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Discuss issues associated with the classification and/or diagnosis of schizophrenia
This essay discusses issues associated with the classification and/or diagnosis of schizophrenia.
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Discuss issues associated with the classification and/or diagnosis of schizophrenia.Schizophrenia is a server mental disorder which requires classification and diagnosis. Classification
involves grouping symptoms into categories. Diagnosis involves deciding what disorder a person has
based on their symptoms and the correspondence of these symptoms with diagnostic manuals such as
the DSM or ICD. Reliability and validity are paramount to the DSM and ICD to ensure diagnosis and
prognosis of mental disorders such as Schizophrenia are accurate. Reliability refers to the consistency
of diagnosis, a high inter-rater reliability is desired by diagnostic manuals such as the DSM-5 as it
suggests different assessors arrive at the same conclusion demonstrating a consistency in diagnosis
and prevents under or over diagnosis. Validity is the extent to which a classification system such as
the ICD measures what it claims to measure.
The ICD-10 and DSM-5 are the two main diagnostic manuals used in the classification and diagnosis
of schizophrenia. The DSM requires one positive symptom such as hallucinations for a diagnosis. A
positive symptom is a change to regular thoughts or behaviours. The ICD requires two negative
symptoms such as speech poverty and avolition. Negative symptoms cause people to withdraw from
the world around them. Speech poverty which is the withdrawal from conversation and avolition
which is a lack of motivation to do anything are indicative of negative symptoms as the individual
removes themselves from social interactions.
An issue associated with classification and diagnosis is inconsistent validity. This issue was
highlighted in Rosenhan’s 1973 field experiment. Rosenhan and seven other colleagues admitted
themselves into twelve different psychiatric hospitals displaying the symptoms of having heard a
voice say empty, hallow and thud. Hearing voices is indicative of a positive symptom and therefore
the confederates were admitted. However, after being admitted they proceeded to act normally.
Despite, their normal behaviour their diagnosis did not change highlighting a flaw in classification
and diagnosis. It suggests that psychiatrists cannot reliably tell the difference between a mentally ill or
non-mentally ill individual. Rosenhan’s study demonstrates a lack of validity and inter-rater reliability
as the measures do not accurately reflect the illness it sought to identify. This is an issue of
classification and diagnosis of schizophrenia as it can expose individuals to incorrect treatment and
contribute to inconstant diagnosis.
Rosenhan’s study clearly exposes issues in classification and diagnosis that derive from flawed
diagnostic manuals such as the DSM and ICD. However, since Rosenhan’s study there have been
many revisions of the DSM. Therefore, Rosenhan’s study lacks temporal validity as it was conducted
in the seventies and since then the DSM as been altered to improve inter-rater reliability and validity
for example questionnaires have been made more extensive and now provide more reliable diagnoses.
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