Schizophrenia - A02

Reliability of the ICD and DSM
Implications - wrong diagnosis could lead to the wrong treatment
Implications - negative labels associated with the person with sz

Variation in Symptoms
Klosterkotter et al - 489 admissions were assessed and they found using positive symptoms led to a more reliable diagnosis of sz

Differentiating SZ
Implications (Jackson and Birchwood) - evidence that early diagnosis and prompt treatment has a better long-term outcome for people with sz

Cultural Relativism
Implications (Keith et al) - 2.1% of black americans were diagnosed with sz compared with 1% of the white population, this could be due to misinterpretation of symptoms

Biological Explanations - Genetics
Concordance rates are not 100% so other factors must be involved
It is difficult to find MZ twins with sz (prevalence of 1% for whole population)

Adoption Studies
Tienari - finnish adoption study using 155 children whose biological mothers had sz, compared with a group of twins whose parents had no history of sz. 10% of the group whose mothers had sz would go on to develop it

Biological Explanations - Biochemical
Antipsychotic drugs can reduce sz symptoms by blocking dopamine activity

Biological Explanations - Biochemical
Drugs tend to only work on positive symptoms rather than negative

Psychological Explanations - Family Systems Theory
Berger - found that sz's had a higher recall of double-bind statements by their mothers than non-sz's

Family Systems Theory -Expressed Emotion
Israli High Risk Study - followed children who had a parent with sz and found they were more likely to develop sz if they had negative relationships. However, none of those that received 'good parenting' went on to develop sz

Psychological Explanations - Cognitive
Mckenna - people with sz do not seem any easier to distract than normal people when engaged in cognitive tasks

Biological Therapies - Conventional Antipsychotics
Effectiveness - antipsychotic drugs are effective for 70% of people and may reduce positive symptoms

Biological Therapies - Conventional Antipsychotics
Problems with Measuring Effectiveness - sz is an episodic disorder so there may be periods of time when a patient is not showing any symptoms

Biological Therapies - Atypical Antipsychotics
Effectiveness (DeLima et al) - atypical anitpsychotics do seem to improve negative symptoms as well as positive

Biological Therapies - Atypical Antipsychotics
Appropriateness - serious side effects which effect 1-2% of patients

Psychological Therapies - CBT
Effectiveness (Tarrier et al) - controlled trial on people with sz, CSE showed significant alleviation of positive symptoms and effective use of coping skills compared with a non-treatment group

Psychological Therapies - CBT
Problems Measuring Effectiveness - episodic disorder

Psychological Therapies - Family Intervention
Effectiveness (Brown) - sz patients divided into 2 groups, living with family members with high EE and low EE. Found that 10% returning to the low EE home relapsed and 58% of the high EE group relapsed

Psychological Therapies - Family Intervention
Appropriateness - the treatment involves talking and taking part which some patients may not be comfortable with