Reliability and Validity of diagnosing schizophrenia

Two different diagnostic manuals both used

DSM-IV and ICD-10

Arent identical meanning concistancy of diagnosis needs to be questioned

Risk of Proffessional Jargon

Wording in manuals are used for specialists to understand not laymen

BECK

Looked at the inter-rater reliablity between two psychiatrists of 154 patients.

Reliablity was only 54%

Diagnosis can only be made once patient has been clinical interviewed

Psyciatrists rely on retrospective data

Given by an individual whose ability to recall relevent information is unpredictable.

Voices/disillusions symptoms 

Hard for psychitrists to tell if their telling the truth.

ROSENHAN

Tested the subjectivity, reliablilty and validity of diagnostic tools

Recruited 8 friends to psychiatric hospitals reporting 1 symptom

When admitted they began to act normally

All apart from one were diagnosed with schizophrenia

ROSENHAN told them about his results and warned they should expect more fakes.

41 patients were suspected of being fakes when he had admitted noone this time. 

Limited time and resources available in NHS

Diagnosis made when they are rushed and preoccupied

Only admit most serious cases to safeguard the resources 

Characteristics taken out of their cultural norms may be seen as abnormal.

Resulting in an inaccurate diagnosis

Asain cultures: show no emotion (characteristic of schizo)

Arabic cultures: public emotion encouraged

without this knowledge, an individual displaying overt emotional behaviour may be diagnosed wrongly

Clinician may not speak the same language as patient

Leading to things being 'lost in translation'

May lead to inappropriate/no treatment

the end