schizophrenia

Schizophrenia

Profound disruption of cognition and emotion effects language, perception, sense of self, late teens early 30’sw,

DSM-IV= diagnostic and statistical- 400 mental disorder, defined by pos symp, evidence of disruption for 6 months, withdrawal, hallucinations, delusions,

ICD-10- international classification, symp present all time for month, neg symp, like lack of speech

Ideas of reference- attach great significance to external objects, think neighbours plotting to kill

Ideas of grandeur- think napoleon cant speak French, have a false belief opinion

Language impairment- repeat sounds, use invented words, speech is illogical word salad,

Negative symptoms- absence of emotion, lang deficits, apathy, avoidance of social occasions,

Positive symp- more important to diagnosis, 5 in category, 4 +, 1-, have several neg symp, respond poorly to drugs hard to treat, 2 types- T1- dominated by pos symp, greater chance of recovery,(biochemical abnorm) T2- neg symp (structural abnorm)

TYPE

CHARATERISITCS

Disorganised

Involves greater disorganisation, delusion, hallucinations, incoherent speech, mood swings

Catatonic

Immobility, strain blankly

Paranoid

Different delusions

Undifferentiated

broad categories, not found in any category

Residual

Don’t have prominent pos symp

Evaluation- exception of paranoid, other types difficult to diagnosed even with specialist, symp may change over time, display 1 some time then another other times

Catatonic is rare, may be because better drug therapy, or mis diagnosed in first place, awakenings sleeping sickness,

Clinicians cant agree on one definition hard to differences between schizophrenia often confused with depression, still variability among people in terms of symp, led to suggestion schiz not single disorder

reliability- doctors should be able to be consistent over time give same diagnosis using same diagnostic criteria in order for classification system to be reliable same diagnosis should be made each time it is used, different doctors should reach same diagnosis

Validity- that a diagnostic system is assessing what it aims to be assessing, this means that patients diagnosed as suffering from schizophrenia, actually have that disorder

Link between R and V- reliability refers to consistency- different clinicians should be able to get same diagnosis, lack of reliability reduces validity- refers to whether they have been given correct diagnosis-

Diagnosis- in theory diagnosis is simple, if patient fulfils relevant criteria they are categorised as having it, not fulfils not ill , however reality is never that straight forward

Comorbidity- some individuals may suffer 2 or more mental disorders at same time

Sim et al- studies of Schiz patients, 32% of whom had a depressive disorder, found those with Comorbidity had less awareness of their condition, has implication for reliability, e.g.- is the lack of motivation found in a patient a result of SCH or the depressive disorder,

Cultural bias- effects reliability- Harrison et al- over diagnosis of sch in west Indian psychiatric patients in Bristol may be because the symptoms of ethnic minority patient can display the symptoms but receive different diagnosis, because of their background

However evidence for cultural bias in unconvincing, may be that there are genuine difference in rates of incidence, the more stressful lives experienced by many…