Diagnosis & Classification

• (AO1) Define diagnosis

  Refers to identifying the illness a person may have.
• (AO1) Define reliability and validity of diagnosis

  Reliability:

  Refers to the level of agreement by different psychiatrists across time and between cultures.

  
  

  Reliable diagnosis if - practitioners are in agreement over who has SZ (if seen by x2 doctors, both should diagnose SZ if diagnostic tool is reliable) + if the diagnosis is stable as there is no change in symptoms over time.

  
  

  Validity:

  If Valid diagnosis - refers to whether the measure used, In UK its the DSM5, is actually measuring SZ.
• (AO1) Define classification

  Classification refers to the disorder itself, defining what it is.
• (AO1) Define reliability and validity in the classification

  Reliability refers to whether Schizophrenia itself is a consistent disorder or whether it in fact changes over time.

  
  

  Whereas the validity of the classification considers whether Schizophrenia is a disorder in itself, or whether it is for example a type of depression.
• (AO3) Give an evaluation

  P: Rosenhan's Experiment - Being Sane In Insane Places

  
  

  E: 11 went doctors saying having auditory hallucinations (hearing thud, empty, hollow), had poor hygiene (not brushing teeth). Research questions ability of medical staff to differentiate between healthy / have SZ = diagnostic tool not valid. + measure is reliable, all patients admitted with same symptoms = high agreement between different doctors.

  
  

  HOWEVER: can be argued medical staff chose safest decision, had auditory hallucinations, trusted/believed patients = paint psychiatry in positive light.
• (AO3) Give evaluation - L

  Point: Comorbidity (more than one mental health issue occurs to the same individual at same time) challenges validity of SZ as a distinct disorder.

  
  

  Evidence: Buckley et al found 50% of SZ ppl also have depression - likely due to social isolation. 47% have substance abuse - using drugs to cope. 29% develop PTSD - from psychotic episode trauma. 23% have OCD - heightened anxiety like continuous hand-washing.

  
  

  Evaluate: High co-morbity suggests SZ may be mix of overlapping conditions, complicating diagnosis & treatment.
• (AO3) Evaluate

  Point: Cultural differences cause inconsistencies in SZ diagnosis.

  
  

  Evidence: (Doctors Culture): A study found 69% of US psychiatrists diagnosed SZ, compared to 2% of British, suggesting US over-diagnosis and UK under-diagnosis, both risking patient harm.

  
  

  Evidence: (Patients Culture): Black patients face over-diagnosis due to communication barriers with white psychiatrists and the myth that they rarely experience affective disorders.

  
  

  Evaluate: These biases lead to unjust treatment, job loses, involuntary hospitalisation, and stigma - highlighting the need for culturally aware diagnoses.
• (AO3) Evaluation

  Point: Gender bias affects SZ diagnosis, leading to under-diagnosis of women.

  
  

  Evidence: 290 psychiatrists assessed x2 case studies of patients' behaviour using standard criteria. Men were diagnosed more often, while women less likely, increasing risk of untreated symptoms. However, only male psychiatrists showed this bias; female psychiatrists were more consistent/fair.

  
  

  Evaluate: Highlights dangers of gender bias, suggesting need for more female psychiatrists to improve diagnostic accuracy.
• (AO1) Define system overlap and give 2 examples

  There is a considerable overlap between the symptoms of schizophrenia and other conditions.

  E.G. Depression – avolition

  E.G. Bipolar – delusions
• (AO3) Link Seper et al (1999) to symptom overlap

  Point: Symptoms overlap challenges the validity of SZ diagnosis, as many symptoms also appear in DID, depression and substance abuse disorders, risking misdiagnosis.

  
  

  Evidence: Seper assessed patients with SZ, cocaine abuse, and both combined. Despite symptoms overlap, clinicians made accurate & consistent diagnoses, suggesting validity not significantly affected.

  
  

  Evaluate: While symptom overlap is a concern, Seper's findings show clinicians can still differentiate SZ, maintaining diagnostic accuracy.
• (AO1) Give the overall conclusion

  Labelling a person with SZ = can affect education/work/relationships.

  
  

  However, treatments such as anti-psychotics can help with the symptoms thus supporting the patients by managing or even limiting their side effects.

  
  

  Therefore, an accurate diagnosis is needed as people need to get the right help and support.