Diagnosis and Classification of Schizophrenia

Questions and Answers

What is SCZ?

A mental illness that usually occurs in late adolescence/early adulthood characterized by psychosis where the sufferer has no concept of reality.

The DSM-5 and ICD-10 have the same criteria for diagnosing schizophrenia.

False

What are positive symptoms?

Additional experiences beyond those of ordinary existence.

What are hallucinations?

Sensory experiences that have no basis in reality. Signup and view all the answers

What are delusions?

Beliefs that have no basis in reality, held firmly despite evidence. Signup and view all the answers

What are negative symptoms?

Loss of usual abilities and experiences. Signup and view all the answers

What is avolition?

Severe loss of motivation to carry out everyday tasks. Signup and view all the answers

What is speech poverty?

Reduction in the amount or quality of speech. Signup and view all the answers

What issues affect the diagnosis of schizophrenia?

Reliability, validity, co-morbidity, symptom overlap, culture bias, and gender bias. Signup and view all the answers

What does reliability mean in the context of schizophrenia diagnosis?

The consistency of the diagnosis of schizophrenia. Signup and view all the answers

What does validity mean in the context of schizophrenia diagnosis?

The extent to which classification techniques measure what they are designed to measure. Signup and view all the answers

What was the key finding of Rosenhan's study in 1973?

Psychiatric staff could not consistently distinguish sanity from insanity. Signup and view all the answers

What is co-morbidity?

The occurrence of two illnesses together that complicates diagnosis and treatment. Signup and view all the answers

What did Buckley et al (2009) conclude regarding co-morbidity?

About half of patients with a diagnosis of schizophrenia also have another diagnosis. Signup and view all the answers

What is symptom overlap?

When two or more conditions share symptoms, questioning the validity of classification. Signup and view all the answers

What are the implications of misdiagnosis?

It can lead to delays in treatment, increased suffering, and higher suicide rates. Signup and view all the answers

What evidence suggests culture bias in diagnosing schizophrenia?

Research shows significant variation in diagnoses between countries and among different ethnic backgrounds. Signup and view all the answers

Study Notes

Schizophrenia (SCZ) Overview

SCZ is a mental illness typically manifesting in late adolescence or early adulthood.
Associated with psychosis; patients may have no concept of reality due to a personality breakdown.
Culturally universal; symptoms and incidence vary significantly across cultures.
Approximately 1% of the global population develops SCZ during their lifetime.

Diagnostic Criteria: DSM-5 vs. ICD-10

DSM-5 requires at least one positive symptom for diagnosis.
ICD-10 allows diagnosis with two or more negative symptoms.

Positive Symptoms

These represent additional experiences beyond ordinary existence.

Hallucinations

Involve sensory experiences without real external stimuli.
Can affect any sense, including auditory hallucinations (e.g., hearing voices).

Delusions

Firmly held false beliefs, often illogical, with no supportive evidence.
Common types include delusions of persecution, grandeur, or control.

Negative Symptoms

Characterized by a loss of standard abilities and experiences.

Avolition

A significant decrease in motivation for everyday tasks such as work and personal care.

Speech Poverty

Refers to reduced amount or quality of speech and possible delays in conversation.
DSM emphasizes speech disorganization and incoherence.

Diagnostic Issues

Major challenges include reliability, validity, co-morbidity, symptom overlap, as well as cultural and gender bias.

Reliability

Relates to the consistency of SCZ diagnoses across different evaluators (inter-rater reliability).

Validity

Concerns if diagnosis and classification methods successfully measure what they are meant to.

Key Study: Rosenhan (1973)

Eight confederates posed as pseudo-patients in 12 hospitals, claiming to hear voices ("empty, hollow, thud").
11 were diagnosed with SCZ; a further patient was diagnosed with manic-depression.
Staff failed to recognize the sanity of the pseudo-patients, questioning the reliability of SCZ diagnoses.

Co-morbidity

Refers to the co-occurrence of SCZ with other mental illnesses, complicating diagnosis and treatment.
Raises questions about the validity of classifications when severe depression resembles SCZ symptoms.

Research by Buckley et al. (2009)

Around 50% of SCZ patients also experienced depression, while 47% had substance abuse issues.
PTSD was found in 29% and OCD in 23% of SCZ patients, highlighting common co-morbidity with other disorders.

Symptom Overlap

SCZ shares symptoms with bipolar disorder, complicating diagnosis and classification validity.
Example: Delusions as a positive symptom in both disorders.
Research also found that individuals with Dissociative Identity Disorder exhibit more SCZ symptoms than those diagnosed with SCZ.

Implications of Misdiagnosis

Misdiagnosis due to symptom overlap can delay relevant treatment, leading to potential suffering and higher suicide rates.
Addressing symptom overlap issues could save lives and reduce healthcare costs.

Cultural Bias in Diagnosis

Significant diagnosis variations suggest cultural influences, with ethnic minority symptoms often misinterpreted.
Harrison et al. (1984) noted overdiagnosis of SCZ in West Indian individuals by white doctors.
Copeland et al. (1971) demonstrated contrasting diagnoses across countries, highlighting reliability concerns in SCZ diagnoses.

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Description

Explore key concepts and terminology related to the diagnosis and classification of schizophrenia in this quiz. Gain insights into the definitions, differences in classifications like DSM-5 and ICD-10, and the universal symptoms of this complex mental illness.