SCHIZOPHRENIA A03 TOPIC 1

TOPIC 1- Schizophrenia

STRENGTH

One strength of diagnosis of schizophrenia is good reliability. For example, Osorio et al reported excellent reliability for schizophrenia diagnosis(DSM-5) with inter-rater reliability being +.97 and test-retest reliability of +.92. This means that schizophrenia is a reliable diagnosis as it is consistent between clinicians(inter-rater) and between occasions(test-retest). Therefore, the diagnosis of schizophrenia is consistently applied, supporting its usefulness as a standardized tool in clinical settings.

LIMITATION

One limitation of diagnosis of schizophrenia is low validity. For example, Cheniaux et al had 2 psychiatrists independently assess the same 100 clients. He found that 68 clients were diagnosed with schizophrenia with ICD and 39 with DSM. This means that, schizophrenia is either over or under diagnosed suggesting that criterion validity is low. Therefore, inconsistent diagnoses across systems raise ethical concerns, as misdiagnosis could expose patients to unnecessary treatment, and harmful side effects which breaks the protection from harm rule.

LIMITATION (2)

Another limitation is symptom overlap. For example, there is an overlap between the symptoms of schizophrenia and bipolar disorder as both involve delusions and avolition. This means that, schizophrenia and bipolar disorder may be the same condition(a classification issue). Schizophrenia may also be hard to distinguish from bipolar disorder( diagnosis issue). Therefore, the symptom overlap raises questions about the validity of schizophrenia as a distinct diagnostic category, suggesting that it may not exist as a separate condition, which means clinicians cannot confidently conclude whether a patient truly has schizophrenia, limiting its usefulness in practice.

LIMITATION(3)

A further limitation is culture bias. For example, Afro-Caribbean British men are up to 10 times more likely to receive a diagnosis as White British men, due to overinterpretation of symptoms by UK psychiatrists. Some symptoms such as hearing voices are accepted in cultures such as Afro-Caribbean societies. This means that, Afro- Caribbean men living in the UK may be discriminated against by a culturally biased diagnostic symptom. Therefore, schizophrenia diagnoses developed in one cultural context may not generalise to other groups, limiting the usefulness of the diagnostic criteria in multicultural settings and highlighting the need for culturally sensitive assessment tools.