Diagnosis and Classification of Schizophrenia
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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?

<p>Sensory experiences that have no basis in reality.</p> Signup and view all the answers

What are delusions?

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

What are negative symptoms?

<p>Loss of usual abilities and experiences.</p> Signup and view all the answers

What is avolition?

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

What is speech poverty?

<p>Reduction in the amount or quality of speech.</p> Signup and view all the answers

What issues affect the diagnosis of schizophrenia?

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

What does reliability mean in the context of schizophrenia diagnosis?

<p>The consistency of the diagnosis of schizophrenia.</p> Signup and view all the answers

What does validity mean in the context of schizophrenia diagnosis?

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

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

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

What is co-morbidity?

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

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

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

What is symptom overlap?

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

What are the implications of misdiagnosis?

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

What evidence suggests culture bias in diagnosing schizophrenia?

<p>Research shows significant variation in diagnoses between countries and among different ethnic backgrounds.</p> 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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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.

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