...Schizophrenia is a psychotic disorder characterised by a loss of touch with reality. Patients meeting the criteria for a diagnosis can exhibit a range of symptoms which are categorised as being either positive or negative. Positive symptoms include hallucinations (auditory, visual, and tactile), inappropriate delusions (of grandeur and power), thought control and disordered thinking. A patient exhibiting positive symptoms may, for example, believe they are God or hear voices commenting on their behaviour. Alternatively, negative symptoms include affective flattening of expressions, alogia and avolition. For instance they may show no emotional expressions or speak slower. In order to be diagnosed with the disorder using DSM 5, 2 or more positive symptoms must persist for at least a month. However, if the delusions are bizarre or a voice is keeping a running commentary on the individual, the diagnosis can be made with just one symptom. There are also other criteria’s that must be met in order to be diagnosed with schizophrenia, for example criteria B: social/occupational dysfunction, where for a significant portion of time one or more major areas of functioning e.g work or relationships should be markedly lower than the level prior to onset. A second example of criteria to be met is criteria E: exclusion of known organic causes - the doctor must ensure that the disturbance is not due to the direct effects of drugs (such as LSD, causing hallucinations for example) or a brain...
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...Discuss issues of reliability and validity associated with the classification and diagnosis of schizophrenia (8+16) One issue related to classification and diagnosis is reliability. Reliability refers to the consistency of a measuring instrument like DSM that is used when diagnosing schizophrenia. It can be measured by the extent to which psychiatrists can agree on the same diagnosis when independently assessing patients (inter rater reliability). The use of DSM III in 1990 was believed by Carson to have fixed any problems of IRR. Therefore the system is now more advanced with the DSM 5, there would be much greater agreement over who did and didn’t have schizophrenia by comparing the diagnosis which would make it reliable. However there is little evidence that DSM is routinely used with high reliability by mental health clinicians. For example Whaley found that IRR between health professionals were low as .11 between different raters. This suggests that when independently assessing patients the diagnosis was rarely consistent between them, meaning the DSM tool is unreliable in accurately and consistently diagnosing schizophrenia. There are also cultural differences about the interpretations of schizophrenia which poses a threat to reliability of the diagnosis of schizophrenia. For example Copeland et al gave a description of a patient showing clinical characteristics associated with schizophrenia to US and UK psychiatrists. From the US psychiatrists 69% diagnosed the patients...
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... Discuss validity and reliability of diagnosis. Paragraph 1 (Introduction): ● Classification system is said to be reliable when it is possible for 4 different clinicians, using the same system, to arrive at same diagnosis for same individual ● Examples: DSM-4, CCMD, ICD-10 ● Though diagnosis systems use more standardized assessment techniques and more specific diagnostic criteria than in the past, classification system is far from perfect ● Classification system said to be valid when it is able to classify a real pattern of symptoms, which can lead to an effective treatment ● However, problem with this is that the classification system is descriptive and doesn’t identify any specific causes for disorders Paragraph 2 (Study 1): Sane or Insane-Rosenhan (1973) Aim: test reliability of psychiatric diagnosis Procedure: field experiment Part 1 ● 8 healthy people (5 men, 3 women) gained admission to 12 different psychiatric hospitals ● Complained of hearing unclear, unfamiliar voices of same sex repeating words “thud” and “empty” ● Participants said they felt fine after admission to hospital (no more symptoms) Part 2 ● Rosenhan told staff at psychiatric hospital that pseudopatients will try to get admitted ● No pseudopatients were actually sent Results: Part 1 ● 7 diagnosed with schizophrenia ● Took average 19 days for discharge and were classified as “schizophrenia in remission” (possibility of symptoms...
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...Schizophrenia has become a label for a severe mental illness often involving a loss of contact with reality. In addition, it is a highly complex disorder covering a wide variety of symptoms and types e.g. catatonic, paranoid and disorganised, meaning that classification and diagnosis is often difficult. Nevertheless, the risk is around 19%and there are no cultural or gender differences, although onset may occur later in females due to oestrogen which may slow down brain degeneration, nevertheless this hormone is said to decrease with age. In terms of symptoms which are used in diagnosis and classification, there are the positive symptoms which reflect an excess or distortion of normal functions, - hallucinations, delusions, experiences of control and disorganised thinking. Furthermore, there are also negative symptoms which in fact reflect a loss or reduction in normal functions e.g. alogia (the loss of fluent speech) avolition (the loss of motivation) and accecore flattening (a reduction in the range of emotional intensity). According to the DSM-IV-TR there are 5 distinct points which must be met for diagnosis to be made. Firstly, the patient must have been experiencing at least 2 symptoms for 1 month (N.B. if delusions bizarre one is enough), occupational/social dysfunction , continuous disturbance over 6 months with one month of symptoms, no other sign of mental illness and no other known organic cause e.g. drug abuse or brain tumour. However, issues of classification and...
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...Assignment Each student will present a written case study of a selected patient with schizophrenia and provide a critical evaluation of the assessment, treatment and management of the patient utilizing relevant research evidence. The work should include the following areas: 1. A critical analysis of the assessment and diagnostic process 2. A critical analysis of the management/ rehabilitation-medical, nursing and other management 3. Appropriate referencing Methodology A random method was used to select the patient for this study. The patient was chosen from a cohort of patients on a psychiatric ward. The aim was to critique the assessment, treatment and management of a patient medically diagnosed with Schizophrenia. Various sources of information were utilized in the collection of information for this project. A research of this caliber demands that sources of information are peer reviewed current and of scholarly sources. Therefore it was with this in mind that the information was collected using internet medical portals, journal article and appropriate text books with a wide variety of information on the topic of choice. The patient’s docket was also used because it is a primary source of information about the management of the condition. Introduction Schizophrenia is a serious psychiatric disorder characterized by impaired communication with loss of contact with reality and deterioration from previous level of functioning at work, social...
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...strength to defy his father and study at the Royal College in London. The consequence he faces is disownment and a lifelong estrangement from his father, which sadly never mends. While in London he begins to experience the beginnings of his mental decline with what appears to be schizophrenia. After achieving notoriety as a musician, the musical world loses him to his mental illness. David finds himself living in psychiatric hospitals, and with support of others, eventually lives back on his own. Through a series of events, he finds himself reunited with the piano, first in a local restaurant and eventually returning to the concert hall. His reclamation of music parallels his reclamation of relationships as he adjusts to a functional life with schizophrenia. The movie instills hope as it shows a marked return to positive functioning as David finds love and fulfillment in his life. Client name: David Helfgott Psychiatric diagnosis: Schizophrenia—Disorganized Type DSM-IV-TR criteria: * Client has two or more of the following characteristic symptoms for a significant portion of 1 month: 1. delusions 2. hallucinations 3. disorganized speech 4. grossly disorganized or catatonic behavior 5. negative symptoms (affective flattening, avolition, or alogia) * Client has...
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...e Psychotic Disorder of Schizophrenia Tiffany L. Brewer Southern West Virginia Community and Technical College Abstract Schizophrenia is a long-term mental disorder of the brain that includes positive, negative, and cognitive symptoms. The cause of schizophrenia is unknown, but is thought to be linked to abnormalities in the brain. Certain risk factors can increase the chances of a person developing schizophrenia. There is not a cure for schizophrenia, but successful treatment options are available to help the ill person achieve a functional lifestyle. Keywords: schizophrenia, mental disorder, brain, symptoms, treatment A Look into the Psychotic Disorder of Schizophrenia Schizophrenia is a long-term mental disorder that involves...
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...The book's title is often shortened to DSM , or an abbreviation that also indicates edition, such as DSM-IV-TR, which indicates fourth edition, text revision of the manual, published in 2000. The DSM-IV-TR provides a classification of mental disorders, criteria sets to guide the process of differentialdiagnosis , and numerical codes for each disorder to facilitate medical record keeping. The stated purpose of the DSM is threefold: to provide "a helpful guide to clinical practice"; "to facilitate research and improve communication among clinicians and researchers"; and to serve as "an educational tool for teaching psychopathology." The multi-axial system The third edition of DSM , or DSM-III , which was published in 1980, introduced a system of five axes or dimensions for assessing all aspects of a patient's mental and emotional health. The multi-axial system is designed to provide a more comprehensive picture of complex or concurrent mental disorders. According to the DSM-IVTR, the system is also intended to "promote the application of the biopsychosocial model in clinical, educational and research settings." The reference to the biopsychosocial model is significant, because it indicates that the DSM-IV-TR does not reflect the view of any specific "school" or tradition within psychiatry regarding the cause or origin (also known as "etiology") of mental disorders. In other words, the DSM-IV-TR is atheoretical in its approach to diagnosis and classification— the axes and categories...
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...Methods Overview of data source and collection I examined a previous study of the trends in Assignment of Bipolar Diagnoses in a sample of foster children where ICD-9 code diagnoses were coded into seven diagnostic categories based on the corresponding DSM-IV TR codes: 1) Bipolar disorders, 2) Other mood disorders, 3) Psychotic disorders, 4) Disruptive disorders (including ADHD, Conduct Disorder, Intermittent Explosive Disorder, Oppositional Defiant Disorder, Disruptive Behavior Disorder Not Otherwise Specified, Impulse Control Disorder Not Elsewhere Classified), 5) Developmental disorders, 6) Anxiety disorders, including PTSD, and 7) Other psychiatric disorders, including personality disorders and adjustment disorders. Clinical diagnoses were assigned by the treating clinician and represent standard practice. I used this data base to show the prevalence in Schizophrenia and Major Depressive disorder in comparison of African American to Caucasian foster children. The Participants Two samples for this study were drawn from the Illinois Department of Healthcare and Family Services Medicaid payment database. This database is maintained through interagency agreements between the Illinois Department of Children and Family Services (DCFS), DHFS, and the University of Illinois at Chicago Department of Psychiatry. The data included claims for all medical and psychiatric services including hospitalizations and outpatient visits rendered to foster children. Gender and race/ethnicity...
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...It is estimated that around 1 in 100 people will develop schizophrenia at some point in their lives, of which approximately 3 million live in the United States. Shockingly, 2.1% of African-Americans receive a diagnosis of schizophrenia, compared to 1.4% of whites. What accounts for this? Is it because African-Americans have a biological predisposition to schizophrenia? Is it because clinicians from majority groups either intentionally or unintentionally misdiagnose African-Americans due to their cultural differences? Or maybe it’s because of the fact that African-Americans have always been on average economically disadvantaged compared to whites. The reasons are most likely a combination of these factors, and others may exist. The idea of “racial schizophrenia” dates back to the 1960’s at the Ionia State Hospital for the criminally insane in Michigan, one of the nation’s most notorious insane asylums. During this time, the civil-rights movement was in full force. The author, Jonathan Metzl, researched the diagnosis of schizophrenia among many of the patients admitted to this hospital over the years. He also published a book about it called, The Protest Psychosis: How Schizophrenia Became a Black Disease. He discovered in his findings that many African-Americans during this time were admitted for armed-robbery, and property destruction, and considered insane, ultimately leading to a diagnosis of schizophrenia. These short court sentences were eventually turned into a...
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...DSM Category | Definition | Criteria/Symptoms | Schizophrenia | 1.Schizophrenia | Disorder with 6 month duration continuous , that is characterized with psychosis (delusions/Hallucinations) | Delusions, Hallucinations, Disorganized Speech, Disorganized behavior or catatonic behavior, Flattening affect, Social/occupational dysfunction, persistant duration of more than 6 months continuos, | 2. Schizophreniform Disorder | Mental disorder diagnosed with the prevelance of schizophrenia for at least 1 month but less than 6 months | Meets criteria a, D, and E of schizophrenia, which lasts at least one month but less than six. | 3. Schizoaffective Disorder | Mental disorder characterized by abnormal mood and psychotic behavior | Consecutive period of illness which includes depression, mania or a combination of old meeting criteria a. Delusions or hallucinations are experienced for minimum of two weeks with some mood episode criteria and none of these disturbances are as a result of substances or medications. | 4. Delusional Disorder | Disorder in which delusions are present, but hallucinations are not. | Real-life delusions, realistic delusions, does not meets all criteria a for schizophrenia, functioning is not necessarily impaired. | 5. Brief Psychotic Disorder | Sudden onset of psychotic symptoms, but not attributed to schizophrenia | Presence of delusions, hallucinations, disorganized speech or grossly disorganized or catatonic behavior. The episode will usually last...
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...Psychological Assessment of Nina Sayer, The Black Swan Lisa Pinkerton PSY-215-Q3847 Southern New Hampshire University CASE STUDY Name: Nina Sayer Date of Evaluation: 02/01/2015 Date of Birth: 01/01/1992 Age: 23 years, 1 month PURPOSE FOR EVALUATION: Nina Sayer is a 23 year old, single, white female. She is the lead ballerina in a prestigious New York Ballet Company. She has been under an intense amount of stress due to the pressures of her job and her demands from her ballet director. She suffers from hallucinations and paranoid delusions. She describes her delusions and hallucinations as bizarre and sometimes violent. She has trouble recognizing what is real and what are her delusions and hallucinations. After struggling to get the role as the white swan in Swan lake, she is extremely paranoid and afraid that someone is trying to take her lead role in the ballet. She focuses this paranoia on a particular ballerina named Lily. She is extremely thin and shows signs of an eating disorder. She uses purging as a way to control her weight. Nina also has scars on her shoulders from self- mutilation. She seems very shy, reserved and almost childlike, but has moments of being very dark and reckless. This dichotomy in her personality causes her great distress. She feels she is under extreme pressure to be perfect for her mother and others. This obsession with perfection and her...
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...Abstract Bipolar disorder has two levels that is associated with mental illness. The diagnosis of Bipolar disorder correlation with other disorders and has made it very difficult to diagnoses without connecting it to another mental illness. The most common links associated with Bipolar are mood disorders, disruptive disorders, panic disorders, and anxiety disorders to name a few. Each of these disorders has very similar symptoms changing personalities at any given time. Bipolar I and II have manic and hypomanic episodes occurs in an everyday or a total of a week the symptoms are increased displaying abnormal behavior. Hypomanic episode is a higher level severity of mood swings with elevated energy lasting four consecutive days and is present the majority of the day. Bipolar II has the same episodes reoccurring with escalated energy and activity, lasting longer than four days. According to research, Bipolar II is linked to substance abuse, severe depression, and schizophrenia that are unpredictable with the symptoms that cause clinical distress and impairment in social setting and a work environment. Hypomania episode and Depressive Disorder fluctuate between Bipolar I and II disorders. Researcher has found that Bipolar Disorder is genetically connected at an early age. Diagnosis is very difficult to recognize at such an early age, because is connected to other illness such as medical diagnoses or ADHD. Bipolar disorder is highly unpredictable with students were missed...
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...2810 Term Paper| | Case Study: Brian| | | | Ashley Allen Due: 12/5/2011 Ashley Allen Case Study: Brian Schizophrenia is a severe brain disorder that has affected many people all over the world. It is a term that many people have heard but few understand the true meaning. When described, those with schizophrenia involve abnormal changes in their behaviors, thoughts, feelings, and views on the world. Those with schizophrenia are considered to have their behavior disturbed in particular way along with having difficulty with reality. With a remarkable amount of evaluation on the client, Brian, he has shown a pattern that leads to the diagnosis of Schizophrenia. There are a number of factors that play an important role when considering one with abnormal behavior (Beidel et al, 2010). By acknowledging particular factors such as gender, age, ethnicity, family & health history, work & health status, social relationships, drug & alcohol history, and various behavioral habits, it is easier to fully understand Brian’s behavioral influences. Hyman (2006) explains that schizophrenia affects both men and women equally though men tend to experience symptoms at a younger age than women do. Schizophrenic symptoms often develop in late adolescence to early twenties for males and given that Brian is a 25 years old male, he falls into the appropriate age of onset for schizophrenia. It is important acknowledge that at 19 years old, Brian has experienced his father’s...
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...2015 Critically discuss how people who have been diagnosed with schizophrenia are able to live positively with their disorder Student No: 47851449 Due date: June 17th 2015 Assignment 3 PYC4802 Psychopathology Fatima-H TABLE OF CONTENTS 1. Introduction.............................................................................................. 3 2. Definition of Schizophrenia...................................................................... 3 3. Diagnostic criteria of Schizophrenia......................................................... 4 4. Hallmark features of Schizophrenia......................................................... 5 5. Living positively with Schizophrenia......................................................... 7 5.1 Pharmacological Intervention................................................................. 8 5.2 Cognitive- Behavioural Therapy............................................................. 9 5.3 Psychosocial treatments........................................................................ 9 5.4 Positive psychological interventions...................................................... 10 5.5 Community-based rehabilitation for people with schizophrenia............. 11 5.6 Occupational Therapy............................................................................ 12 5.7 Living a healthy lifestyle.............................................................
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