Theme A Schiziophrenia (Classification & Diagnosis

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  • Created by: Liv Scott
  • Created on: 02-05-15 18:14
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  • Theme A Schizophrenia
    • Clinical Characteristics
      • Positive
        • Disrution of normal function, easier to diagnose
          • E.g. delusions, hallucinations, disorganised speech etc.
      • Negative
        • Lack of normal function, harder to diagnose
          • E.g. Apathy, no emotion, flat effect, social withdrawal
      • Diagnosis
        • 2 or more positive symptoms
        • 1 or 6 months
        • Reduced social function
      • Age of onset
        • Early 20s males
        • Late 20s female
      • Prognosis
        • 1/3 recover more or less
        • 1/3 episodic impairment
        • 1/3 chronic decline
    • Issues of classification
      • DSM
        • American manuel
        • 1 or more symptoms for at least 6 months, 1 month of active symptoms
        • 5 subtypes
      • ICD
        • European manual
        • Symptoms for 1 month
        • 7 subtypes
      • A02- If not diagnosed, don't get the right treatment. Diagnosis relies on manual
      • A02- Reliability questioned because different types in different manuals
      • A02- Ppl don't fit into neat categories. There are blurred distinctions between some subtypes
      • P-Reliability of diagnosis challenged by variation between countries
        • E- Copeland gave 134 US & 194 UK psychiatrists a patient description. 67% US & 2% UK diagnosed sz. Means low inter-rater reliability
          • E-Lacks inter-rater cross culture, can't be diagnosed, can't get treatment
            • L- Could be improved by a universal manual
      • P-Rosenhan showed issues of reliability & validity
        • E- 8 ppts sent to hospitals with the same symptoms. 7 diagnosed with sz. Admitted between 7 & 52 days. Over next 3 months 83/193 were guessed as false, they weren't.
          • E- Initial high inter-rater but lower over next 3 months. However this study only used 8 ppts, criticised for low pop validity. Can't be generalised.
            • L- Shows issues of classification & diagnosis & labelling. But because of issues don't know if that is typical of everywhere
      • P-Harrison et al criticised validity, misdiagnosis of African Caribeans
        • E- Incidence of sz 8x higher in African Caribbean group than for white
          • E-Maybe due to cultural differences, language, mannerism & the difficulties for drs relating to their patients
            • L-To increase validity, employ drs from different backgrounds, give training to increase cultural differences & incorporate them into the manuals


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