Classification of Schizophrenia

• Schizophrenia


  A severe mental disorder where contact with reality and insight are impaired
• Classification of mental disorder


  The process of organising symptoms into categories based on which symptoms cluster together in people with mental disorders
• Positive Symptoms of Schizophrenia


  Atypical symptoms experienced in addition to normal experiences. Examples include hallucinations and delusions
• Negative Symptoms of Schizophrenia


  Atypical experiences that represent the loss of a usual experience such as clear thinking. Examples include speech poverty and avolition
• Hallucinations


  Sensory experiences of stimuli that have no basis in reality or are distorted perceptions of things that are there
• Delusions


  Involve beliefs that have no basis in reality. This may include thinking they are a celebrity
• Speech Poverty


  Involves reduced frequency and quality of speech
• Avolition


  The loss of motivation to carry out tasks and involves lowered activity levels
• Co-morbidity


  The occurrence of 2 disorders together for example having schizophrenia and a personality disorder. When 2 are diagnosed together it calls into question the validity of classifying the 2 disorders separately
• Symptom Overlap


  Occurs when 2 or more conditions share symptoms
• Statistics of Schizophrenia

  • Severe mental disorder experienced by 1% of the population
  • More commonly diagnosed in men than women
  • More commonly diagnosed in cities than in country sides
  • More common in working class people than middle class people
• AO3 Diagnosing: Good reliability

  • Reliability means consistency
  • Reliability for schizophrenia diagnosis was previously low but has now improved
  • 180 people were diagnosed for schizophrenia using the DSM-5
  • Pairs of interviewers achieved inter-rater reliability of +0.97 and test retest of +0.92
• AO3 Diagnosing: Low Validity

  • Validity concerns whether we assess what we are trying to assess
  • On way to assess validity is criterion validity
  • 2 psychiatrists independently assessing the same 100 clients using ICD and DSM-5 and 68 were diagnosed with ICD and 39 with DSM-5
  • Schizophrenia is either under or over diagnosed so criterion validity is low
• AO3 Diagnosing: Co-morbidity

  • If conditions occur at the same time it calls into question the validity of the diagnosis as they might only have 1 condition
  • Schizophrenia is usually diagnosed with other conditions
  • About half the people with schizo also have depression
  • This becomes an issue as schizo is no longer a distinct condition
• AO3 Diagnosing: Gender Bias

  • Men have been diagnosed more than women as women are less vulnerable than men because of genetic factors
  • Women are underdiagnosed because they have closer relationships and get support and function better with schizophrenia
  • Women may not be receiving the treatment they need
• AO3 Diagnosing: Culture Bias

  • Some symptoms such as hearing voices have different meanings in different cultures
  • In some Afro- Caribbean cultures it is communication from ancestors
  • Afro-Caribbeans in the UK are 10 times likely to receive a diagnosis than white people
  • Afro-Caribbean people may be discriminated against by a culturally biased system
• AO3 Diagnosing: Symptom overlap

  • There is considerate overlap between the symptoms of schizo and the symptoms of other conditions
  • Both schizo and bipolar disorder have positive and negative symptoms
  • In terms of classification it would suggest that they may not be 2 different condition but variations of a single condition
  • Schizo is then hard to distinguish from bipolar disorder
• Study on validity of diagnosis of schizophrenia: Rosenham

  • 8 Sane confederates went to 12 psychiatric hospitals claiming to have schizophrenic symptoms
  • Once they arrived in the hospital they then acted 'normally'
  • All hospitals diagnosed confederates as mentally ill
  • None of the staff recognised that they were healthy
  • It took between 7 and 52 days for them to be discharged with the mean length of stay being 19 days
• AO3 Rosenham: Methodological issues and wider implications

  • It was a small sample so it is hard to generalise results to the wider population
  • People with schizophrenia may be under and over diagnosed so may not be getting the help they need