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Classification and Diagnosis of Schizophrenia
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- 1Inter-Rater ReliabilityWhether two different therapists can agree or not on their diagnosis of the same patient.
If the diagnosis is consistent between clinicians or not. - 2Motjabi and Nicholson20 senior psychiatrists had low inter-rater reliability when distinguishing between 'bizarre' and 'non-bizarre delusions'
At the time this was the only factor needed for a full diagnosis of SZ. - 3Copeland194 British and 134 American psychiatrists when asked to make a diagnosis using a case description.
69% Americans, 2% British diagnosed SZ
Caused by the use of different manuals. - 4Test-Retest ReliabilityA measure of reliability obtained by administering the same test twice over a period of time to a group of individuals. The scores from Time 1 and Time 2 can then be correlated in order to evaluate the test for stability over time.
- 5Manuals are revised and updates regularly- Affects Test-Retest Reliability
- a SZ person could have been diagnosed in the past using from one symptom (i.e- bizarre delusions) but now the DSM5 requires 2 symptoms so the person wouldn't be considered SZ. - 6Low Construct ValiditySome clinicians criticize the construct of SZ itself - is it a genuine disorder or not?
- 7Davidson (use for low construct validity)The categories we use to determine SZ are 'constructs' because they were constructed from different combinations of symptoms appearing at once.
Diagnosis is subjective; opinion of clinician. - 8Cultural BiasDiagnosed more frequently in US and UK in African Caribbean and African Americans. (Harrison)
'seeing visions' is seen positively in some cultures and SZ in others. - Classification systems are culturally bias. - 9Consequences of cultural differences- clinicians over or underestimate psychological problems in other cultures (Lopez)
- African-Caribbean are more likely to be admitted to psychiatric hospital, given major tranquillizing drugs or ECT. (Fernando)
- Clinicians predominantly white, middle class, males - not sensitive enough to cultural and social features of patients.
(Winter) - 10Social StigmaThe social stigma of SZ is considerable and can have a long lasting impact on those diagnosed. - ethical implications - diagnosis must be accurate
- 11DSM5- Published in America (English Only)
- Used in UK
- After 6 months of symptoms
- Classifies 5 sub types of SZ
- multi-axial approach - looks at many different factors - 12ICD- Published by WHO - international (multi languages)
- classifies 7 sub types of SZ
- classifies after one month
- mainly positive symptoms
- does not look at social factors
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- Key ideas for an 24 marks essay on the classification and diagnosis of schizophrenia
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