Discuss issues surrounding the classification and diagnosis of schizophrenia.
There are two different classification systems in place to diagnose schizophrenia, the ICD-10 and the DCM. The key difference between the two classification systems is that the DCM measures symptoms over the course of 6 months, whereas the ICD-10 measures them over only one month. This poses a question of reliability, as there is a great lack of consistency between the two systems. Beck et al (1961) looked at inter-rater reliability between 2 psychiatrists who both looked at the same 154 patients, and found that the inter-rater reliability was low at 54%, meaning that the two systems may produce different results when it comes to the classification of schizophrenia. We could improve inter-rater reliability, and therefore the consistency of the diagnoses of schizophrenia by narrowing the classification systems down to one.
Content validity refers to the extent to which the assessment measure covers the range of symptoms of schizophrenia, and so the classification systems have content validity if they provide complete coverage of all the possible symptoms. Jakobsen et al (2005) used OPCRIT, which is a clear and detailed list of symptoms to study patients with a history of psychosis. Unlike ICD-10, there was a good agreement on the diagnosis when OPCRIT was used, indicating a high level of reliability, and a high level of content validity. This suggests that we should be should be using a system like OPCRIT, as it involves working through all the symptoms associated with schizophrenia and other mental disorders to make an informed diagnosis, rather than ICD-10, which only requires one significant symptom to receive the diagnosis of schizophrenia.
Another issue of the diagnosis of schizophrenia is the possibility of giving an incorrect diagnosis, when the patient is not in fact schizophrenic, but has been diagnosed with the disease. Rosenhan researched the possibility of being given...