Classification + diagnosis of schizo

What are some examples of positive symptoms?

Delusions, hallucinations, disordered thinking

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What are some examples of negative symptoms?

Alogia (poverty of speech) , affective flattening , avolition (reduction in motivation)

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What is validity? (specific to schizo)

The extent that a diagnosis represents something that is real + distinct from other disorders

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What is comorbidity?

the extent that 2/more conditions can occur alongside one another

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Buckley et al

Estimates comorbid depression occurs in 50% of patients + a lifetime of comorbid drug abuse occurs in 47% of patients

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AO2 Buckley et al

Shows that it is in fact very difficult in diagnosing the disorder + shows maybe how much more complex schizo is

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Klösterkötter et al

489 patients , trying to determine +/- symptoms are better in diagnosing schizo - found + symptoms more useful

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Ellason + Ross

People with DID (dissociative identity disorder) actually have more schizo symptoms than those diagnose with schizo

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Without a valid diagnosis , the consistency of diagnosis cannot be...

reliable

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Which 2 types of reliability is looked at?

Inter-rater reliability + Test-retest reliability

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What is inter-rater reliability?

whether 2 independent assessors give similar diagnoses

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Which diagnostic tools are looked at?

DSM-III , ICD-10 , RBANS

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Carlson (IRR)

DSM-III was reviewed by him + found how successful it was , therefore should have led to an agreement of who had schizo or not

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Whaley (IRR)

Found only an inter-rater reliability correlation of +0.11

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Rosenhan (IRR)

pseudo patients, including Rosenhan claimed they heard voices saying 'thud' 'empty' 'hollow'. They were diagnosed as having schizo , none of the staff noticed they were normal + found once they had been labelled as schizo, was hard to prove otherwise

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AO2 Rosenhan

Also said he'd send in pseudo patients in next 6 months, he didnt + detection rate dropped by 21%. Also another point is that the researcher should never get involved himself , otherwise they might get too involved + forget what the actual aim was.

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What is test-retest reliability?

Whether tests used in diagnosis are consistent over time

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What is RBANS?

a diagnostic tool used to measure the neurophysiological impairement

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Wilks et al (TRR)

Administered 2 forms of the RBANS test over 1-134 days + found that the test-retest was high as 0.84 - showing maybe this test should be used instead of DSM/ICD

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Cheniaux et al (TRR)

Tested the test-retest reliability of DSM-III + ICD-10 + found it was above +0.50 for both. however more were freq. diagnosed with ICD-10. still pretty poor

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Issues with schizo diagnosis?

Can't really come up with a valid diagnosis + therefore reliable classification system because there is a lack of understanding of the nature of schizo + what it actually is. E.G. undifferenciated schizo- patient doesn't fit any other types.

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Implications?

If we can come up with a better diagnosis + understanding of the disease, then this can lead to a treatment to improve the lives of those with the disease

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Get Revising

Classification + diagnosis of schizo

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