Classification and Diagnosis of Schizophrenia

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  • Created by: Natalie
  • Created on: 17-10-13 12:36
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  • Classification and Diagnosis
    • Nature of schizophrenia
      • Profound disruption of cognition and emotion - affects language, perception and sense of self.
      • Association with violence is largely a media intervention.
      • Around 8% of patients diagnosed with schizophrenia commit a serious act of violence but this figure less than for other mental disorders.
    • Diagnostic criteria
      • Positive symptoms - excess or distortion of normal symptoms e.g. delusions, experiences of control, hallucinations and disordered thinking.
      • Negative symptoms - diminution or loss of normal functions, e.g. affective fattening, alogia, avolition.
      • Diagnosis of schizophrenia - (a) two or more characteristic symptoms, (b) social / occupational dysfunction, (c) duration (at east 6 months), (d) exclusion of mood disorders, (e) exclusion of organic cause.
    • Validity
      • Concerns questions about what schizophrenia really is.
      • little evidence of shared prognosis in schizophrenia, therefore ow predictive vaidity
      • First-rank symptoms distinguish schizophrenia from other disorders, but some of these are aso found in other disorders such as multiple personality disorder.
    • Reliability
      • Extent to which psychiatrists can agree on the same diagnosis.
      • DSM III and later versions claim increased reliability of diagnosis.
      • Whaley (2001) - inter-rater reliability as low as 0.11.
      • Klosterkotter et al. (1994) - positive symptoms more useful for diagnosis than negative symptoms.
      • Mojtabi and Nicholson (1995) - low inter-rater reliability of 'bizarre' versus 'non-bizarre' symptoms.
      • Problem highlighted in Rosenhan's study 'On being sane in insane places'
      • Reliability of diagnosis challenged by difference between US and UK diagnoses (Copeland, 1971).

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