Classification & Diagnosis - Schizophrenia

• Schizophrenia is a psychotic disorder characterised by hallucinations and delusions.
• Schizophrenia has a prevalence of 1% in the general population and can be diagnosed as acute or chronic, depending on the symptoms.
• Schizophrenia can affect both men and women but is more commonly diagnosed in men.
• The onset of schizophrenia in men tends to be around the ages of 18-25 years old.
• The onset of schizophrenia in women tends to be around the ages of 25-30 years old.
• Acute (type I) schizophrenia has more positive symptoms and responds well to treatment.
• Chronic (type II) schizophrenia has more of the negative symptoms and is less responsive to treatment.
• Classification of mental disorder is the process of organising symptoms into categories based on which symptoms frequently cluster together.
• The two main classification systems for mental health disorders are; the international classification of disease (ICD) outlined by the World Health Organisation, which is currently on version 11, and the diagnostic and statistical manual version 5 which is outlined by the American Psychiatric Association.
• A diagnostic system such as DSM or ICD is used to categorise the symptoms in order to make a formal diagnosis for treatment.
• Each diagnostic system has a set of criteria specific to every disorder which helps classify the symptoms so patients receive a reliable and valid diagnosis.
• The Diagnostic Statistical Manual (DSM) is currently on version 5 and recognises groups of symptoms that make up a particular disorder.
• Positive symptoms all those are in addition to normal life experiences and are mostly concerned with losing touch of reality.
• Positive symptoms of schizophrenia include hallucinations, delusions, and disorganised thinking.
• Cognitive symptoms of schizophrenia include difficulties with attention, memory, and executive functioning.
• Negative symptoms detract from normal life experiences and can include anhedonia (loss of pleasure in life), disturbances of affect like emotional flattening and disturbances in thought processing and psychomotor ability.
• Studies have suggested that men are more likely to present with positive symptoms of schizophrenia whereas women are more likely to present with the negative symptoms.
• The symptoms of schizophrenia can interfere severely with everyday tasks, so that many people with schizophrenia end up homeless or hospitalised.
• To get a diagnosis, patients would typically self-report symptoms in a clinical interview with a psychiatrist. The observations of a family member or friend would also be taken into account.
• During the diagnosis process questions would be asked about everyday functioning, early life and childhood.
• The diagnosis process can take several months and depending on the onset, patients may need to be hospitalised beforehand.
• Patients with sudden and severe mental health issues may be admitted to a hospital for their own safety and may be sectioned under the Mental Health Act (2007).
• Diagnosis and classification are interlinked, in order to diagnose a specific clinical disorder we must distinguish one disorder from another.
• The ICD-11 and DSM-5 are the two main classification systems for mental health disorders, including schizophrenia.
• The onset of schizophrenia tends to occur in early adulthood, with men experiencing symptoms around the ages of 18-25 and women around the ages of 25-30.
• To distinguish one disorder from another we identify clusters of symptoms that occur together and subsequently classify this as one disorder.
• Diagnosis is possible by identifying symptoms and deciding based on the criteria which disorder a patient has.
• The DSM-5 criteria for diagnosing schizophrenia include the presence of at least two of the following symptoms: delusions, hallucinations, disorganised speech, grossly disorganised or catatonic behaviour, and negative symptoms.