Schizophrenia Spectrum and Other Psychotic Disorder

Captain of the Ship: Schizophrenia Spectrum and Other Psychotic Disorder

Schizophrenia spectrum and other psychotic disorders are a DSM-5 diagnostic characterized by symptoms of hallucinations, lack of emotions, social isolation, and depressive episodes that result in an impaired ability to function. The symptoms for the condition can be described as positive, negative, or cognitive. People with schizophrenia have high death prevalence rates than other people in society. Ingrid, Ole, & Unn (2016) highlight that psychiatric health care has a major problem in addressing the high death rates in patients with psychotic disorders. The purpose of the paper is to explore schizophrenia psychotic disorder. It will discuss a case, recommend treatment, referrals, follow-up plan, and collaboration needed to manage the diagnosis effectively. Schizophrenia hinders the productivity of a patient and requires a combined effort of CBT and medication to improve the situation.

History of Present Illness (HPI) and Clinical Impression

The patient is a 27-year-old African- American male who lives with his younger brother. The patient was discharged from a one month inpatient stay at a psychiatric hospital. His diagnosis was schizophrenia, the undifferentiated and chronic type. He was easily distracted. Patient-reported being able to function for days with just about three to four hours of sleep per night. Cognitively, he experienced hallucinations and delusions. The brother reported that the subject has been furious, low mood, and isolated for the past six months, which is unlike his outgoing nature. He denies being unable to work independently and thoughts of suicide.

The presentation of the signs and symptoms noted in the HPI indicate the Schizophrenia psychotic disorder. The patient exhibited distractibility and anxiety. His brother observed the patient’s change in mood during the appointment. The signs and symptoms correlate with the diagnostic criteria outlined by the American Nurses Association (2014) in DSM-5. The patient does not exhibit a state of severe need for hospitalization.

Medication

The patient was put on Risperidone in his past hospitalization cases but stopped taking it because of financial difficulties. Thus, Risperidone is still recommended because there were no side effects recorded. Accordingly, Risperidone has been empirically studied and supported as an effective treatment for stabilizing moods and increasing neurocognitive functions (Ferreira et al., 2016). As stated by Ferreira et al. (2016), the medicine will regulate moods, prevent reoccurrence of depressive episodes, and deter suicidal tendencies. These are therapeutic endpoints that Risperidone will likely assist in realizing with the patient.

Psychotherapy

A concerted effort is useful for treating Schizophrenia, which means that Cognitive Behavioral Therapy (CBT), and medication should work together. The American Nurses Association (2014) lists CBT as a type of psychotherapy. The client can function well in a group or individual therapy, but individually-focused treatment will be beneficial in this case. The approach enhances social skills through psychoeducation sessions, positive reinforcements, communication skills training, and problem-solving skills training (Granholm, Holden, Link, & Mcquaid, 2014). The procedure addresses areas of distress and social disruption caused by Schizophrenia. Specifically, the method will increase the level of stimulation and stabilize moods in the client.

Medical Management

Individuals with Schizophrenia and psychotic disorders usually have social phobia as the most common comorbid medical conditions. According to Ingrid et al., (2016), a schizophrenic patient has a high risk for chronic obstructive pulmonary disease (COPD), autoimmune diseases, chronic obstructive pulmonary, cancer, and infections. Therefore, the patient requires screening, management, and regular monitoring by the medical team. Involving the primary care team is for monitoring complications that may arise from psychiatric medication such as Risperidone that leads to progressive renal insufficiency, QT prolongation, and hypothyroidism (Viron, Baggett, Hill, & Freudenreich, 2012). Antipsychotic drugs are known to carry teratogenic risks, which warrant the attention of the General Physician before prescribing such medications to pregnant women (Ferreira et al., 2016; Viron et al., 2012). Doctors, physicians, and nurses are necessary for identifying and making appropriate medical management for these patients.

Community Resources

People with Schizophrenia and psychotic disorders have poor social and occupational integration. Getting and maintaining a job for such patients might be difficult due to erratic moods, disorientation, and aggravated behaviors, which makes them require financial and emotional support from the community (Viron et al., 2012; Granholm et al., 2014). The Medicare program, which offers community resources such as residential care communities, allows for the monitoring of patients by guaranteeing their autonomy and appointments and prescribed medications. They can also acquire information from organizations such as the National Alliance on Mental Illness and Depression on the diagnosis, treatment options, and support groups (American Nurses Association, 2014). Community resources facilitate these individuals and their families to have access to printable materials, hotline numbers, and websites that contain strategies for living with psychosis, suicide prevention, and crisis management.

Follow -up Plan and Collaboration

Clients diagnosed with Schizophrenia and Psychotic disorders requires a follow-up plan. The program monitors their behavior and adherence to medication. (American Nurses Association, 2014). Viron et al. (2012) state that antipsychotic treatment, like Risperidone presents significant safety issues, which require regular monitoring. It is essential to monitor the white blood count for immunosuppression.

It is crucial to collaborate with the primary care team to identify drugs interactions and monitor adverse effects. Ferreira et al. (2016) claim that every drug has a side effect, and thus, tests determine the reaction of atypical and typical drugs. Laboratory tests like thyroid function tests, blood glucose test, pregnancy test, and diagnostic tests such as electrocardiogram are crucial before administering medicine. Undertaking these tests offer insights that determine the right doses and medicine.

Another essential collaboration is with other stakeholders such as Nutritionists and social workers. Social workers contribute to information about the disease that includes reduced costs, affordable housing, medications, or even support groups (Viron et al., 2012). Additionally, Nutritionists helps the patients to create a healthy meal plan. Ferreira et al. (2016) claim that some antipsychotic drugs lead to weight gain, which signifies the merits of consistently drinking water and following a sodium diet. Collaboration with all these individuals and groups disseminates information on patient’s behaviors, adherence to treatment, and medication’s effectiveness.

Conclusion

Schizophrenia Spectrum and Psychotic disorder can impair an individual’s ability to function if not properly managed. Antipsychotic drugs such as Risperidone are effective in treating the disease. Cognitive-behavioral therapy, through social skills training, improves a patient’s ability to manage Schizophrenia, function independently, and reduce distress.

Medication requires collaboration with other interdisciplinary measures to achieve the best outcomes for the client. A follow up is necessary for the client to receive continuous care and prevent re-hospitalization.

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