Schizophrenia
Question: Outline and evaluate the diagnosis and classification of
schizophrenia.
AO1: • Schizophrenia --> a mental disorder that affects 1% of the
6 population characterised by disruptions in thought processes,
perceptions and social interactions.
• Classification of schizophrenia --> schizophrenia does not have a
single defining characteristic; it has many symptoms unrelated
symptoms.
- Two major classification systems: World Health Organisation’s
International Classification of Diseases Edition 10 (ICD-10) and
the American Psychiatric Association’s Diagnostic and Statistical
Manual Edition 5 (DSM-5).
- Classification --> DSM-5 requires one positive symptom to be
present, ICD-10 requires two or more negative symptoms to be
present.
- If an individual displays two of the four main symptoms, and these
have persisted for 6 months or more then they will be diagnosed
with schizophrenia.
• Positive symptoms --> additional experiences to a person’s ordinary
behaviour. They include hallucinations and delusions.
- Hallucinations --> are distorted perceptions of reality that feel
like unusual sensory experiences. The most common hallucinations
are auditory ones, for example a schizophrenic person may
hallucinate hearing voices that aren’t there.
- Delusions --> false beliefs that are firmly held even if they are
illogical or there is no evidence to support them.
• Negative symptoms --> lack of abilities associated with normal
functioning resulting in a loss of functioning. They include speech
poverty and avolition.
- Speech poverty --> inability to speak properly. A person will not
be able to produce fluent words; due to slowing or blocked
thoughts.
- Avolition --> lack of desire and motivation for anything. People
will be unable to start and continue with goal-directed behaviour.
AO3: • Culture bias in diagnosis
10 - Escobar (2012) found that white psychiatrists tended to over-
interpret symptoms and distrust the honesty of black people during
diagnosis. This could be due to a Western psychiatrist would not
understand that positive symptoms of SZ like auditory
hallucinations, are a norm in African cultures. So cultural
differences in language and mannerisms is the issue. Therefore,
clinicians and researchers must pay attention to the effects of
cultural differences on diagnosis.
• Gender bias in diagnosis
- Longenecker concluded that men since the 1980s are much more likely
to be diagnosed than women. This is due to them being more
genetically vulnerable to SZ, but this suffers from gender bias as
women’s better interpersonal functioning may bias practitioners to
under-diagnose SZ in women and over-diagnose it in men. This
decreases the validity as it means that many women are left
undiagnosed.
• Issue of co-morbidity
- Buckley et al (2009) found half of patients with a diagnosis of EZ
also have a diagnosis of depression. 47% of patients had a
diagnosis of substance abuse. This shows that SZ commonly occurs
32
, alongside other mental illnesses and the disorders are co-morbid.
This makes the classification and diagnosis of SZ less valid as
people may become misdiagnosed or undiagnosed in the diagnosis.
33
Question: Outline and evaluate the diagnosis and classification of
schizophrenia.
AO1: • Schizophrenia --> a mental disorder that affects 1% of the
6 population characterised by disruptions in thought processes,
perceptions and social interactions.
• Classification of schizophrenia --> schizophrenia does not have a
single defining characteristic; it has many symptoms unrelated
symptoms.
- Two major classification systems: World Health Organisation’s
International Classification of Diseases Edition 10 (ICD-10) and
the American Psychiatric Association’s Diagnostic and Statistical
Manual Edition 5 (DSM-5).
- Classification --> DSM-5 requires one positive symptom to be
present, ICD-10 requires two or more negative symptoms to be
present.
- If an individual displays two of the four main symptoms, and these
have persisted for 6 months or more then they will be diagnosed
with schizophrenia.
• Positive symptoms --> additional experiences to a person’s ordinary
behaviour. They include hallucinations and delusions.
- Hallucinations --> are distorted perceptions of reality that feel
like unusual sensory experiences. The most common hallucinations
are auditory ones, for example a schizophrenic person may
hallucinate hearing voices that aren’t there.
- Delusions --> false beliefs that are firmly held even if they are
illogical or there is no evidence to support them.
• Negative symptoms --> lack of abilities associated with normal
functioning resulting in a loss of functioning. They include speech
poverty and avolition.
- Speech poverty --> inability to speak properly. A person will not
be able to produce fluent words; due to slowing or blocked
thoughts.
- Avolition --> lack of desire and motivation for anything. People
will be unable to start and continue with goal-directed behaviour.
AO3: • Culture bias in diagnosis
10 - Escobar (2012) found that white psychiatrists tended to over-
interpret symptoms and distrust the honesty of black people during
diagnosis. This could be due to a Western psychiatrist would not
understand that positive symptoms of SZ like auditory
hallucinations, are a norm in African cultures. So cultural
differences in language and mannerisms is the issue. Therefore,
clinicians and researchers must pay attention to the effects of
cultural differences on diagnosis.
• Gender bias in diagnosis
- Longenecker concluded that men since the 1980s are much more likely
to be diagnosed than women. This is due to them being more
genetically vulnerable to SZ, but this suffers from gender bias as
women’s better interpersonal functioning may bias practitioners to
under-diagnose SZ in women and over-diagnose it in men. This
decreases the validity as it means that many women are left
undiagnosed.
• Issue of co-morbidity
- Buckley et al (2009) found half of patients with a diagnosis of EZ
also have a diagnosis of depression. 47% of patients had a
diagnosis of substance abuse. This shows that SZ commonly occurs
32
, alongside other mental illnesses and the disorders are co-morbid.
This makes the classification and diagnosis of SZ less valid as
people may become misdiagnosed or undiagnosed in the diagnosis.
33
