Discussion of Issues Surrounding the Classification and Diagnosis of Schizophrenia

One issue think to classification and diagnosing is reliability. Reliability refers to the consistency of a measuring instrument, such as DSM (the Diagnostic and Statistical Manual) that is apply when diagnosing schizophrenia. Reliability can be measured in impairment of whether two independent assessors give similar scores (inter-rater reliability). High reliability is indicated by a naughty confirmative correlation. Inter-rater reliability has been assessed for diagnoses of schizophrenia and anchor to be relatively low.This was especially true for earlier versions of DSM scarce it was hoped that later(prenominal) revisions of DSM would prove more(prenominal) reliable. However, more recent versions have continued to conjure low inter-rater reliability scores. For example, Whaley (2001) found only a small positive correlation of +0. 11 between different raters. Differences in cultural interpretations alike pose a threat to the reliability of the diagnosis of schizophreni a. A question study by Copeland et al. (1971) gave a description of a patient showing clinical characteristics associated with schizophrenia to US and UK psychiatrists.Of the US psychiatrists, 69% diagnosed schizophrenia, whereas only 2% of the UK psychiatrists gave the same diagnosis. This suggests that the diagnostic criteria had quite a different meaning in different cultures and therefore ar not reliable when gived in different cultural settings. Reliability is also an issue for diagnosis. This was raised by Rosenhan (1973) who claimed that situational factors were more important in determining the ultimate diagnosis of schizophrenia, earlier than any specific characteristics of the person. Rosenhan demonstrated this in his well-known study called fair in insane places.He arranged for pseudopatients to present themselves to psychiatric hospitals claiming to be consultation voices (a symptom of schizophrenia). All were diagnosed with schizophrenia and admitted, despite the fact they displayed no nurture symptoms during their hospitalisation. Throughout their stay, none of the staff recognised that they were actually normal. The unreliability of diagnosis was further demonstrated in a follow-up study by Rosenhan. Psychiatrists at several mental hospitals were told to expect pseudopatients over a gunpoint of several months.This resulted in a 21% detection rate by the psychiatrists, even though none were actually sent. This shows that the diagnostic criteria used by psychiatrists could not reliably identify a person with schizophrenia. A flake issue is asperity which concerns both classification and diagnosis. For example, there is the issue of comorbidity which is related to the validity. Comorbidity refers to the design that two (or more) conditions co-occur (such as schizophrenia and depression) and therefore the extent to which the condition is real and distinct.One way to avoid the issue of comorbidity is to just use first-rank symptoms of sch izophrenia when diagnosing (e. g. delusions or hallucinations). However, Bentall et al. (1988) claim that many of the first-rank symptoms of schizophrenia are also found in former(a) inconvenience oneselfs (e. g. depression and bipolar disorder). This makes it punishing to separate schizophrenia as a distinct disorder from other disorders and suggests that schizophrenia is not a distinct condition. It may be more realistic to suggest that there is no such discrete disorder as schizophrenia but instead there is a spectrum of insane symptoms.Allardyce et al.(2001) claim that symptoms used to characterise schizophrenia do not peg down a specific disorder because its symptoms are also found in other categories of psychosis described in DSM and therefore there should just be a psychotic spectrum. Another aspect of validity is forestallive validity. predictive validity demonstrates the validity of a diagnosis by demonstrating that it can predict scores on some criterion measure. If a disorder has high predictive validity then it should be clear how the disorder would burgeon forth and how people would respond to treatment. Research has found low predictive validity for schizophrenia.Some patients (about 20%) do recover their previous level of functioning but 40% never really recover. This much variation in the chance suggests that the original diagnosis lacked predictive validity. It means that diagnosis was not instrumental in dealing with the course of schizophrenia. Research has shown that other factors may be more influential on the ultimate outcome of having schizophrenia. For example, it seems more to do with gender (Malmberg et al. , 1998) and psychosocial factors, such as social skills, academic achievement and family adjustment of schizophrenic behaviour (Harrison et al. , 2001).