PSYCH; Classification & Diagnosis

what are the 2 major systems for the classification of mental disorders

ICD-10

DSM-5

how does ICD-10 and DSM-5 differ in the classification of schizophrenia

in the DSM-5; positive symptoms must be present for diagnosis

BUT

in ICD-10; two or more negative symptoms are sufficient for diagnosis

what are positive symptoms

additional experiences to everyday ordinary life

what are the positive symptoms of schizophrenia

hallucinations - sensory experiences that have no basis in reality e.g. voices/seeing things

delusions (paranoia) - irrational beliefs that have no basis in reality e.g. person believes they are victim of something

what are negative symptoms

involve the loss of usual abilities and experiences

what are negative symptoms of schiz

speech poverty - reduction in amount/quality of speech e.g. delay in person’s verbal responses

avolition (apathy) - difficulty to begin/keep up with goal directed activities e.g. reduced motivation resulting in poor hygiene, lack of persistence in work/education and lack of energy

limitation of classification&diagnosis - low inter-rater reliability

E; Cheniaux et al (2009) found that two psychiatrists evaluated 100 patients using both ICD-10 and DSM-5 criteria. one psychiatrist diagnosed 26 using DSM and 44 using ICD, while the other diagnosed 13 using DSM and 24 using ICD

E; This inconsistency suggests that the diagnostic systems are not objective.

E; Therefore, the low reliability weakens the scientific validity of the diagnosis.

limitation -low validity, risk of comorbidity

E; Buckley et al (2009) found 50% of schizophrenia patients also had diagnosis of depression, while 29% had PTSD and 23% had OCD

E; This high level of comorbidity suggest that schizophrenia may not be a distinct disorder

L; Therefore, this creates confusion and suggests that the classification system lacks precision to distinguish schizophrenia accurately from other conditions

limitation - culture bias in diagnosis

E; research has shown that african-americans are more likely to be diagnosed with schizo than white patients. Luhrmann (2015) found that in Ghana and India, patients often reported positive relationships with voices they heard whereas American patients reported negative experiences

E; This shows that white western psychiatrists may interpret culturally specific behaviours as abnormal

L; Therefore, the lack of cultural relativism in the DSM-5, limits its generalisability to all minority groups which suffers from ethnocentrism.

limitation - gender bias in diagnosis

E; Research found that men are more likely to be diagnoses with schizo than women, meta analyses show men are upto 42% more likely to suffer from schizo.

E; This suggests that females often have better interpersonal functioning and coping mechanisms than men, causing them to be under diagnosed

L; Therefore, this implies that diagnosis of schizo is not based on purely clinical symptoms but heavily influenced by gender stereotypes, so the diagnosis is likely to suffer from androcentrism