Describe and Evaluate the Classification and Diagnosis of Schizophrenia

AO1

CLASSIFICATION OF SCHIZOPHRENIA

  • SCHZOPHRENIA: a PSYCHOTIC DISORDER involving a BREAK in REALITY which involves a disruption of COGNITION and EMOTION, which affects LANGUAGE, THOUGHT, PERCEPTION and SENSE OF SELF
  • 2 MANUALS : ICD 10 AND THE DSM5
  • DSM-5: ONE of the POSITIVE features (delusions or hallucination or speech disorganisation)
  • ICD-10: TWO or MORE NEGATIVE FEATURES and recognises SUBTYPES of SCHZOPHRENIA e.g. PARANOID SCHIZOPHRENIA = powerful DELUSIONS and HALLUCINATIONS but few other + HEBEATRNIC SCHIZOPHRENIA = DISTURBANCE of MOVEMENT, leaving the sufferer IMMOBILE or OVERACTIVE

POSITIVE SYMPTOMS

  • HALLUCINATIONS: they SEE, HEAR, TASTE or EVEN FEEL something that ISN’T REALLY THERE – HEARING VOICES or imagining PEOPLE/ANIMALS/DISTORDED FACIAL EXPRESSIONS
  • DELUSIONS: IRRATIONAL BELIEFS e.g. being an important figure – beliefs that have NO BASIS in reality and ACT in a way that makes SENSE TO THEM

NEGATIVE SYMPTOMS

  • AVOLITION: finding it DIFFICULT to perform ACTIVITIES that are GOAL-ORIENTED e.g. poor hygiene, lack of energy and inconsistency in work/education
  • SPEECH POVERTY: REDUCTION in the AMOUNT and QUALITY OF SPEECH e.g. slurred speech or a delay in the sufferer’s verbal responses during a conversation

AO3

  • RELIABILITY: (CONSISTENCY) INTER-RATER RELIABLITY: the extent to which DIFFERENT ASSESSORS/TWO or MORE MENTAL HEALTH PROFESSIONALS AGREE on the ASSESSMENTS/SAME DIAGNOSIS (DIAGNOSTIC RELIABILTY) – CHENIAUX ET AL: 2 psychiatrists INDEPENDENTLY diagnose 100 patients using the DSM + ICD = POOR INTER-RATER RELIABILITY (1ST – 26 w/ DSM + 44 w/ ICD AND the other – 13 w/ DSM + 24 w/ ICD)
  • VALIDITY: the extent to which we are MEASURING what we WANT to measure – the number of VALIDITY ISSUES à measured through the CRITERION VALIDITY; do different ASSESSMENT SYSTEMS arrive at the SAME DIAGNOSIS – CHENIAUX ET AL: MORE likely to be diagnosed with ICD – either an OVER-DIAGNOSES with ICD or UNDER with the DSM = LOW VALIDITY + NOT STANDARDISED
  • SYMPTOM OVERLAP: SCHIZOPHRENIA + BIPOLAR DISORDER involve POSITIVE SYMPTOMS like DELUSIONS and NEGATIVES like AVOLITION – questions the VALIDITY – under the ICD, the patients may be diagnosed as a SCHIZOHRENIC but under the DSM may be diagnosed with BIPOLAR DISORDER
  • CULTURAL DIFFERENCES: LUHRMAN ET AL: interviewed 60 adults diagnosed with SCHIZPHRENIA, 20 in GANA, INDIA AND THE US – each were asked about the VOICES they heard. A person who claimed that he was HOD ON EARTH would be considered DELUSIONAL in WESTERN SOCIETY but in INDIA is a spirit medium who is the HUMAN INCARNATION of a HINDU GOD