Issues with classification and diagnosis of schizophrenia
- Created by: lauramakin
- Created on: 30-04-15 10:25
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- Issues surrounding the classification and diagnosis of schizophrenia
- schizophrenia
- Thought process disorder characterised by disruption to a person's emotions Thought and beliefs
- acute
- sudden onset many symptoms present at once
- Gradual
- Symptoms gradually appear over a length of time
- Affects 0.5% of the population
- Males developing it mostly in late teens
- Females normally develop it 4 or 5 years later
- Type 1 and Type 2 symptoms
- Type 1-positive symptoms - hallucinations,dellusions, thought insertion, feelings of control
- Type 2 negative symptoms-social withdrawal apathy, inappropriate emotions-lack of motivation
- First and second rank symptoms
- No single agreed definition-problems with reliability and validity of diagnosis
- Rosenhan's studies
- Pesudo patients went into hospitals in America- reported hearing voices
- The pseudo patients were consistently admitted to hospitals none were suspected as being pseudo patients
- Show problems with reliability/validity
- Diagnostic criteria could not distinguish between real and fake patients
- Shows criteria to be to general-not individual enough
- As the study was done along time ago many improvements have been made so findibgs may be different if study was carried out in modern day hospitals
- There are few other disorders which could be attributed to hearing voices
- Going to a clinic is a sign of serious mental disturbance in itself-if the clinitian had any doubts they heir on the side of caution as the results of letting a sick patients out are very serious
- In Rosenhan's second study the hospital identified 43 fake patients when none were sent in
- Suggests staff may have been on the look out for fake patients
- This may only really be testing the expectation of the staff and not the accuracy of the diagnostic criteria
- Wasn't carried out under normal conditions
- Untitled
- Suggests staff may have been on the look out for fake patients
- The first study also shows problems with labelling once the pseudo patients were diagnosed everything they did was seen as a symptom of their disorder.
- Beck's study
- compared 4 psychiatrist diagnosis of 153 patients
- Each patient was interviewed separately by 2 different psychiatrists
- Only agreed on the classification in 54% of cases
- This study shows that the diagnostic criteria is low on inter-rater reliability
- Low percentage of agreement for such a serious disorder
- Individual opinion can never be discounted as disorder is mainly diagnosed on behaviour
- compared 4 psychiatrist diagnosis of 153 patients
- Three main types of validity
- Ateological (similar cause)
- Concurrent (similar symptoms)
- predictive (similar prognosis)
- Best to use a criteria which stratifies al three types as most likely to be accuracte
- Some argue that schizophrenia should be classified as a dimensional disorder and should be classified by the extent the symptoms have on their life
- Culture
- Howes study found that language and background differences between psychiatrist and patient may provide unwanted barriers to accurately assessing symptoms
- Although schizophrenia occurs generally across cultures it is a consistent finding in the usa and the uk that it is diagnosed more frequently in African American and Caribbean population
- schizophrenia
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