Sample Philosophy Coursework Paper on Schizophrenia Diagnosis and Treatment Planning

Schizophrenia Diagnosis and Treatment Planning

Introduction

            Schizophrenia is a chronic critical and disabling brain disorder affecting all genders worldwide, patients tend to become withdrawn due to signs and symptoms they experience (WHO, 1992). Available treatment approaches reduce symptoms of the disease but does not permanently heal the person. This study describes methods applicable in the evaluation and diagnosis of the client. Strengths and weaknesses of the approaches used are highlighted. The study further diagnoses the client represented comprehensively when applying a DSM-5. Principal diagnosis, medical conditions among others is focused for clinical attention.

Signs and symptoms

            This brain disorder affects all gender irrespective of the age and race. On this patient, he came with the problem of hearing voices that only he could hear. He had a problem of believing that he could read the mind of his relations and controls the mind and complained to his close kin that he had read the mind of a person who wants to harm him. The kin had to seek medical attention because the man could sit for hours without moving or talking, had a problem holding a job, and thus had to move from one job to another. On physical observation, the patient looked perfectly fine.

Other symptoms of schizophrenia

            Swanson, et al (2006) observes that there are positive, negative, and cognitive symptoms of schizophrenia. Positive symptoms are characters rare in healthy people. Patients with schizophrenia are likely to have recurring positive symptoms such as hallucinations, delusions, thought and movement disorders. Negative symptoms are at times difficult to realize as they are related to depression. These are flat effect where the patient talks in a dull voice, absence of ability and pleasure in daily activities. Cognitive symptoms are likewise difficult to realize unless the patient is tested. These symptoms include disability to understand and wisely make decisions, focusing on an issue and challenges with the working memory. These are the main causes of emotional distress among patients as they are mostly unable to lead a normal life.

Rationale

            Schizophrenia is a chronic disease of the brain, which is can be managed but the patient is not guaranteed to entire recovery. It is devastating to acquire the diagnosis since most of the signs and symptoms are related to other forms of diseases. A proper diagnosis and management is necessary to manage complications and improve the probability to recover (Walsh, Buchanan & Fahy, 2002). The signs and effects of this problem are critical as it results to the loneliness of the patients since most of the effects are embarrassing. Based on the highlighted signs and symptoms, it is essential to perform the DSM-5 for the patient to reduce these effects. It is therefore necessary to minimize and control these effects so the patient can return to daily normal activities and at least be dependent. It is besides necessary to control the effects of the disease to minimize its spread and drastic effects. Various methods applied in the management of the disease are available in combination of the DSM-5 which is a more precise and accurate diagnosis of the problem. From previous studies, it is believed that one in every five patients improve within the first five years of the problem, three in every five patients improve but have the symptoms. At times, the patients may have worse symptoms. It is besides believed that only one in every five have critical symptoms despite the treatments.

Diagnosis

            Schizophrenia is not related to any laboratory results. According to DSM-5, a patient must have experienced at least two of the symptoms, which are disorganized speech, hallucinations, delusions, and negative symptoms (Zupanick, 2015). Other the delusions, disorganized speech, and hallucinations, this particular patient had experienced negative symptoms. After close examinations, the symptoms became worse and thus had to be introduced to the treatments. It was necessary for the patient to be introduced to treatment, which comprised of the medication, psychosocial treatment, and support system.

Criteria applied in the diagnosis

            Other than the hallucination and delusion, the patient must experience other symptoms like negative symptoms for one month (Zupanick, 2015). The next criteria is to examine the level of functioning of the patient. If the patient has a low level of achieved prior onset, then the condition may be for schizoaffective disorder. If the symptoms began in childhood and adolescence, then the level of functioning may not be attained. If the patient becomes withdrawn to prior activities he used to enjoy then this may be termed as the first disorder. The patient is expected to have experienced the symptoms for at least six months. To determine the difference between schizophrenia and schizoaffective disorder, criterion D is applied. Basic psychosis and mood symptoms in schizophrenia should have been experienced. The last criterion demands that the attendance rule out psychosis may be a result of medical condition is application if drugs. Other conditions to look out for include reduced cognitive function, which is the basis of brain disease. The patient may additionally suffer from unawareness of the disease, which has been previously assumed a mechanism of denial. It is noteworthy to note than schizophrenia patients are never aggressive but have been previously victimized than the common population (Zupanick, 2015).

Management

            Schizophrenia affects all gender and races equally in 16-30 years. Men are likely to be affected than women. Previous research asserts that people do not suffer from schizophrenia after 45 years and in children. Antipsychotic medications reduce positive symptoms and relapses. Clozapine has been identified as the applied drug due to its effectiveness. This comprises of social skills, cognitive remediation, cognitive- behavioral therapy, social cognitive training. Treatment is to be managed according to the recovery model.

Causes

            Numerous factors attribute to the causes. Among them are the genes and environment. Previous studies assert that schizophrenia runs in a family. The disease is realized within 1% of the common population and 10% of the relation to first-degree relatives with the disorder. This implies that a brother may have the disease when the sister ahs it, a son or a daughter may have it when one of the parents suffers from it (National Institute of Mental Health, 2009). Additionally, second-degree relations may also suffer than in the common population. A twin to the patient is 40-60% likely acquire the disease. A person may have the gene carrying the disease of may have inherited from the relations. Diverse brain chemistry in terms of imbalanced complex and chemical reactions may result to schizophrenia. Recent research has discovered that the brain content in the schizophrenia patients is different from normal people. Affected people tend to have larger ventricles and less gray matter (WHO, 1992).

Goals of treatment

The main objectives of this treatment comprise of minimization of the symptoms, prevention of relapse and need for hospital visitation, reduction of undesirable side effects from medication, maintenance of relief from the symptoms and return to the daily activities of the patient.

Methods for assess and diagnosis

            Since the causes of schizophrenia are still unknown, treatments are applied to reduce symptoms. It is possible to live a meaningful life despite the presence of schizophrenia through several evaluation methods. Through these approaches, the patient can lean towards personal goals, manage symptoms, and become satisfied in life. Among these approaches, include psychosocial treatment, medication, support system,

Psychosocial treatment

            This approach assists the patients to manage the symptoms, overcome long-term psychotic periods, restores functioning ability and enables a patient enjoy a purpose driven life. It is more appropriate for patients who have responded well to the medication. These treatments are beneficial to the patients as they enable the patient manage challenges like communication, work, maintenance of relationships and self-care. By becoming equipped with the socialization skills, the patient is able to return to normal activities like work and school. Patients applying this method can continue using the drugs. They rarely experience relapses and the need for hospitalization. This method is however challenging as it relies on other modes of treatments such as supportive services and therapy for best results. It demands teamwork of the patients, family members, and medical professionals for effective results.

Support System                           

This approach is effective as it involves family members, friends. It offers assistance in maintaining the right treatment. Patients are able to control the symptoms. This form of treatment requires support from close family members and friends, which may be missing. This treatment plan comprises of rehabilitation, family education, and illness management skills. Family education enables the family to learn how to cope with the problem and assist the patient in sticking with the treatment.

Medication

As a component of treatment, this approach is suitable as it controls psychotic symptoms like hallucinations and disordered thoughts, treats other psychotic symptoms like social withdrawal, absence of emotional expressions and motivation. Medication is challenging as it has diverse disabling effects like drowsiness, weigh gain, muscle spasms, and sexual dysfunction. Besides this, it relies on medical assistance. Common medication for the disorder comprise of chlorpromazine and loxapine for the first generation and Aripiprazole and Olanzapine for the second generation. Of these, clozapine has been depicted as more effective in the treatment of hallucinations and psychotic symptoms (Meltzer, 2003). Its major effect is agranulocytosis. Therefore, patients using this drug need to undergo weekly testing of the white blood cells. This makes the treatment more costly especially to the patients who are unresponsive to other medications (Swanson, 2006). Other drugs such as Paliperidone and Ziprasidone have minimal agranulocytosis and thus can be used instead of clozapine. When the doctor stops the patient from using medication, gradual tapering off may be applied. 

Treatment planning

In this case, the three mentioned treatment plans would be applied. First, the patient will be put under medication examination in the hospital where he will obtain medication in form of vaccines twice a week. This measure is to reduce the symptoms and assists in managing the side effects of the drugs, which includes tremors. Thereafter one month after the patient has adjusted to treatment, he will be taken through support treatment followed by psychosocial treatment. This is to ensure that the family, the caregivers, and the patient will manage to cope with the problem and overcome challenges posed by the disease. First, the family and the patient will have to be taken through illness management skills where they will be trained on how to manage the illness. This support will enable the patients and the family understands the development, source, and management of the challenges as they arise. This training may take one month. The patient before discharged will have to undergo rehabilitation where he will be taught communication skills, money management, and job counseling. This is to enable the patient remain self reliant and supportive to the family.

Conclusion

Schizophrenia is a chronic critical and disabling brain disorder affecting all genders and races especially from the age of 16. This implies that the disease does not affect children and adults above 45 years. Patients tend to become withdrawn due to signs and symptoms they experience and the tendency to become dependent on the society. Available treatment approaches reduce symptoms of the disease but does not permanently heal the person.

References

Meltzer, H. Y. “International Suicide Prevention Trial Study Group. Clozapine treatment for

suicidality in schizophrenia: International Suicide Prevention Trial (InterSePT).”

Archives of General Psychiatry. 2003 Jan;60(1):82-91.

National Institute of Mental Health. Schizophrenia. 2009

http://www.nimh.nih.gov/health/publications/schizophrenia/index.shtml#pub10

Swanson,  J. W., et al. “A national study of violent behavior in persons with schizophrenia.”

Archives of General Psychiatry. 2006. 63(5):490-499.

Walsh, E., Buchanan, A., & Fahy, T. “Violence and schizophrenia: examining the evidence.”

British Journal of Psychiatry. 2002 Jun;180:490-495.

World Health Organization (WHO). Catatonic Schizophrenia. The ICD-10 Classification of

Mental and Behavioural Disorders: Clinical descriptions and diagnostic guidelines.

Switzerland. 1992.

Zupanick, C. E. “The New DSM-5: Schizophrenia Spectrum and Other Psychotic Disorders.”

AMHC. 2015. 207: 498-6431

http://www.amhc.org/1418-dsm-5/article/51960-the-new-dsm-5-schizophrenia-spectrum-and-other-psychotic-disorders