed together it calls into question the validity of classifying the two disorders separately.

Question 53

Cheniaux et al. (2009) –

Answer 53

Reliability in Diagnosis
Reliability refers to consistency in diagnosis. Cheniaux et al. examined inter-rater reliability by having two psychiatrists independently diagnose 100 individuals using both DSM and ICD criteria.

Question 54

Cheniaux et al. (2009) –
Findings

Answer 54

• Findings: One psychiatrist diagnosed 26 people with schizophrenia according to DSM and 44 according to ICD, while the other diagnosed 13 with DSM and 24 with ICD.
• Evaluation: This poor reliability indicates a weakness in the diagnostic process for schizophrenia, as diagnoses differed significantly between psychiatrists.

Question 55

Cheniaux et al. (2009) – Criterion Validity

Answer 55

Validity assesses whether we are measuring what we intend to measure. Criterion validity looks at whether different diagnostic systems yield the same diagnosis for the same person.

Question 56

Cheniaux et al. 2009-criterion validity
Findings

Answer 56

• Findings: Schizophrenia was diagnosed more frequently using ICD than DSM in Cheniaux et al.’s study.
• Evaluation: This suggests poor criterion validity, as schizophrenia may be over-diagnosed in ICD or under-diagnosed in DSM, creating inconsistencies in diagnosis.

Question 57

Peter Buckley et al. (2009) – Co-morbidity

Answer 57

Co-morbidity refers to two or more conditions occurring together. Buckley et al. reviewed cases where schizophrenia was diagnosed alongside other conditions.

Question 58

Peter Buckley et al. (2009) – Co-morbidity

Findings

Answer 58

• Findings: Around 50% of people with schizophrenia also had depression, 47% had substance abuse, 29% had PTSD, and 23% had OCD.
• Evaluation: High co-morbidity challenges both diagnosis and classification. If schizophrenia is frequently diagnosed with other conditions, it suggests difficulty distinguishing between them. It also raises questions about classification, as severe depression may resemble schizophrenia.

Question 59

Peter Buckley et al. (2009) – Co-morbidity

Findings

Answer 59

• Findings: Around 50% of people with schizophrenia also had depression, 47% had substance abuse, 29% had PTSD, and 23% had OCD.
• Evaluation: High co-morbidity challenges both diagnosis and classification. If schizophrenia is frequently diagnosed with other conditions, it suggests difficulty distinguishing between them. It also raises questions about classification, as severe depression may resemble schizophrenia.

Question 60

Symptom Overlap in Schizophrenia and Bipolar Disorder

Answer 60

Symptom overlap occurs when different conditions share similar symptoms, challenging diagnosis and classification.

Question 61

Symptom Overlap in Schizophrenia and Bipolar Disorder
Findings

Answer 61

• Findings: Both schizophrenia and bipolar disorder involve positive symptoms like delusions and negative symptoms like avolition.
• Evaluation: This overlap undermines the validity of diagnosis, as ICD might diagnose a person with schizophrenia, while DSM could diagnose the same person with bipolar disorder. This similarity suggests that schizophrenia and bipolar disorder may not be distinct conditions.

Question 62

A03 Gender:

Answer 62

Over a lifetime men and women are equally likely to be diagnosed, however men’s average age of diagnosis is 25, 5 years sooner than women. Men are more likely to have drug abuse as a comorbidity, have worse social functioning and suffer negative symptoms. Women are more likely to display positive symptoms.

Question 63

A03 Gender Bias:

Answer 63

It’s suggested that women’s experience of schizophrenia is taken less seriously and underdiagnosed compared to men, Cotton suggests this is due to women’s better social coping strategies leading to being less likely to seek treatment.
Culture People with Afro-Caribbean heritage in the UK and African Americans are up to nine times more more likely to be diagnosed with Schizophrenia compared to 1% of the general population. (2005: Fearon)

Question 64

A03 Culture Bias:

Answer 64

As schizophrenia rates are also 1% in countries of origin the rise in diagnosis rates are likely due to cultural bias, or as Fernando (1998) suggests
“category failure”, western definitions of mental illness are applied to non-western cultures. A specific example is how hearing the voices of angels would be defined as an auditory hallucination in the UK but a religious experience in the west indies.