Schizophrenia Disease Analysis, Essay Example

Schizophrenia is a serious mental illness that affects how a person thinks, feels and behaves. A person with a mental health problem shows signs of distress, which worries their families and friends. The onset of the medical condition is mostly in the late teenage or when adults approach their thirties. However, the beginning of the medical condition differs between males and females. In the case of the former, the onset is much earlier compared to females. Evidence-based studies indicate that the medical condition could begin in the late adolescent or early twenties. In females, the medical condition could start in the late twenties or early 30s. Nonetheless, the disease is detrimental for all genders.

Several risk factors contribute to the occurrence of medical conditions in a person. Genetics plays a significant role in the risk of the development of the medical condition. A person born in a family with a history of schizophrenia has an increased risk of developing the disorder (Rosenberg, 2022). Despite the lack of information that identifies a single gene that contributes to the medical condition, a person born in the family with a history of schizophrenia is at risk compared to a person born without a history of the medical condition. Concordance rate in twins’ studies on the prevalence of the medical condition shows that the differences between twins with schizophrenia are primarily because of DNA methylation. Accordingly, the studies show environmental factors could be an element that would explain the prevalence of the disease in certain communities or regions. Besides, scientists assert that the difference between brain structure and neurotransmitter processes could be a risk to developing the medical condition. Further, some studies also identify stressful environments as contributors to schizophrenia. For this reason, the rate of prevalence of the medical condition is much higher in low-income countries than in wealthy nations. The stressful living conditions help trigger the onset of the ailment earlier than individuals leaving in less taxing scenarios.

The medical condition occurs throughout the globe, and it stands at around 1.5 per 100,000. Nonetheless, some areas of the world have higher rates of schizophrenia compared to the rest. The prevalence of the medical condition includes Oceania, East Asia and the Middle East. On the other hand, Australia, Europe, the U.S and Japan have the lowest rates of the medical condition. This disparity in schizophrenia occurrences in developed countries supports the above causal factor of the disease.

Diagnostic Criterion

The basic diagnosis of the ailment has been focusing on the psychotic symptoms, negative symptoms and cognitive symptoms. The psychotic symptoms of the medical condition include elements such as hallucination, delusions and thought disorder. Conversely, negative effects include reduced motivation, diminished feelings and reduced speaking. Besides, cognitive symptoms of the medical condition concentrate on areas such as difficulties in processing data, problems in using some information, and attention deficit. These classifications are still helpful during the diagnosis process (DSM-5) required when analyzing the medical condition. According to De Pablo et al. (2020), the DSM-5 identifies the medical condition as Schizophrenia Spectrum compared to simply schizophrenia by DSM-IV. The diagnostic process identifies the occurrences of delusions, hallucinations, disorganized speech, catatonic behavior, and negative symptoms (alogia and avolition) in the cases where neglect and no treatment is administered. The above features form part of the characteristic symptoms of the medical condition.

The next diagnostic process is the analysis of occupational dysfunctions. The primary features for evaluation in social dysfunctions include interpersonal relationships, self-care and other functioning. The primary procedure at this level will be evaluating levels of academic performances, interpersonal functioning and occupational functioning. The duration diagnosis process will look for features such as continuous disturbances, especially in six months. The diagnosis must evaluate if the person experiences one month of negative symptoms such as odd beliefs and unusual experiences. At the Schizoaffective and Mood Disorder exclusion, the primary checks will include elements such as lack of maniac episodes and small active and residual periods of the medical condition (Fusar-Poli et al., 2018). The Substance/general medical condition exclusion will engross identification of the connection between the impact of substance use and the occurrence of the medical condition.

The subsequent step of Relationship to a Pervasive Developmental Disorder will look into the occurrences of delusions and hallucinations, and other symptoms as factors contributing to the additional diagnosis of the mental problem. The classification of longitudinal course will seek to look into areas such as First Episode, where primary concentration will be on the areas of elaborating on diagnostic symptom and time criteria, checking whether it is on the first remission and identification whether it is on a full remission (Seow et al., 2018). The diagnosis process also notes that if the medical condition manifests itself with catatonia. The diagnosis of the disease can occur without focusing on severity.

Patient Analysis

Smith Nash is a mathematician who was born and grew up in Massachusetts. The patient is married to his school sweetheart. The wife is patient, thus making Nash believed he is lucky to have her, but she may be getting tired of his character. The client is interested in making beer and, at one point, stipulates he has much respect for the drink. Nash has been diagnosed with schizophrenia, where he has admitted seeing things, which are not there. The patient stipulated he is now used to the medical condition and has made peace with the fact it might be happening to everyone. The description of his personality differs from the accounts of the wife and the wife who accompanied him to the hospital during the current check-up. The wife noted that Nash could be complicated and shy sometimes.

On the other hand, his mother noted he could be brilliant and foolish at the same time. The wife also reported in previous medical reports that the character has many facets, and therefore, it is difficult to pinpoint what makes the character happy or sad (De Pablo,et.al 2020). And in conclusion, the reports showed that it is difficult to understand what to expect with the patient.

The mother documented the first instance when she noted that Nash could be having medical problems. According to the parent, the trouble began when Nash was on campus. The mother indicated that her child started exhibiting delusions, reduced speaking and poor executive functioning. In particular, the parent noted that her child was quiet most of the time, but when he chose to speak, it was with emotions (Rosenberg, 2022). The above narrations were part of clear explanations of the onset and a person with characteristics of schizophrenia. However, as part of the professional practice, it was necessary to document the current behavior to judge the stage and how to handle the medical condition.

The report that will assist with the diagnosis and treatment of Nash’s schizophrenia condition reads like this: “The patient identified as Smith Nash was reported to be roaming in town moving from one shop to another. The patient was arrested before being brought to the hospital, before being booked at the facility. The relevant signs recorded during the onset of the diagnosis and the patient’s treatment include complaints of difficulties in sleeping, constant roaming at the university and town, sometimes the patient being physically abusive to his understanding colleagues and wife. The patient was also experiencing instances of loss of appetite. The patient’s medical examination revealed he was informally dressed and exhibited characteristics such as stupid laughter and apprehensive behavior. The client also showed signs of auditory hallucinations, with this fact clear with his talking to the non-existent third persons (Rosenberg, 2022). The patient also reported instances where he heard people talking and insulting him. Accordingly, he was suspicious of any person around him, including his wife, who joined later. The wife reported that he complained that some people have been calling him lately, issuing threats over his life. Accordingly, she made an effort to look into the issue where he discovered it is non-existent. However, this did not stop him from making noise at night as if pleading for forgiveness from the attackers.”

Diagnosis Process

The DSM-V diagnosis procedure will be applied in this scenario to identify the mental issue exhibited by the client. The diagnosis process shows that the patient exhibits all the characteristic symptoms of delusions, hallucinations, disorganized speech, catatonic behavior and negative symptoms. The client also failed to achieve the expected social functioning practices such as interpersonal relationships and occupational functioning. The continuous signs of disturbances have been happening in the past 6 months. The patient has not registered depressive disorders that occurred concurrently with the primary condition in the last six months. Besides, the disturbance is not attributable to drug abuse as his drinking is within moderate levels. The client did not have any underlining mental problems during his childhood until his late teenage years. The patient has been experiencing multiple episodes currently in full remission. The current severity is on a scale of 5, meaning the situation has been most severe in the last 7 days.

The diagnosis process ruled out any role of physiological effects of a substance or another medical condition. Although the wife indicated that the client has been taking suspicious tablets, which she suspects are new, the medical check-up revealed that the patient was taking pain-relieving medication because of a fall experienced during bad weather (Seow, et.al 2018). The wife’s report was primarily because the patient was defensive of the medicine, which raised her suspicion that he might be using new drugs, contributing to the latest deteriorating health. The process also rules out any other underlining medical conditions. The samples indicated that the patient did not have any underlining medical condition that contributed to the latest episodes.

Recommended Treatment

The severity of the condition will demand a combination of treatment options to guarantee a positive outcome. The intervention will include antipsychotic medication, psychosocial treatments and family education and support. The first step will consist of administering injections twice a month. The choice of this injection is because it would assist in the reduction of the intensity and the frequency of the episodes currently experienced. This is the first-choice treatment for the patient. However, in any case, the patient will be unresponsive to the medication; it will force the use of clozapine (Rosenberg, 2022). This medication has been effective, but it has strong side effects that will prompt routine blood testing to establish the severity of the medicine. When administered with antipsychotic medication, the patient should expect side effects such as weight gain and drowsiness and restlessness. Nonetheless, as a caregiver, the wife must ensure that the patient does not stop the medication suddenly since it will be detrimental to his health.

The next intervention will be psychosocial treatment. This intervention will be utilized with antipsychotic medication for maximum benefit. The intervention will be a combination of cognitive-behavioural therapy and behavioral skills training. Cognitive-behavioural therapy targets the wellness of the mind in preventing episodes experienced with schizophrenic attacks. The approach will include a series of practices that seek to restructure negative thoughts. The patient will be asked about negative thoughts shared with the solution being reframing of the conditions. The other CBT approach will be exposure therapy (Fusar-Poli et.al 2018). This approach will assist the patient in confronting his fears. The therapist will identify things that provoke anxiety and then work towards strategies that allow the coping process. Further, CBT will entail journaling the process to assist the patient in keeping track of new thoughts and behavior that will help document the progress being made.

Moreover, CBT steps will include progressive relaxation techniques to help lower stress. The fact that the individual is engaging in stressful conditions will increase the chances of outbursts. The CBT processes to assist with attaining relaxation processes include deep breathing exercises, muscle relaxation and imagery. The last CBT approach used will be role-playing. In this case, there will be techniques such as practicing social skills, improving communication skills, and assertiveness training. All these processes would seek to boost the well-being of the patient.

The behavioral interventions will assist with the training of metacognitive and social skills. These areas are affected by the episodes experienced by the patient. The reframing processes will be useful in improving the behavior of the individual when the attacks strike. The use of psychosocial treatment is because medication alone will not assist in the prevention of stressors and other causal features that triggers schizophrenia. Therefore, the involvement of these interventions will be helpful in the attainment of the goal of improvement in personal and social behavior.

Family, education, and support entail training family, friends, and caregivers about schizophrenia disease and handling patients with the medical condition. The approach intends to improve the ability of caregivers to be part of the treatment and care process. In the case of Nash, the wife is the primary caregiver who is on the brink of a breakdown because of the difficulties of handling her patient. At one time, the caregiver noted it is difficult to explain who Nash exactly is (Rosenberg, 2022). This lack of information about caring for a person with schizophrenia prolongs the problems that impact the patient’s life. Family-based education is instrumental in lessening caregivers’ distress, improving their coping mechanisms, and strengthening their ability to provide better care to patients. Caregivers could receive training on supporting and caring for their patients through family-based services offered through multi-family workshops.

References

De Pablo, G. S., Catalan, A., & Fusar-Poli, P. (2020). Clinical validity of DSM-5 attenuated psychosis syndrome: advances in diagnosis, prognosis, and treatment. Jama Psychiatry, 77(3), 311-320.

Fusar-Poli, P., De Micheli, A., Cappucciati, M., Rutigliano, G., Davies, C., Ramella-Cravaro, V., & McGuire, P. (2018). Diagnostic and prognostic significance of DSM-5 attenuated psychosis syndrome in services for individuals at ultra-high risk for psychosis. Schizophrenia bulletin, 44(2), 264-275.

Rosenberg, G. F. (2022). Psychology: Perspectives and Connections (5th ed.). New York: McGraw-Hill.

Seow, L. S. E., Verma, S. K., Mok, Y. M., Kumar, S., Chang, S., Satghare, P., … & Subramaniam, M. (2018). Evaluating DSM-5 insomnia disorder and the treatment of sleep problems in a psychiatric population. Journal of Clinical Sleep Medicine, 14(2), 237-244.