Discuss some of the issues surrounding the classification and diagnosis of schizophrenia
Classification systems are needed for the purpose of treatment and research. It can also be comforting to and individual and their family to be able to identify what their problem is and give it a name. Any classification system relies on the symptoms an individual display. However, symptoms tend to cluster together, so most classification systems of mental disorder focus on syndromes (i.e. clusters of symptoms that tend to occur together). However there isn’t always a perfect fit between the symptoms an individual displays those identified for a particular diagnostic category, such as schizophrenia.
The two systems currently used to classify psychological abnormality are the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM).
For a classification system to be meaningful and useful, it needs to be valid and reliable. Reliability refers to the consistency of a measuring instrument, such as a questionnaire or scale to assess, for example, the severity of their schizophrenic symptoms. Reliability of such questionnaires or scales can be measured in terms of whether two independent clinicians give similar diagnoses (this is known as inter-rate reliability) or whether the diagnoses are consistent over time (this is known as test-retest reliability).
Validity refers to the extent that diagnosis represents something that is real and distinct from other disorders and the extent that a classification system such as ICD or DSM measures what it claims to measure. One problem is that of differential diagnosis where clinicians find it difficult to distinguish schizophrenia from those of other psychiatric illnesses presenting similar symptoms. Co-morbidity refers to the extent to which two or more conditions co-occur and psychiatric co-morbidities are common among schizophrenia patients- these including substance...
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