Schizophrenia
Discuss issues associated with the classification and diagnosis of
schizophrenia
AO1
- Schizophrenia is a severe mental disorder where contact with reality
and personal insight are impaired
- It is a type of psychosis which widely known across the world but its
classification is highly controversial
AO3
Diagnosis criteria
- Ranges from country to country – the ICD 10 is used around the
world and the DSM-5 in America
- Each manual describes a different criterion with ICD 10 requiring
two negative symptoms to be present and DSM-5 one positive
symptom
- Decreases the reliability of diagnosis as it is not consistent
- Implications for treatments or care a person receives and can lead
to misdiagnosis which can lead to them questioning their thoughts
and feelings and incorrect medication – side effects
Validity
- Symptom overlap – bipolar disorder also has delusions as a
symptom – may not be sperate issues but instead variations of a
single disorder
- This questions the validity of schizophrenia diagnosis as it may be
trying to label a much larger complex issue as a different disorder
entirely
- Co morbidity is when a patient has two disorders at once
- A study found that 50% of patients also have depression, 29% have
PTSD and 23% have OCD
- Suggests the classification is unclear and unspecified which can lead
to a patient being diagnosed with two disorders
- This lowers the validity of the diagnosis as it is not detailed enough
which has implications in real life as patients receive the wrong or
ineffective treatment
Culture bias
- In western societies we classify symptoms like delusions and
hallucinations as signs of insanity and things which should be cured
- In several African cultures hallucinations are seen as something that
should be celebrated as they are often linked to religious or spiritual
experiences
- Therefore by listing hallucinations as a positive symptom of SC we
are imposing our own cultural beliefs about their experiences onto
other cultures who don’t believe the same thing
- Found that white psychiatrists will often tend to over interpret
symptoms in black people during their diagnosis
, - Those with Afro – Caribbean heritage are seven times more likely to
be diagnosed with SZ in the UK and US than white individuals
- Rates are not higher in African and Caribbean countries
- Decreases the reliability of SZ diagnosis
Discuss the biological explanation for schizophrenia
AO1
Genetics
- The genetic explanation states that schizophrenia is passed on from
one generation to the next through our genes, so therefore runs in
families
- The idea that some people are born with a gene that makes them
predisposed towards developing schizophrenic symptoms
- This means the closer someone is related to a person with
schizophrenia the more likely they would be to get it
- Gottesman found that the probability of identical twins developing
schizophrenia was 48%, went down to 9% for children and, 1% for
general population
Neural Correlates
- Role of dopamine = is widely believed to be involved in
schizophrenia because it is featured in the functioning of brain
systems related to the symptoms of schizophrenia
- Original dopamine hypothesis = high dopamine activity in the
subcortex associated with hallucinations and poverty of speech –
excess of DA receptors in pathways linking from the subcortex to
the Broca’s area
- Updated version = has added low levels of DA in the prefrontal
cortex, could explain negative symptoms – there is less dopamine
activity in the prefrontal cortex. This seems to relate to symptoms
as avolition
AO3
EVIDENCE FOR GENETICS
- Kendler et al (1985) found that the first-degree relatives of those
with SZ were 18 times more at risk at developing the disorder
- This shows that the more genetically similar the greater the risk of
developing SZ
- If there was no genetic element then there should be no difference
in the level of risk between first degree relatives and a random
member of the public (1% risk) but there is
- Adoption studies (Tienari et al 2004) show that biological children of
parents with schizophrenia are at a greater risk even if they grow up
in an adoptive family
HOWEVER
- Family members share more than genetics – usually the more
closely related you are to a person the more likely you are to be
growing up and living in the same environment as each other
Discuss issues associated with the classification and diagnosis of
schizophrenia
AO1
- Schizophrenia is a severe mental disorder where contact with reality
and personal insight are impaired
- It is a type of psychosis which widely known across the world but its
classification is highly controversial
AO3
Diagnosis criteria
- Ranges from country to country – the ICD 10 is used around the
world and the DSM-5 in America
- Each manual describes a different criterion with ICD 10 requiring
two negative symptoms to be present and DSM-5 one positive
symptom
- Decreases the reliability of diagnosis as it is not consistent
- Implications for treatments or care a person receives and can lead
to misdiagnosis which can lead to them questioning their thoughts
and feelings and incorrect medication – side effects
Validity
- Symptom overlap – bipolar disorder also has delusions as a
symptom – may not be sperate issues but instead variations of a
single disorder
- This questions the validity of schizophrenia diagnosis as it may be
trying to label a much larger complex issue as a different disorder
entirely
- Co morbidity is when a patient has two disorders at once
- A study found that 50% of patients also have depression, 29% have
PTSD and 23% have OCD
- Suggests the classification is unclear and unspecified which can lead
to a patient being diagnosed with two disorders
- This lowers the validity of the diagnosis as it is not detailed enough
which has implications in real life as patients receive the wrong or
ineffective treatment
Culture bias
- In western societies we classify symptoms like delusions and
hallucinations as signs of insanity and things which should be cured
- In several African cultures hallucinations are seen as something that
should be celebrated as they are often linked to religious or spiritual
experiences
- Therefore by listing hallucinations as a positive symptom of SC we
are imposing our own cultural beliefs about their experiences onto
other cultures who don’t believe the same thing
- Found that white psychiatrists will often tend to over interpret
symptoms in black people during their diagnosis
, - Those with Afro – Caribbean heritage are seven times more likely to
be diagnosed with SZ in the UK and US than white individuals
- Rates are not higher in African and Caribbean countries
- Decreases the reliability of SZ diagnosis
Discuss the biological explanation for schizophrenia
AO1
Genetics
- The genetic explanation states that schizophrenia is passed on from
one generation to the next through our genes, so therefore runs in
families
- The idea that some people are born with a gene that makes them
predisposed towards developing schizophrenic symptoms
- This means the closer someone is related to a person with
schizophrenia the more likely they would be to get it
- Gottesman found that the probability of identical twins developing
schizophrenia was 48%, went down to 9% for children and, 1% for
general population
Neural Correlates
- Role of dopamine = is widely believed to be involved in
schizophrenia because it is featured in the functioning of brain
systems related to the symptoms of schizophrenia
- Original dopamine hypothesis = high dopamine activity in the
subcortex associated with hallucinations and poverty of speech –
excess of DA receptors in pathways linking from the subcortex to
the Broca’s area
- Updated version = has added low levels of DA in the prefrontal
cortex, could explain negative symptoms – there is less dopamine
activity in the prefrontal cortex. This seems to relate to symptoms
as avolition
AO3
EVIDENCE FOR GENETICS
- Kendler et al (1985) found that the first-degree relatives of those
with SZ were 18 times more at risk at developing the disorder
- This shows that the more genetically similar the greater the risk of
developing SZ
- If there was no genetic element then there should be no difference
in the level of risk between first degree relatives and a random
member of the public (1% risk) but there is
- Adoption studies (Tienari et al 2004) show that biological children of
parents with schizophrenia are at a greater risk even if they grow up
in an adoptive family
HOWEVER
- Family members share more than genetics – usually the more
closely related you are to a person the more likely you are to be
growing up and living in the same environment as each other
