Classification & diagnosis of Sz

megan langdon
Mind Map by megan langdon, updated more than 1 year ago
megan langdon
Created by megan langdon almost 5 years ago
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mind map on the classification and diagnosis of Schizophrenia

Resource summary

Classification & diagnosis of Sz
1 Reliability
1.1 For diagnosis to be of any use
1.1.1 Must be reliable
1.1.2 Must be consensus in way people diagnosed
1.2 Qs & scales can be measured
1.2.1 Whether 2 independent assessors give similar diagnosis (inter - rater) / whether tests to deliver diagnosis consistent over time (test - retest)
2 Validity
2.1 Extent which diagnosis reps something real & distinct from other disorders
2.1.1 Extent that classification system - ICD / DSM - measure what claims to measure
2.2 Reliability & validity = linked
2.2.1 If scientists can't agree what Sz is (validity) how can they accurately / consistently diagnose it (reliability)
3 Low predictive validity
3.1 Little predictive validity
3.1.1 Diagnosis not helpful in dealing w/ outcomes / treatment
3.1.2 Prognosis varies massively
3.2 20% recover to prev lvls of functioning, 10% achieving lasting improvements, 30% some improvements w/ relapses
3.3 Malmberg et al (1998)
3.3.1 Prognosis more to do w/ gender
3.4 Harrison et al (2001)
3.4.1 Prognosis more to do w/ psychosocial factors
4 Comorbidity (validity)
4.1 Fairly common to show symptoms of 2 mental disorders simultaneously
4.1.1 Sz can be accompanied by depression
4.2 Clinicians make dual diagnosis - appropriate treatment for both disorders
5 Symptom overlap (validity)
5.1 Some of Sz symptoms found in many other disorders
5.1.1 Depression & bipolar disorder
5.1.2 Affects validity of diagnosis
5.2 Differential diagnosis
5.2.1 Diff to define boundaries between Sz & other disorders
5.2.1.1 Mood disorders, personality & developmental disorders - autism
5.2.1.2 People w/ temporal lobe epilepsy often show similar symptoms to Sz
5.3 Becomes dimensional disorder
5.3.1 Degree of prob hearing voices (coping strategies
6 Inter rate reliability
6.1 Low in earlier versions of DSM, attempts made make US & EU versions made consistent
6.2 Remains relatively low
6.3 Vague criteria for diagnosis (bizarre delusions)
6.3.1 Leads to incorrect diagnosis
6.3.1.1 Result of probs w/ defining Sz
6.3.1.1.1 If you cannot classify Sz how do you diagnose it?
7 Cultural variations (reliability)
7.1 Although Sz occurs across cultures
7.1.1 Finding in USA / Uk = more freq among African American & African Caribbean pops
7.2 Not clear what this reflects
7.3 In some Asian cultures, a person experiencing some emotional turmoil is praised & rewarded if they show no expression of their emotions
7.4 In certain Arabic cultures, outpouring of public emotion is understood & often encouraged
7.4.1 W/out this knowledge an individual displaying overt emotional behaviour may be seen = abnormal
8 Rosenhan 1973 'On being sane in insane places'
8.1 Aimed
8.1.1 Test hypothesis that psychiatrists cannot reliably tell diff between people who are sane & those who aren't
8.2 Highlighted unreliability of diagnosis
8.3 But was over 40 yrs ago, lots have changed
9 Why does this matter? What are the implications?
9.1 Japan - Sz literally translates to 'disease of the disorganised mind'
9.1.1 Stigma of this is so great that psychiatrists are reluctant to tell patients of their cond
9.1.2 Result - 20% of those w/ Sz are actually aware of it, while other 80% are left undiagnosed
9.1.2.1 Kim & Berrios (2001)
10 How useful is a diagnosis of Sz?
10.1 Not helpful label (psychosis)
10.2 No universally agreed definition
10.3 Life long cond / label
10.4 Classification systems can be dangerous (marginalise those who don't fit w// society)
10.5 If we don't know what it is, how can we decide who has it?
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