classification of symptoms

• Sz is a psychotic disorder, onset is usually late adolescence


  term 'psychosis' encompasses several symptoms associated with significant alternations to a person's perception, thoughts, mood and behaviour, the person has no concept of reality

  the DSM-5 and the ICD-10 are used to diagnose Sz

  the economic cost of Sz is very great
• diagnostic criteria for Sz (ICD-11) require symptoms to be present fr most of the time for a month or more:

  hallucinatory voices

  thoughts echo

  delusions

  persistent delusions

  incoherence or irrelevant speech

  catatonic behaviour like excitement

  negative symptoms

  change in personal behaviour
• positive symptoms

  an excess or distortion of normal functioning

  internal voices not heard by others

  believing other people can read their minds

  may leave them fearful and withdrawn

  speech and behaviour can be disorganised that they may be incomprehensible or frightening of others
• negative symptoms 


  cause a decline in functioning

  negative symptoms appear to reflect a loss of normal functioning

  may not be able to work at a job that requires a large amount of concentration

  can affect their ability to function at home: unable to complete household chores, raise children or maintain an active social life
• delusion: false beliefs that are firmly held despite being illogical 


  persecution: the belief that people want to harm, threaten or manipulate you

  grandeur: belief that you are an important individual, god-like

  control: belief that they are under the control of an alien force that has invaded their mind or body
• hallucinations: disturbances in perceptions, no basis in reality


  auditory: hearing voices, hallucinations can also be smells and sights

  could appear to be a single person talking, or many people, familiar and unfamiliar

  hearing voices: instruct them to do something or tell them they are wicked and evil
• speech poverty: lack of ability to produce fluent words


  alogia: the inability to speak properly

  thought to reflect slowing or blocked thoughts

  can manifest itself as short and empty replies to questions
• avolition: the reduction, difficulty or inability to start and continue with goal-directed behaviour 


  mistaken for apparent disinterest

  includes poor hygiene

  social withdraw: no longer being interested in going out and meeting with friends

  anhedonia: no longer being interested in activities that the person used to show enthusiasm for

  flat affect: lacking emotions and energy
• reliability: the consistency of the data, when repeated the same results are found


  improved through inter-rater reliability: two or more psychiatrists need to agree with 0.8 concordance in their diagnosis

  importance: inconsistent diagnosis could mean that a type 11 error might be made where patients are diagnosed incorrectly, to ensure that the data can be replicated
• validity: the accuracy of the measure of the DV


  needs to be accurate, gender culture and use of different statistical manuals can all affect the diagnosis

  improved: reducing other factors that could affect diagnosis, eliminate biases, use high levels of controls to eliminate any extraneous variables

  importance: use of valid data provides the empirical evidence needed, taking anti-psychotic medications can be fatal
• co-morbidity: two or more disorders exist at the same time it becomes difficult to diagnose them 


  when two disorders are diagnosed together, it questions the validity of the classifications of them

  the findings of the research could be due to the psychiatrists not being able to tell the difference between the two conditions

  Buckely et al (2009) concluded that half of patients with Sz also have a diagnosis of depression (50%) or substance abuse (47%)

  PSTD in 29% and OCD in 23% shows Sz commonly occurs alongside other mental illnesses
• symptom overlap: when symptoms of one condition overlap with another condition, difficult to diagnose a more sever disorder


  Sz and bipolar disorder both share positive symptoms

  Ellason and Ross (1995): people with DID have more Sz symptoms than people diagnosed with Sz using the ICD

  Ophoff et al (2011): assessed genetic material from 50,000 p's to find that of seven gene locations on the genome associated with Sz, three were also associated with bipolar disorder suggesting a genetic overlap between the two disorders
• symptom overlap

  Ketter (2005): misdiagnosis due to symptom overlap can lead to delays in recieving relevant treatment, where degeneration and suicide can occur, therefore fixing the issue can save money and lives
• gender bias: diagnostic criteria are based where females tend to be pathologized more frequently than males and androcentrism


  Broverman et al (1970) found that clinicians in the US equated mentally healthy 'adult' behaviour with mentally healthy 'male' behaviour therefore women can be seen as mentally ill when they don't follow male behaviour

  Loring and Powell (1988): randomly selected 290 psychiatrists to look at 2 cases, 56% males were diagnosed with Sz and 20% females, shows gender bias is influenced by both gender of the patient and clinician
• culture bias: variation in diagnosis of Sz across different cultures

  Harrison et al (1984): showed that West Indian Black people were being diagnosed with Sz

  Copeland et al (1971): gave a description of a p to 134 US and 194 British psychiatrists, 69% US diagnosed Sz and 2% of British diagnosed Sz

  suggests that the symptoms of ethnic minorities are misinterpreted, questions the reliability of the diagnosis of Sz as they can be influenced by their ethnic background: e.g. hallucinations may not be seen as an issue because it can be a sign of communication with ancestors