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What is a difference between ICD-10 and DSM-5 in classifying schizophrenia? - DSM-5
... [Show More] must have one of the positive symptoms for diagnosis whereas ICD-10 must have two or more negative symptoms.
Positive symptoms - additional experiences beyond those of ordinary existence e.g. hallucinations and delusions
Hallucinations - -unusual sensory experiences
-some are related to events in the environment whereas others may have no relation to the env. they're in e.g. voices talking to or commenting on a person -can be from any sense e.g. distorted faces, people/animals that aren't there
Delusions - - also known as paranoia
-are irrational beliefs
- examples are delusions of grandeur, delusion of persecution, their body is under external control
-they make one behave in a way that makes sense to them but seem bizarre to others
Other examples of positive symptoms - 1) Disorganised thinking- breaks or interpolations in train of thought
2)Catatonic behaviour-strange positions or movements, moments of motionlessness, rigid or excessive movement
3)Speech disorganisation-speech becomes incoherent or speaker changes topic midsentence
Negative symptoms - the loss of usual abilities and experiences e.g. speech poverty and avolition
Speech poverty - reduction in the amount and quality of speech. is often accompanies by a delay in the verbal responses during conversation.
Avolition - finding it difficult to begin or keep up with goal-directed activity. often have a sharply reduced motivation to do a range of activities.
Andersen identified 3 signs: poor hygiene and grooming, lack of persistence in work/education and lack of energy.
Reliability - -consistency of symptom measurement
-can be measured by inter-rater reliability which is the extent that two or more MH professionals arrive at the same diagnosis for the same patients, as well as test-retest reliability
Reliability of ICD and DSM-5- concordance rates - Soderberg et al reported a concordance rate of 81% using DSM whereas Nilsson et al found only a 60% concordance rate using ICD classification system which implies that DSM is more reliable
Validity - the extent to which we are measuring what we are intending to measure so how accurate the diagnosis is
-a way to assess it is criterion validity
What is schizophrenia? - a serious mental disorder experienced by about 1% of the world that is more common in men, city-dwellers and lower socio-economic groups. it is an example of psychosis as the contact with reality and insight is impaired.
Classification of mental disorders - The process of organising symptoms into categories based on which symptoms cluster together in sufferers
How is reliability a strength of diagnosing Sz? - Osorio et al reported excellent reliability for diagnosis in 180 individuals using DSM-5. Pairs of interviewers achieved inter-rater reliability of +.97 and T-R reliability of +.92
How is validity a limitation of diagnosis of Sz? - Cheniaux et al had 2 psychiatrists independently assess the same 100 clients using ICD and DSM. Found that 68 diagnosed with Sz using ICD and 39 under DSM, so the systems may over or underdiagnose Sz
How is co-morbidity a limitation of diagnosis of Sz? - it questions the validity of diagnosis and classification as the conditions may be a single condition.
Buckley et al. found that about half of those diagnosed with Sz were also diagnosed with depression.
How is gender bias a limitation of diagnosis of Sz? - Since the 1980s, men have been diagnosed with it more (Fischer and Buchanan). This may mean women are less vulnerable to it than men due to genetic factors. However, it seems that women are underdiagnosed as they have closer relationships ad get support (Cotton et al). Sz women function better than Sz men.
How is culture bias a limitation of diagnosis of Sz? - Some symptoms like hearing voices have diff meaning sin diff cultures. In Haiti, it is considered communications with ancestors. Afro-Caribbean British people are up to 9x more aren't to be diagnosed than white British people (Pinto and Jones), although people in Afro-Caribbean countries arent, which rules out a genetic vulnerability.
How is system overlap a limitation of diagnosis of Sz? - there is an overlap of symptoms of Sz and symptoms of other conditions, such as bipolar disorder which involves neg. symptoms (Delusions) and pos. symptoms (avolition).
-in terms of classification, Sz and BPD may be variations of a single disorder -in terms of diagnosis, they are hard to distinguish
What are the 2 biological explanations for Sz? - genetics and neural
Genetic basis of SZ- Family studies - Family studies have confirmed the increased risk if you have a relative with SZ. Gottesman found that someone with a SZ aunt has 2% chance and someone with a sibling is 9% and for an MZ twin, it is 48%. For DZ, it is 17%.
Genetic basis of SZ- candidate genes - SZ is polygenic and the most likely genes would be those coding for dopamine.
Ripke et al combined all previous data from genome-wide studies- genetic makeup of 37000 SZ people to 113000 controls, 108 genetic varia [Show Less]