Schizophrenia Spectrum
Schizophrenia Spectrum Essay Paper
Schizophrenia Spectrum Essay Paper
***Select an adult or older adult client with a schizophrenia spectrum and other psychotic disorder you have seen in your practicum*** Describe the HPI and clinical impression for the client. Recommend psychopharmacologic treatments and describe specific and therapeutic endpoints for your psychopharmacologic agent. (This should relate to HPI and clinical impression.) Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices. Identify medical management needs, including primary care needs, specific to this client. Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client. Recommend a plan for follow-up intensity and frequency and collaboration with other providers. Schizophrenia Spectrum Essay Paper
The main causes of schizophrenia spectrum and other psychotic disorders include environmental and genetic factors. Symptoms of schizophrenia spectrum include negative symptoms such as catatonia, disorganization, and alexithymia, and positive symptoms such as delusions and hallucinations. On the other hand, symptoms that characterize psychotic disorders include dissociation that manifests as impairment of functions of perception, consciousness, and memory (Selwyn et al, 2017). Accordingly, this paper will present an analysis of a client presenting with schizophrenia spectrum and other psychotic disorders.
History of Present Illness and Client’s Clinical Impression
A 42-year-old Caucasian woman presented to the clinic accompanied by her husband. The client was delusional and exhibited both audio and visual hallucinations as she narrated that some bizarre religious delusions. The client would also hear “voices talking to her”. The husband reported that the client barely sleeps, talks uncontrollably, manifest aggression, and is easily irritable.
According to the husband, the client was treated for delusions and hallucinations five years ago. The husband reported that the client had the first diagnosis for mental illness (schizophrenia) five years ago and has been on treatment since then. The prescribed medications for the client include 20mg of Omeprazole and Risperidone 2mg. However, the client had discontinued her medications five months ago and she believed that she was healed. The client’s father was diagnosed with bipolar 1 disorder, while her brother once has a diagnosis of major depressive disorder.
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The provided information indicates that the client exhibits symptoms such as dissociation, hallucinations, sadness, delusions, psychotic behavior and disorganized speech and thus fits the diagnosis of schizophrenia spectrum and other psychotic disorders (Caqueo-Urízar et al, 2015). Schizophrenia Spectrum Essay Paper
Psychopharmacologic Treatments
Lorazepam 2 mg: Lorazepam would be appropriate for the client in order to sedate her because she is acutely disturbed. According to Pelzer, van der Heijden & den Boer (2018) lorazepam is effective in sedating individuals who are acutely disturbed.
Clozapine 12.5 mg: Clozapine is the prescribed antipsychotic for the client. The efficacy of clozapine in treating hallucinations and psychosis in people with schizophrenia and other psychotic disorders has been demonstrated (Lowe, Krivoy, Porffy, Henriksdottir, Eromona & Shergill, 2018).
Carbamazepine 200mg: Carbamazepine is the last prescribed medication for the client. Carbamazepine is a mood stabilizer and therefore the mediation will treat mood disorder for this client (Pelzer et al., 2018).
Psychotherapy Treatments
Cognitive-behavioral therapy (CBT) and family therapy are the recommended psychotherapy choices for this client. CBT was selected because its efficacy in improving residual symptoms and psychotic symptoms in individuals with schizophrenia has been demonstrated in studies (Mander & Kingdon, 2015). CBT will also aid the client to understand her mental disorder and alter some of her maladaptive thinking patterns into a positive thinking pattern. Laws et al (2018) also explain that CBT reduces distress and improves the quality of life for people having schizophrenia. Family therapy will be used to educate the client and her family regarding his condition, symptoms triggers, and how to recognize and manage the psychotic symptoms. Through family therapy, all family members will get to understand the condition of the client and offer the required supports, particularly when the client is experiencing psychotic symptoms (Caqueo-Urízar et al, 2015).
Medical Management Needs
The priority medical management needs for this client include managing her psychotic symptoms and stabilizing her. Symptoms such as delusions and hallucinations may impair the client’s judgment and her ability to adhere to the prescribed treatment regimen (Bhatia & Saha, 2017). Additional medical management needs for the client are managing any side effects and observing the hygiene and nutritional patterns for this client to avoid other comorbidities such as metabolic syndrome, obesity, and cardiovascular conditions (Bhatia & Saha, 2017).
Community Support Resources & Community Agencies
The client will be referred to a local support group so that she can meet people experiencing similar mental health problems; this will be an encouragement to the client. A local social worker will be assigned to the client so that her progress and adherence to treatment can be monitored. In addition, the client will be provided with reading resources about schizophrenia so that the client can access essential information about her condition and how to manage it.
Follow-Up Plan
A social worker will be assigned to monitor the client through home visits and monitor her response and adherence to treatment. In addition, the client will be reviewed after four weeks to assess her progress. The management and treatment of this client will include an interprofessional team of a social worker, psychiatrist, and PMHNP (Holm et al, 2018). Schizophrenia Spectrum Essay Paper
Conclusion
The client presented to the clinic manifesting symptoms such as dissociation, hallucinations, sadness, delusions, psychotic behavior and disorganized speech and hence met the diagnosis of schizophrenia spectrum and other psychotic disorders. The prescribed medications for the client include clozapine, lorazepam, and carbamazepine. The prescribed psychotherapy treatments include CBT and family therapy. Management of the psychotic symptoms and stabilizing the client are the priority medical management needs. The client will be monitored by a social worker and will be reviewed every four weeks.
References
Bhatia M & Saha R. (2017). Role of primary care in the management of schizophrenia. Indian J Med Res, 146(1), 5–7.
Caqueo-Urízar A, Mar R, Urzua A, Jrge E & Jose G. (2015). The role of family therapy in the management of schizophrenia: challenges and solutions. Neuropsychiatr Dis Treat, 1(11), 145–151.
Holm S, Hansen B, Solem S et al. (2018). Post-treatment predictors of follow-up status for mental disorders treated with concentrated exposure therapy. Clinical Psychology & Neuropsychology, 1(1).
Laws K, Nicole D, Kondel T, Peter M & Sameer J. (2018). Cognitive Behavioural Therapy for schizophrenia – outcomes for functioning, distress, and quality of life: a meta-analysis. BMC Psychol, 6(32).
Mander H & Kingdon D. (2015). The evolution of cognitive-behavioral therapy for psychosis. Psychol Res Behav Manag, 1(8), 63–69.
Selwyn B, Rafaele R, Paul L, Moskowitz A, Gerdina A & Pijborg M. (2017). Unique and Overlapping Symptoms in Schizophrenia Spectrum and Dissociative Disorders in Relation to Models of Psychopathology: A Systematic Review. Schizophrenia Bulletin, 43(1), 108–121 Schizophrenia Spectrum Essay Paper
