Classification and Diagnosis of Schizophrenia

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What are the two types of symptoms of schizophrenia?
Positive and negative
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What does the DSM-IVR require to diagnose schizophrenia?
At least a one-month duration of two or more positive symptoms.
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What are positive symptoms?
Excess or distortion of normal symptoms, eg, delusions, experiences of control, hallucinations, disordered thinking
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What are negative symptoms?
Diminution or loss of normal functions, eg, affective flattening, alogia, avolition
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What is the issue of inter-rater reliability?
There is still little evidence that the DSM is routinely used with high reliability by mental health clinicians
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What did Wilks et al (2003) find?
Screening tests show high test-retest reliability
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What did Rosenhan (1973) find?
'On being sane in insane places' - demonstrated unreliability of diagnosis
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What did Mojtabi and Nicholson (1995) find?
Unreliable symptoms - diagnosis based on 'bizarre' delusions are not a reliable method of distinguishing between schizophrenic and non-schizophrenic patients
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What did Prescott et al (1986) find?
Test-retest reliability performance on measures of cognitive deficits associated with schizophrenia stability over a 6-month period
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What did a comparison between the DSM and ICD find?
Schizophrenia was more frequently diagnosed according ICD-10 than DSM-IV critera
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What did Copeland (1971) find?
Reliability of diagnosis challenged by difference between US and UK diagnoses
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What can create difficulties in diagnosing schizophrenia?
Psychiatric comorbidities
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What did Klosterkotter et al (1994) find?
Positive symptoms are more useful for diagnosis than negative ones
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People diagnosed with schizophrenia rarely share the same symptoms, nor the same outcomes: True or false?
True
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What did Weber et al (2009) find?
Evidence of many comorbid non-psychiatric diagnoses among patients with schizophrenia
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What does this affect?
Prognosis
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What did Kessler et al (1994) find?
Persons with schizophrenia at risk for suicide, with comorbid depression are the major cause for suicidal behaviour
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What did Harrison et al (1997) find?
Rates of schizophrenia among Afro-Caribbeans was much higher than in white populations
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What did Ellason and Ross (1995) find?
Schizophrenic symptoms are also common in many other disorders, such as depression and DID
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Card 2

Front

What does the DSM-IVR require to diagnose schizophrenia?

Back

At least a one-month duration of two or more positive symptoms.

Card 3

Front

What are positive symptoms?

Back

Preview of the front of card 3

Card 4

Front

What are negative symptoms?

Back

Preview of the front of card 4

Card 5

Front

What is the issue of inter-rater reliability?

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