Classification of Schizophrenia

AQA A2 Psychology A: Schizophrenia

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Classification of Schizophrenia by Mind Map: Classification of Schizophrenia

1. ICD-10 Definition

1.1. At least one of the following:

1.1.1. Thought echo, insertion, withdraw or broadcast

1.1.2. Delusions of control, influence or passivity; delusional perceptions

1.1.3. Hallucinatory voices: running commentary, discussion of patients, or coming from another part of the body

1.1.4. Persistant delusions that are culturally inappropriate

1.2. At least two of the following:

1.2.1. Persistent hallucinations in any modality accompanied by half formed delusions or overvalued ideas

1.2.2. Neolgisms, breaks in the train of thought, resulting in incoherence or irrelevant speech

1.2.3. Catatonic behaviour (a marked motor abnormality, usually rigidity of limbs)

1.2.4. Negative symptoms - apathy, paucity of speech, blunting or incongruity of emotional response

1.3. Symptoms should be persistent, lasting for at least one month at some time during most days

2. Basic information

2.1. Positive symptoms - an addition to the person's behaviour e.g. hallucinations

2.2. Negative symptoms - involves loss of emotion, interests, pleasure etc.

2.3. SZ is characterised by disordered thinking, impaired emotional responses, poor interpersonal skills and a distortion of reality

2.4. Prevalence of SZ is around 1% in the population aged over 18

2.5. Generally develops early in adult life

2.6. 10-15% of SZs commit suicide

3. Course of the disorder

3.1. Prodromal period (a few weeks or months) - changes to mood and behaviour are evident to those close - low mood, anxiety, difficulties in social relationships, difficulties in concentrating on work/ study

3.2. Emergence of psychotic symptoms

3.3. Active phase - one to six months but can extend to a year

3.4. Recovery - full recovery is impossible but many patients will make a substantial recovery

4. Issues surrounding classification and diagnosis

4.1. In America, the diagnosis was used liberally compared to other countries because their classification system used broader definitions - in 1950s, 80% of US patients were diagnosed with SZ whilst 20% of patients were in the UK

4.1.1. In attempt to eliminate the diagnostic differences, the ICD and DSM were made more similar

4.2. There are several other tools in addition to the DSM and ICD that have been developed to diagnose SZ - the use of this can improve the reliability of diagnosis

4.2.1. This can be confusing - the fact that it is so difficult for physicians to agree emphasises the point that all definitions are fairly arbitrary and liable to be modified

4.3. Szasz (1979) has questioned the whole concept of mental illness, suggesting that it is a political form of social control

4.4. It is stigmatising to attach the 'label' of SZ to patients, since the individual may then conform to this label as it becomes a self fulfilling prophecy

4.5. Can be difficult to define the boundaries between SZ and other clinical disorders, mainly mood disorders such as autism or depression- can lead to people being wrongly diagnosed

4.6. There is a marked variability among people with SZ in terms or treatment response, symptoms and course or the disorder - there may be sub-types of SZ - validity of these have been questioned

4.7. It has proved very difficult to predict outcome or response to the treatment of SZ with accuracy and there are wide individual variations - questions the validity of the classification system

5. Sub-types of SZ

5.1. Paranoid

5.1.1. Delusions and hallucinations

5.1.2. Disorganised speech and flat affect are usually ABSENT

5.2. Catonic

5.2.1. Unusual motor activity - marked agitation or complete immobility

5.2.2. Extremely negative attitude

5.2.3. Peculiar posturing

5.2.4. RARE

5.3. Hebephranic (ICD) or Disorganised (DSM)

5.3.1. Often begins at an early age

5.3.2. Incoherent and disorganised speech

5.3.3. Flat and/or inappropriate affect

5.3.4. Bizarre behaviour

5.3.5. Hallucinations and delusions

5.3.6. Not as structured as paranoid SZ