Schizophrenia - issues in the diagnosis Flashcards
What are the advantages of schizophrenia diagnosis
Can access appropriate therapies (antipsychotics or family), removal of symptoms begins recovery process
What are the disadvantages of schizophrenia diagnosis
Disempowerment, as their lack of knowledge on their condition leaves them to believe they are not in control of tiger own lives. Labelling, leads to stigma which affects recovery processes. Social exclusion, stigma and stereotypes
What is inter rater reliability
Occurs when clinicians make identical, independent diagnosis of the same patient with schizophrenia
What study conducted by Beck et al relates to inter rater reliability
Group of 153 schizophrenic patients were each assessed by 2 psychiatrists with agreement rate of only 54%
What study conducted by Copeland relates to inter rater reliability
Gave description of patient to 134US and 194 British psychiatrists. 69% diagnosis by US, and 2% diagnosis by British, showing culture threatens consistency
What is test retest reliability
Occurs when clinicians make the same diagnosis of the same patient on separate occasions
What research was conducted by Farmer et al into schizophrenia (evaluation point)
Found standardised interview technique known as Present state examination (PSE), which increases reliability by focusing on frequency and severity of symptoms (patients asked same questions)
What did Read suggest about schizophrenia diagnosis
Test retest analysis is as low as 37% for schizophrenia, which could concerningly create many false positives and negatives
What is validity
The extent to which we are measuring what we are intending to measure
What validity affected by in schizophrenia
Comorbidity and overlapping symptoms
What is comorbidity
More thane disorder which exist alongside a primary diagnosis
What are overlapping symptoms
Symptoms relevant to other disorders not exclusively to schizophrenia, reducing validity of diagnosis
What did Buckley et al find about the validity of schizophrenia (evaluation point)
Following symptoms were comorbid with schizophrenia:
- Panic disorder = 15%
- PTSD = 29%
- OCD = 23%
- Depression = 50%
- Substance abuse = 47% (can develop positive symptoms of schizophrenia but may be diagnosed with substance abuse)
What did Konstantareas and Hewitt find about the validity of schizophrenia (evaluation point)
14 male autistic patients and 14 male patients with schizophrenia. Found no autistic symptoms in schizophrenic patients, but 50% of schizophrenic symptoms in the autistic patients
How does the DSM improve validity of schizophrenia diagnosis (evaluation point)
DSM V states patients must have two or more symptoms for at least one month, with one being either hallucinations, disorganised speech or delusions. Makes diagnosis more accurate
What did Rosenham study in relation to schizophrenia
12 psychiatric hospitals across US, 8 pseudo patients, 5 men, 3 women of various ages and occupations, Rosenham was one of them.
Method: naturalistic observation where pseudo patients had to say they heard voices of “thud”, “empty”, and “hollow”. Once admitted to hospital, they told staff they felt well. Made notes of their data collected firstly in secret then openly, which was seen as a symptom.
Results: 7/8 were admitted to hospital, length of stay was 7-52 days until staff believed they were sane (average 19). Were still labelled as schizophrenic after hospitals were informed it was a study. Shows low validity with high levels of false positives (diagnosing a healthy person)
