Schizophrenia

• Schizophrenia in the Population

  • Affects about 1% of the population.
  • Symptoms first show in mid to late adolescence.
• Psychological Classification of SZ

  • ICD-10 needs 2 or more negative symptoms.
  • DSK-5 needs only 1 positive symptom and 1 negative symptom.
• Types of SZ

  • Paranoid SZ is characterised by powerful delusions and hallucinations
  • Hebephrenic SZ involves mainly negative symptoms.
  • Catatonic SZ involves disturbances in movement, leaving the sufferer immobile.
• Positive Symptoms of SZ

  • Symptoms that are not present in non-schizophrenic individuals and include hallucinations and delusions.
• Negative Symptoms

  • The loss of usual abilities and experiences, such as a volition and speech poverty.
• Cheniaux et al. (2009)

  • 100 patients were diagnosed by independent psychiatrists using both ICD-11 and DMS-5.
  • Results showed poor reliability,
• Validity of SZ Diagnosis

  • Diagnosis suffers form a number of validity issues, including : Co-morbidity ; Symptom overlap ; Gender Bias ; Cultural Bias.
• Co-Morbidity

  • The extent which two or more conditions occur together, calling into question the validity of diagnosis.
  • It could be that very severe depression can present as schizophrenia because the signs look a lot like it.
• Buckley et al. (2009)

  • Found that around half of all patients diagnosed with SZ also had a diagnosis of depression. This factor is called into question the ability to tell the difference between the two conditions and diagnose accurately.
• Symptom Overlap

  • Refers to the extent to which the symptoms of one disorder are also present in a different disorder.
  • E.G: SZ and Bipolar both include symptoms such as delusions and avolition.
• Gender Bias SZ

  • A disproportionate number of men are diagnosed with SZ in comparison to women.
• Cotton et al. (2009)

  • While it could be that men are more commonly diagnosed as they are genetically vulnerable, it may be that women are able to function better with the disorder than men.
• Cultural Bias SZ

  • A higher number of African American and Afro-Caribbean descent are diagnosed with SZ compared to in Africa and the West Indies.
  • Some African cultures have different attitudes to some positive symptoms, such as hearing voices, which may be acceptable due to their believes with communicating to ancestors.
• Escobar (2012)

  • Because the psychiatric profession is dominated by white people, psychiatrists might be over-interpreting symptoms and distrusting the honesty of black people for diagnosis.
• Māori Culture

  • Some symptoms of schizophrenia are seen as acceptable in some cultures. For example, a study of 80 Māori people showed they deemed hearing voices to be completely normal.
• Pinto et al (2017).

  • Investigate the risk of schizophrenia in Black Caribbean people and their descendants, as a meta-analysis of databases from 1950-2013.
  • Elevated incidence rates in Black Caribbean groups were found, present across all major psychotic disorders.
• Copeland et al (1971).

  • An investigation into cultural variations in the diagnosis of schizophrenia.
  • In an experiment, Copeland (1971) gave 134 US and 194 British psychiatrists a description of a patient.
  • 69% of the US psychiatrists diagnosed SZ but only 2% of the British ones gave the same diagnosis.
  • Diagnosis of SZ in not reliable between cultures.
• Family Dysfunction

  • Family relations, communication patterns and though processes that do not support upbringing.
• Theory of Expressed Emotion SZ

  • If family of high levels of negative expressed emotion cause greta deals of stress, this can be an initial onset factor for schizophrenia.
  • This is also correlated to relapses in SZ patients.