Issues Surrounding Classification and Diagnosis of Schizophrenia

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[pic] Schizophrenia, severe mental disorder characterised by a profound disruption of cognition and emotion, which affects a person’s language, thought, perception, affect and even sense of self. In most countries across the world, the lifetime risk of being diagnosed with schizophrenia is 1 per cent. There is a distinction between acute and chronic onset schizophrenia. In chronic onset, there is often an insidious change in an apparently normal young person who gradually loses drive and motivation and starts to drift away from friends. After months or even years of this deterioration, more obvious signs of disturbance such as delusional ideas or hallucinations, appear. In acute onset, obvious signs such as hallucinations can appear quite suddenly, usually after a stressful event, and the individual shows very disturbed behaviour within a few days. In terms of symptoms that are used in diagnosis and classification, there are positive symptoms, which reflect an excess or distortion of normal functions, hallucinations, delusions, experiences of control and disorganised thinking. 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 affective flattening (a reduction in the range of emotional intensity). People who have been diagnosed with schizophrenia will not all display the same behaviour, so the major classification systems include lists of symptoms only some of which need to be present before a diagnosis can be made. The DSM-IV-TR classification system has the following diagnostic criteria: At least a month’s duration of two or more positive symptoms, e.g. delusions and hallucinations. Delusions are bizarre beliefs that seem real to the person with schizophrenia but are not real. Delusions may be paranoid or may involve inflated beliefs

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