Schizophrenia Clinical Characteristics

Question 1

What percentage of the population is affected by schizophrenia?

Answer 1

1%

Question 2

What classifications are used to diagnose schizophrenia?

Answer 2

ICD-11: Europe.

DSM: America

Question 3

What is a positive symptom?

Answer 3

Symptoms that are not usually present in a normal person and reflect an excess or distortion of normal functioning.

Question 4

Give examples of positive symptoms.

Answer 4

Delusions of persecution - The belief that others want to harm you

Delusions of grandeur - The belief that you are god-like and are the most important individual

Delusions of control - The belief that you are under control by ab alien force that has invaded your mind or body

Hallucinations - Disturbances in perception such has hearing voices

Question 5

What are negative symptoms?

Answer 5

Symptoms that result in a decline in functioning

Question 6

Give examples of negative symptoms.

Answer 6

Speech poverty - inability to speak properly and producing fluent words

Avolition - inability or reduction to start and continue goal-directed behaviour such as going out with friends.

Question 7

What is reliability?

Answer 7

The extent to which a finding is consistent.

Question 8

What is validity?

Answer 8

The extent to which we are measuring what we are intending to measure.

Question 9

What is inter-rater reliability?

Answer 9

The measure of how two observers agree.

Question 10

What is test-retest reliability?

Answer 10

If the doctor is able to give the same diagnosis overtime.

Question 11

What are the factors that can affect the reliability/validity of diagnosing patients with schizophrenia?

Answer 11

• Co-morbidity
• Culture
• Gender bias
• Symptom overlap

Question 12

Which study evaluates the reliability of diagnosing schizophrenia?

Answer 12

Beck
- He reviewed the diagnosis of 153 patients who had been diagnosed by multiple doctors. The results showed that there was only a 54% concordance rate between the doctors diagnosis. This means that the inter-rate reliability of schizophrenia diagnosis is low which suggests many people might be diagnosed incorrectly or receiving incorrect treatment.

Question 13

What is comorbidity? Evaluate it.

Answer 13

Refers to more than one disorder or disease that exists alongside a primary diagnosis.

Bucky et al found that out of half the patients diagnosed with schizophrenia, 50% of them have depression, 47% have substance abuse and 23% of them have OCD.

Question 14

Discuss and evaluate culture into diagnosing schizophrenia.

Answer 14

In Britain, people of Afro-Caribbean descent are more likely to be diagnosed with schizophrenia when compared to white people which highlights that diagnosis may not be valid. This could be because Afro-Caribbean descents tend to be spiritual and so hearing voices could be a sign that they are hearing voices from God instead of a sign of schizophrenia.

Fernando argued that people from ethnic minorities experience more racism and prejudice than the white population and these stressors can trigger schizophrenia and explains that cultural biases should be expected in diagnosis.

Question 15

Discuss gender bias into diagnosing schizophrenia.

Answer 15

Females tend to develop schizophrenia approximately 4-10 years later than males and they also develop a much later form of schizophrenia after the menopause which suggests that different types of schizophrenia exists. It is also suggested that a womans experience of schizophrenia is taken less seriously which could be due to the idea that women have better coping strategies.

Gender bias can also occur due to clinicians failing to consider that males tend to suffer more negative symptoms than women and have higher levels of substance abuse and that women have higher recovery rates than men. These misconceptions could be affecting the validity of a diagnosis since clinicians are not considering all symptoms.

Question 16

Explain the Loring and Powell study

Answer 16

They sent 290 psychiatrists 2 identical case studies. The gender and race of the case studies were changed and were either a white male, a black male, a white female or a black female, or no gender or race disclosed. It was found both the sex and race influenced the diagnosis. Women were less likely to be diagnosed as schizophrenic and black males were more likely. The most accurate diagnosis was when the clients race and sex was the same as the psychiatrists.

Question 17

Discuss symptom overlap

Answer 17

Overlapping of symptoms can occur between schizophrenia and other conditions which questions the validity of the classification and diagnosis of schizophrenia. Ellason and Ross pointed out that people with dissociative identity disorder have more schizophrenic symptoms that people who were diagnosed as schizophrenic. using ICD-11 a patient may be diagnosed with schizophrenia but many of the same patients would be diagnosed with bipolar disorder when using DSM criteria.

Question 18

Evaluate symptom overlap

Answer 18

According to Ketter, symptom overlap can have serious consequences since the misdiagnosis due to symptom overlap can lead to years of delay in receiving the right treatment which can lead to prolonged suffering and higher rates of suicide.