Schizophrenia
Schizophrenia= type of psychosis/mental disorder
- Characterised by loss of contact with reality
- 1 in 100 in the uk
- Men, cities, low socio economic groups
Positive symptoms = Undesirable additional experiences
→ Hallucinations = unusual sensory experiences
→ Delusions = irrational beliefs
→ Speech disorganisation = incoherent or random speech
→ Disorganised thinking
Negative symptoms = Loss of usual abilities/or experiences
→ Avolition/apathy = reduced motivation/attention
→ Speech poverty = changes in quality of speech
Classification:
DSM-5: At least 1 positive symptom or speech disorganisation
ICD-10: 2 or more negative symptoms
, Reliability and validity in classification and diagnosis of schizophrenia
AO1 VALIDITY
Within the context of schizophrenia, validity refers to the extent that a classification system
such as the DSM and ICD measures what it claims to measure. Also the extent to which a
diagnosis represents something distinct from other disorders.
One issue is comorbidity which is the occurrence of two illnesses being diagnosed together.
This is common among patients with schizophrenia because they often suffer with
depression, substance abuse, or anxiety, making it difficult for psychiatrists to know which
symptoms belong to which disorder, consequently threatening the validity or their diagnosis
and classification.
Another issue is gender bias which occurs when the accuracy of diagnosis is dependent on
the gender of an individual, which could be influenced by stereotypical judgements about
them. Since 1980’s, men have been diagnosed with schizophrenia more commonly than
women in the ratio 1.4 : 1. This reduces the accuracy of diagnosis which reduces the validity.
A third issue is symptom overlap where there is a considerable overlap between the
symptoms of schizophrenia and the symptoms of other conditions. For example Bipolar and
schizophrenia both involve positive symptoms (delusions) and negative symptoms
(avolition). This makes it hard to distinguish between the two disorders.
A03 VALIDITY
● Issue of comorbidity is supported by research
Buckley et al concluded that comorbid depression occurs in 50% of schizophrenic patients,
and typically 47% of patients also have a lifetime diagnosis of comorbid substance abuse.
They also reported an estimated prevalence of 15% for panic disorder and 29% for post
traumatic stress disorder. This demonstrates how many disorders can occur at the same
time. Therefore highlighting the issue that the high rates of comorbidities among
schizophrenia patients can affect the validity of their diagnosis and classification.
● Issue of gender bias is supported by research
Loring and Powell randomly selected 290 male and female psychiatrists to read two case
studies of patient’s behaviour. They then used standard diagnostic criteria to assess the
patients. It was found that 56% of patients were diagnosed with schizophrenia if they were
presented as ‘male’ or with no gender identified, but only 20% were diagnosed if presented
as ‘female’. However, this bias wasn’t present among female clinicians meaning that gender
bias depends not only on the gender of the patient but also the gender of the clinician.
Therefore, gender bias reduces the validity of diagnosis.
● Symptom overlap can lead to negative real world implications
Ketter reports that symptom overlap often leads to misdiagnosis which can lead to years of
delay in receiving necessary treatment. During this time suffering can occur along with high
levels of suicide. This does not only affect the patients wellbeing, but has an economic
impact on the NHS as there is further pressure when relapse occurs.
Schizophrenia= type of psychosis/mental disorder
- Characterised by loss of contact with reality
- 1 in 100 in the uk
- Men, cities, low socio economic groups
Positive symptoms = Undesirable additional experiences
→ Hallucinations = unusual sensory experiences
→ Delusions = irrational beliefs
→ Speech disorganisation = incoherent or random speech
→ Disorganised thinking
Negative symptoms = Loss of usual abilities/or experiences
→ Avolition/apathy = reduced motivation/attention
→ Speech poverty = changes in quality of speech
Classification:
DSM-5: At least 1 positive symptom or speech disorganisation
ICD-10: 2 or more negative symptoms
, Reliability and validity in classification and diagnosis of schizophrenia
AO1 VALIDITY
Within the context of schizophrenia, validity refers to the extent that a classification system
such as the DSM and ICD measures what it claims to measure. Also the extent to which a
diagnosis represents something distinct from other disorders.
One issue is comorbidity which is the occurrence of two illnesses being diagnosed together.
This is common among patients with schizophrenia because they often suffer with
depression, substance abuse, or anxiety, making it difficult for psychiatrists to know which
symptoms belong to which disorder, consequently threatening the validity or their diagnosis
and classification.
Another issue is gender bias which occurs when the accuracy of diagnosis is dependent on
the gender of an individual, which could be influenced by stereotypical judgements about
them. Since 1980’s, men have been diagnosed with schizophrenia more commonly than
women in the ratio 1.4 : 1. This reduces the accuracy of diagnosis which reduces the validity.
A third issue is symptom overlap where there is a considerable overlap between the
symptoms of schizophrenia and the symptoms of other conditions. For example Bipolar and
schizophrenia both involve positive symptoms (delusions) and negative symptoms
(avolition). This makes it hard to distinguish between the two disorders.
A03 VALIDITY
● Issue of comorbidity is supported by research
Buckley et al concluded that comorbid depression occurs in 50% of schizophrenic patients,
and typically 47% of patients also have a lifetime diagnosis of comorbid substance abuse.
They also reported an estimated prevalence of 15% for panic disorder and 29% for post
traumatic stress disorder. This demonstrates how many disorders can occur at the same
time. Therefore highlighting the issue that the high rates of comorbidities among
schizophrenia patients can affect the validity of their diagnosis and classification.
● Issue of gender bias is supported by research
Loring and Powell randomly selected 290 male and female psychiatrists to read two case
studies of patient’s behaviour. They then used standard diagnostic criteria to assess the
patients. It was found that 56% of patients were diagnosed with schizophrenia if they were
presented as ‘male’ or with no gender identified, but only 20% were diagnosed if presented
as ‘female’. However, this bias wasn’t present among female clinicians meaning that gender
bias depends not only on the gender of the patient but also the gender of the clinician.
Therefore, gender bias reduces the validity of diagnosis.
● Symptom overlap can lead to negative real world implications
Ketter reports that symptom overlap often leads to misdiagnosis which can lead to years of
delay in receiving necessary treatment. During this time suffering can occur along with high
levels of suicide. This does not only affect the patients wellbeing, but has an economic
impact on the NHS as there is further pressure when relapse occurs.
