The current concept of schizophrenia is neither valid nor useful’. Drawing on module content and independent research, evaluate the empirical basis for this claim, and propose what an alternative system could look like.

This is the essays title: 

According to Moncrieff and Middleton (2015), ‘The current concept of schizophrenia is neither valid nor useful’. Drawing on module content and independent research, evaluate the empirical basis for this claim, and propose what an alternative system could look like.


This is what I have written so far: 

Introduction:

Schizophrenia is clinically defined as a multiplex mental condition that affects cognitions, and behaviours while impacting greatly personal and social life. Initially characterised by Dr. Emile Kraepelin as “dementia praecox,” it was understood as a form of early dementia (Jablensky, 2010). The term “schizophrenia,” introduced by Eugen Bleuler, originates from the Greek words schizo (split) and phrene (mind), reflecting the then-believed concept of a fragmented personality (Ashok et al., 2012). Schizophrenia is defined by a dichotomy of symptoms, positive symptoms such as hallucinations and delusions, and negative symptoms from alogia (speaking less), avolition (lack of interest) and anhedonia (inability to feel pleasure). Disorganised speech, erratic behaviour, and cognitive decline further compound the disorder’s manifestation (Owen et al., 2016).


The validity and usefulness of the current concept of schizophrenia have come under scrutiny over recent years. Validity concerns how accurately the term “schizophrenia” represents a distinct, diagnosable condition with consistent characteristics across individuals and cultures. Usefulness assesses its practicality in treatment, prognosis, and understanding patients’ experiences. Moncrieff and Middleton (2015) argue that the existing framework for interpreting schizophrenia obscures the fundamental role of the mental health system and advocate for a new framework to enhance mental health services. This endeavour aims to evaluate the empirical basis supporting the current concept of schizophrenia, investigate the empirical evidence supporting Moncreiff and Middleton’s claim as well as proposing an alternative system for understanding and addressing the complex phenomena currently labelled as schizophrenia.


Current Concept of Schizophrenia

Schizophrenia is currently conceptualised as a synthesis of clinical criteria, research findings, and theoretical understanding, recognizing it as a complex, multifaceted psychiatric disease (Orsolini et al., 2022). 


Clinical Criteria (DSM -5) 

Clinically, schizophrenia is diagnosed when an individual displays persistent and notable disruptions in thought, perception, emotions, and behaviour. A diagnosis requires the presence of two or more core symptoms previously mentioned such as positive and negative symptoms, disorganised speech, erratic behaviour, and cognitive decline. These symptoms must persist for a significant portion of time within a one month period, accompanied by some level of impairment of work, interpersonal relations, or self-care. Additionally, continuous signs of disturbance should persist for at least six months to confirm the diagnosis (American Psychiatric Association. (2013).


These are the citations I have used so far:
 Citations

Moncrieff, J., & Middleton, H. (2015). Schizophrenia: A critical psychiatry perspective. Current Opinion in Psychiatry, 28(3), 264-268.

Owen, M. J., Sawa, A., & Mortensen, P. B. (2016). Schizophrenia. The Lancet, 388(10039), 86-97. https://doi.org/10.1016/S0140-6736(15)01121-6.

Jablensky, A. (2010). The diagnostic concept of schizophrenia: its history, evolution, and future prospects. Dialogues Clin Neurosci, 12(3), 271-287. https://doi.org/10.31887/DCNS.2010.12.3/ajablensky

Ashok, A. H., Baugh, J., & Yeragani, V. K. (2012). Paul Eugen Bleuler and the origin of the term schizophrenia (SCHIZOPRENIEGRUPPE). Indian Journal of Psychiatry, 54(1), 95-96. https://doi.org/10.4103/0019-5545.94660 

Orsolini, L., Pompili, S., & Volpe, U. (2022). Schizophrenia: A Narrative Review of Etiopathogenetic, Diagnostic and Treatment Aspects. Journal of Clinical Medicine, 11(17), 5040. https://doi.org/10.3390/jcm11175040 

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596 

Instructions:

Guidance for structuring an essay

Component Structure
Presentation • Double spaced
• Line space between paragraphs • Left aligned
General structure • Intro, main body, conclusion • Good paragraph structure
Introduction • Appropriate length – approx. 10% of word limit
Should include:
• Brief background relevant to the question
• Introduce question, defining any key terms or acronyms
• Tell reader what to expect
Paragraph structure • Opening ‘topic’ sentence to introduce points/ideas
to be covered
• Body of paragraph elaborates on ideas/points
with examples/ evidence/explanations
• Sentences connect to the main point of the paragraph
and to one another
• Includes a closing sentence drawing paragraph
content together
• Links to next paragraph
Graphics (optional) • Appropriate and relevant (better if adapted or original)
• Source acknowledged, if appropriate
• Must be explained in the text (used to enhance/support
text, not used in place of text)
• Well labelled • Placed appropriately in text
Conclusion • Succinctly restates most important points/ideas
and associated evidence
• Not simply a repetition of the essay
• Might include a reflection on the content covered or
highlight remaining questions and areas for future
research.
• No new information introduced
Language/punctuation • Appropriate style and formal tone, avoiding use of the first
person
• Correct terminology, acronyms expanded on first mention
• Good spelling, grammar
Referencing • Appropriate in-text citations
• Appropriate sources are research literature, books and
academic websites
• Inappropriate sources: lectures, lecture transcripts,
non-academic websites
• No footnotes
• List of appropriately formatted.

Use the style of writing I have used for the first part of the essay.  Also this is an overview of what the essay structure should look like: 

  • Introduction (Approx. 50 words)

    • Brief background on schizophrenia and its significance in mental health.

    • Definition of key terms: schizophrenia, validity, usefulness.

    • Outline of essay structure: examination of Moncrieff and Middleton’s claim, review of empirical evidence, proposal of an alternative system.

  • Current Concept of Schizophrenia (Approx. 100 words)

    • Description of the current clinical definition and understanding of schizophrenia.

    • Historical development and changes in the concept of schizophrenia.

    • Overview of Moncrieff and Middleton’s critique regarding validity and usefulness.

  • Empirical Evidence Supporting the Current Concept (Approx. 100 words)

    • Presentation of key research supporting the validity and usefulness of the current schizophrenia concept.

    • Discussion of successful diagnostic methods and treatment strategies.

    • Counterarguments to Moncrieff and Middleton’s critique.

  • Empirical Evidence Against the Current Concept (Approx. 100 words)

    • Detailed examination of research and case studies that align with Moncrieff and Middleton’s critique.

    • Analysis of the limitations and challenges in diagnosing and treating schizophrenia.

    • Discussion of the societal and clinical implications of these limitations.

  • Proposal for an Alternative System (Approx. 100 words)

    • Description of proposed changes or alternatives to the current concept of schizophrenia.

    • Integration of new research findings or theories that could enhance understanding and treatment.

    • Discussion of how these changes could address the issues identified by Moncrieff and Middleton.

  • Conclusion (Approx. 50 words)

    • Summary of the key points made in the essay, linking back to the initial critique by Moncrieff and Middleton.

    • Reflection on the importance of continuous evaluation and adaptation in psychiatric diagnosis and treatment.

    • Highlighting areas for future research and implications for clinical practice.

  • References and Citations


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