Schizophrenia

- Several Issues surrounding the diagnosis of Schizophrenia

- These include the issues surrounding relibility and validity of diagnosis

- The Diagnositc and Statistical Mannual of Mental Disorder (Edition 4) was last publishedin 1994

- It is produced by the American Psychiatric Association and is the most widely used.

- There is also the International Stastical Classification of Diseases

- Produced by the World Health Organisation and is currently in its 10th Series

- Diagnosing a mental disorder is almost always done uding the DSM-IV and the ICD-10

- Is a risk of using this professional jargon, as the wording is written for specialists

- Main issue is the reliability and validity of the diagnosis

- Beck (1961) looked at the inter-rater reliability between two psychiatrists when considering the cases of 154 patients

- Reliability was only 54% - only agreed on a diagnosis for 54% of the 154 patients

- True diagnosis cannot be made until a patient is clinically interviewed

- Psychiatrists are relying on retrospective data, given by a person whose ability to recall much relevant information is unpredictable.

- Originally hoped that diagnostic tools could provide a standardised method of recognising mental disorders.

- Behaviour of an individual is always to some interpretation. Process is subjective.

- Rosenhan (1972) was the most famous study carried out testing the subjectivity, reliability and validity of diagnostic tools.

- Rosenhan recruited 8 people who went to a psychiatric hospital and reported only 1 symptom. A voice said only single words like, "thud", "empty" and "hollow"

- When admitted, they began to act "normally". All were diagnosed with suffering Schizophrenia

- Individualsstayed in the institutions for between 7 to 52 days

- Rosenhan told the institutions about is results, and warned the hospital that they could expect other individuals to try and get themselves admitted

- 41 patients were suspected as being fakes and 19 of these individuals had been diagnosed by 2 members of staff

- Tempting to label a person as a sufferer os Schizophrenia, without really knowing the extent.

- Beliefs and biases of some might mean the unnecessary labelling

- Sometimes a disorder must reach a particular level before it can be recognised

- System of classification and diagnosis reflect the true nature of the problems the patient is suffering.

- The prognosis and how great a positive effect the proposed treatment will actually have.

- Many individuals do not fit into categories that have been created. Instead of acknowledging this, clinicians tend to diagnose 2 seperate disorders

- Someone who has suffered a mental disorder has to disclose that information, such as a job interview.

- Label of Schizophrenia stays with the person