Issues with the Classification And Diagnosis of Schizophrenia

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  • Issues with the Classification and Diagnosis of Schizophrenia
    • The main issues surround the validity of classification systems (CS) which in turn affects the reliability + validity of diagnosis
    • Poor inter-rater reliability of diagnosis
      • Cooper et al 1971
        • American diagnosticians made a larger diagnosis of SZ compared to British diagnosticians
        • Evaluation
          • Cultural differences between USA and UK - each group may have picked up on different behaviours than the other and may consider different behaviours as "abnormal"
          • The study was set in 1971, CS have had time to develop along with new research and refine their diagnostic criteria
      • This means that all diagnosticians using a CS should all come to the same conclusion regarding a patient
    • The difference between classification systems
      • DSM and ICD both have different criteria that the patient has to meet in order to be classed as SZ this reduces both validity of CS and the I-R-Reliability
    • Comorbidity (Overlap with other disorders)
      • Tim Crow 1991 (NOT a study!)
        • The concept of the excluded middle which is the tendency to only examine patients who *clearly* meet the criteria for either SZ or bipolar disorders....
          • ...Whilst ignoring schizoaffective patients suffering from both types of symptoms.
      • If patients do not *neatly* fit into the categories created, they are diagnosed as having two different disorders (these disorders may just occur together)
    • Positives of The C + D of SZ
      • So people suffering can get appropriate treatment for their disorder
      • Prognosis
        • So patients know the:
          • Severity of symptoms
          • Symptoms
          • Approximate duration of the disorder
      • Updated along with new research to address any issues
    • Ethical concerns with the C + D of SZ
      • Misdiagnosis
        • Labelling
          • The label "SZ" is permanent and subsequently all behaviour is labelled as such, even if the person has been misdiagnosed
        • Inappropriate Treatment
          • Side Effects which can potentially be dangerous
    • Cultural Differences
      • If the clinician doesnt speak the same language as the patient, there is a risk of lack of understanding between the two parties.
        • The symptoms of mental illness are already quite unclear and hard to understand so need to be described in as much detail as possible otherwise...
          • ...there is a risk of misdiagnosis and inappropriate treatement


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