Issues associated with the classification and diagnosis of schizophrenia

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Discuss issues associated with the classification and/or diagnosis of schizophrenia.

An important aspect of any classification system is its reliability, high inter-rater reliability is important as it means that each time the system is used it has the same outcome. There has been little consistency in the diagnosis of schizophrenia in the past due to vagueness of the classification systems and inconsistencies between them, it is difficult to achieve reliable diagnosis when there is no universally agreed definition of schizophrenia. In order to improve reliability of diagnosis a group of symptoms characteristic of schizophrenia but rarely found in other mental disorders were identified as first rank symptoms, these form the basis of the current DSM and ICD and have helped reduce misdiagnosis. However DSM and ICD systems do still differ in a few key ways, for example in the length of time symptoms have to be present for diagnosis, ICD is one month while DSM is six months, this is a significant difference given how quickly severe symptoms can present in acute onset schizophrenia.

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Another important issue in classification is the validity of the classification system, this is the degree to which the system measures what it set out to measure, in this case it refers to the appropriateness of the categories in diagnosing schizophrenia. Reliability can still be high if the classification system is consistently inaccurate, so high validity is important in ensuring patients get the correct diagnosis and subsequently the appropriate treatment. Of particular importance is predictive validity, if someone is given a diagnosis of schizophrenia then it is predicted they will respond to certain treatments. It is possible for two patients ...

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