Classification Issues

• schizophrenia is a type of psychosis that causes a huge disruption of cognition and emotion
• studies have shown that living in cities increases the risk of an individual developing schizophrenia
• schizophrenia is the most common psychotic disorder, with it effecting 1% of the population at some point in their life
• according the the DSM-5, an individual would need to showcase two or more positive symptoms of schizophrenia to be diagnosed
• according to the ICD-10, an individual would need to showcase two or more negative symptoms of schizophrenia to be diagnosed

  the ICD-10 also has subtypes of schizophrenia (e.g. catatonic schizophrenia) that the DSM doesn't have
• positive symptoms include:

  1. paranoid delusions- where an individual believes that something/someone is trying to hurt them in anyway
  2. delusion of grandeur- where an individual believes they have imaginary power or authority (e.g. having a mission from god)
• negative symptoms include:

  1. avolition- finding it difficult to keep up with their goals, like having poor hygiene
  2. speech poverty- changes in patterns of speech as well as occupied by a delay in verbal responses during a conversation which reflects slowing or blocked thoughts
• gender bias: the accuracy of the diagnosis depends on the gender of the individual. this can be due to gender bias being present in the diagnostic material or clinicians basing their judgements on stereotypical beliefs
• co-morbidity: this is the occurrence of two illnesses or conditions together, for example, a person with both schizophrenia and depression. where two conditions are frequently diagnosed together. this questions the validity of classifying the two disorders
• symptom overlap: the use of positive and negative symptoms were created in the hope that schizophrenia diagnoses would be more valid. however, may of the symptoms overlap with other disorders like depressions or bipolar disorder.
• cultural differences: research suggests that there are significant differences between countries when it comes to diagnosing schizophrenia
• stigma: people who suffer from mental health problems often face stigmatisation from society. this makes it harder for them to seek treatment and recover from their condition. this could lead to misdiagnosis if someone feels uncomfortable seeking medical attention
• social constructionism: the idea that our understanding of reality is shaped by social factors rather than objective truths. this suggests that the way we define mental illness is influenced by cultural norms and values. this means that the criteria used to make a diagnosis of schizophrenia may change over time depending on societal attitudes towards mental illness
• Elie Cheniaux et al (2009) had two psychiatrists independently diagnose 100 patients of schizophrenia using both the DSM and ICD criteria. the intra-rater reliability was poor, with one psychiatrist diagnosing 26 patients with schizophrenia using the DSM and 44 using the ICD. the other psychiatrist diagnosed 13 patients using the DSM and 24 with the ICD.
• Longenecker et al (2010) reviewed studies of schizophrenia and concluded that since the 1980s men have been diagnosed with schizophrenia more often than women. it appears that female patients typically function better than men, being more likely to work and have a family which may be why practitioners under diagnose schizophrenic women.