Validity in diagnosis of Schizophrenia

VALIDITY is whether you are measuring what you are trying to measure or whether your results are true or not. 2 issues in the validity of diagnosing schizo

1) DOES SCHIZO EXIST? Not questioning symptoms but questioning schizo like does it exist and do all sufferers have same disorder?

2) IS DIAGNOSES ACCURATE? Validity in whether the Doc is right in their diagnosis, both may agree but maybe wrong.

FACTORS affecting validity in diagnosis of schizo

1) WIDE RANGE OF SYMPTOMS only need to display two to be diagnosed so two ppl ,may not have same symptoms at all but both be diagnosed with schizo. Is it fair to say they have same illness?

2) LACK OF PATHOGNOMIC SYMPTOMS/ SIMILARITIES WITH OTHER MENTAL ILLNESSES schizo don't have any pathognomic symptoms. All symptoms of schizo are also symptoms of other mental illnesses. LOWERS VALIDITY as a person may have another mental illness and be diagnosed with schizo. Important to get diagnosis right so person isn't given an unnecessary stigma

Validity is important cuz

1) to make accurate diagnosis so patient is given appropriate treatment

2) avoid labelling person as schizo if they don't have have it as carries stigma

THORNICROFT ET AL

Looked at 732 patients who had schizo since diagnosis 47% hard to keep and maintain mates 29% hard to keep job 43% suffered from discrimination from fam. Illustrates that schizo carries a huge stigma and an accurate diagnosis needs to be made.

ROSENHAN 1973
Rosenhan and 8 others went to different mental institutions claimed they heard a voice saying the word 'thud'. All other details given weren't lies bar their occupation. 9/9 pseudo patients were admitted and 8/9 diagnosed with schizo. Other diagnosed with manic depressive psychosis. Behaved normally once in institution and kept for btw 7-52 days. SUPPORTS LOW VALIDITY when diagnosing schizo as docs inaccurately diagnosed 8/9 with schizophrenia.
Cuz of this it was said that schizo isn't a valid concept cuz if diagnosed inaccurately. But they did lie. So testing docs lie detecting skills rather than ability to diagnose schizo.
KIM AND BERRIOS
Provide evidence to support that low validity found that 80% of those with schizo are undiagnosed. Some Docs don't wanna burden their patients with the stigma of it. Not diagnosed cuz of doc ability but cuz of stigma. Shows LOW VALIDITY as patients don't get accurate diagnosis. Renamed schizo from 'mind split disease' to 'integration disorder' as less -ve connotations. Supports that V affected by stigma, docs don't wanna burden with stigma.
ELLASON AND ROSS
Investigated lack of pathognomic symptoms in schizo reduces validity of the concept. Looked at those diagnosed with schizo and dissociative identity disorder. Found that those with DID had more symptoms of schizo than those with schizo. Supports the fact that schizo isn't a valid concept, and that overlap btw mental illness and schizo is gr8 therefore easy to misdiagnose a person.

BLUER
Examined validity of schizo by looking at predictive validity of disease. Looked at 2000 patients diagnosed, 20% made full recovery, 40% recovered from +ve symptoms, 40% had continuing psychotic episodes. If all were suffering from same disorder should have been similarity in recovery. Supports idea that schizo ain't a valid concept as not all with schizo have same disorder and if they did there wouldn't be a difference in recovery.
MARIUS ROMME
Eminent psychiatrist and one of schizos biggest critics. Claims that schizophrenia has no scientific validity cuz when diagnosing no attention paid to as how the patient developed symptoms ie did stressful life experiences trigger delusions? Goes back to all those with schizophrenia treated in the same way with little regard to diff in symptoms. Harmful as if no attention to how symptoms arose little can be done to treat illness.