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Schizophrenia - Coggle Diagram
Schizophrenia
Classification of Schizophrenia
type of pscyhcosis
thoughts and emotions impaired so contact lost with reality
affects 1% of population
mostly diagnosed between 15 and 35
Symptoms
Positive symptoms
- those that appear to reflect an excess or distortion of normal functions.
Delusions
bizarre beliefs seem real to the person with schizo but hey are not real
sometime delusions are paranoid, often that they’re being spied on or that their phone is bugged
delusions of grandeur- inflated ebliefs about a persons power adn importance e.g that ther are famous or magic
delusions of reference- when event in the environment appear to be directly related to them
Disorganised speech
issues organising thoughts so shows in speech
may jump from one topic from another, even mid sentence
in extreme cases
“word salad’
- when words get so mixed up they’re incoherent
Hallucinations
unreal perceptions of the environment that are usually auditory but may be visual or olfactory (smell) or tactile (touch).
e.g hearing voices, seeing objects, smelling randoms smells, feeling things on your skin
many schizos report hearing voices or several telling them to do something like telling them to harm themseleves or someone else or commentingon their behavior
Grossly disorganized or catatonic behavior
includes the inability or lack of motivation to initiate a task or complete once started leading to difficulties in daily living
can result in a decreasaed interest in personal hygene
Negative symptoms
Anhedonia
loss of interest or pleasure in all or almost all activities
lack of reactivity to normally pleasureable stimuli
may be pervasive (all-embracing) or confined to just one aspect of the experience
Alogia/ Speech poverty
lessening of speech fluency and productivity- though to reflect slowing or blocked thoughts
produce fewer words in a given time on a task of verbal fluency (e.g name as many animals in a minute)
not a matter of not knowing words but inability to spontaneously produce them
less big words or complexity
Affective flattening :
expressionless
very monotone
Avolition
reduction of interest adn desires as well as inability to initiate and persist in goal-directed behavior (e.g sitting there doing nothing all day due to no interest in anything)
distinct from poor social function or disinterest which can be the result of other circumstances
e.g individual may have no social contact with family or friends because they have none, or communication with them or difficult
not however considered avolition which is specified as a reduction in self-initiated involvement in activities that are available to the patient
Diagnosing schizophrenia
Criterion B- Social/occupational dysfunction
"for a significant portion of the time since the onset of the disturbance, the level of functioning in one or more major areas (work, self-care etc) is below the level achieved prior to the onset"
Criterion C - duration
continuous signs of the disturbance persist for at least 6 months. .
must include at least 1 month of symptoms that meet criteria A
Criterion A
Two or more of the following
Delusions
Hallucinations
Disorganised speech
Completely disorganized or catatonic behavior
Negative symptoms
Reliability and validity in diagnosis and classification of Schizophrenia
Reliability
Diagnostic reliability
Diagnostic reliability means that a diagnosis of schizo must be repeatable (clinicians must reach the same conclusions at two different points in time, test-retest reliability), or different clinicians reach the same conclusions (inter-rater reliability)
inter-rater reliability- measured by a statistic called a
kappa score
a score of 1 indicated 0 agreement
a score of 0.7+ is considered good
DSM-V trials the diagnosis of schizo only had a kappa score of
0.46
Cultural differences in diagnosis
research suggests significant variation between countries when it comes to diagnosing schiz i.e culture influences the diagnostic process
Copeland 1971
gave 134 US and 19 British psychiatrists a description of a patient
69% of US psychiatrists diagnosed but 2% of Brits
Luhrmann et al 2015
interviewed
60 adults with schiz
, 20 each in
Ghana
, India and the
US
each asked about voices
African and Indians described voices as
positive
and offering advice, US described them as
negative and violent
Durham suggests the ‘harsh violent voices so common in the west may not be an inevitable feature of schiz’
Ao3
Unreliable symptoms
for a diagnosis only one symptoms is needed if the "delusions are bizarre" like what does that even mean?
subjective cuz like what do you even mean by that
50 senior psychiatrist had to differentiate between bizarre and not and the inter rater correlation was only like 0.4 soooooo
concluded that the diagnostic hasn't got enough reliability to be a reliable method for diagnosis
Cultural differences
Barnes 2004 established the differences in schizo
Lurhman
et al 2015
less distress with other groups
Brekke and Barrio (long lost mario brother)
184 individuals with schizo from 2 groups of ethic majority and ethnic minorities
Non minority groups were consistently more symptomatic, probably because the DSM was written for white Americans so they're more likely to fit the diagnostic mold
Lack of inter-rater reliability
little evidence that DSM is used with high reliability between different clinicians
Whaley 2001
found inter rater realiabiility of diagnosis as low as 0.11
Rosenhan found more problems with impostor study
suggets that diagnosis is subjective to each diagnoser, so causes problem for reliability
Validity
Symptom overlap
stella :<3:
Co-morbidity
Gender bias? i barely know er bias
when accuracy of diagnosis is depndent on th egender of individual
DSM is andro centric
mentally healthy behavior is based off of studies done with men so women more likely to be considered unhealthy
Biological explanations for Schizophrenia
Drug therapies