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total on e page ( half a page student post, plus two short responses.
1)HALF A PAGE SINGLE SPACED.
Select one disorder of interest from the DSM-5 covered this week. In your initial posting, discuss the diagnostic criteria, treatment options, and prognosis of the disorder. Use at least two current references other than the DSM-5. After you have posted your initial posting by the third day of the module, respond substantively to at least two peers by the end of the module.
2) first response to the following post. Little more than ¼ a page, two citation.
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Schizophrenia is a mental disorder affecting the way one thinks, feels, and behaves resulting in losing touch with reality (National Institute of Mental Health, 2020). Some symptoms of schizophrenia include delusions, hallucinations, disorganized thinking, abnormal motor behavior, and negative behaviors such as the ability to neglect personal hygiene. These symptoms are thought to occur due to a dysfunction of the dopaminergic neurotransmission (Mayo Clinic, 2020).
Schizophrenia can be clinically diagnosed based on history and the examination of mental state. There are no diagnostic tests or biomarkers, but a differential diagnosis can be made based on the duration of the illness, the nature and pattern of a substance being abused, any somatic illness, and the co-occurrence of depression and mania (Owen, Sawa, & Mortensen, 2016). A person with schizophrenia may present with psychosis. The main differential diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), is affective psychosis such as bipolar or major depression with psychotic features, nonaffective psychosis such as schizoaffective disorder, delusional disorder, brief psychotic disorder, psychotic disorder not otherwise specified, substance-induced psychosis such as alcohol or other substance-induced, and any general medical condition causing psychosis (Owen et al., 2016).
Antipsychotics are the drug of choice in managing schizophrenia. The first-generation antipsychotics such as Haloperidol, Chlorpromazine, and Fluphenazine usually cause neurological side effects such as tardive dyskinesia. The second-generation antipsychotics are generally preferred now due to lower risk of side effects than the first-generation antipsychotics. Examples of second-generation antipsychotics include Clozapine, Olanzapine, Risperidone, Lurasidone, Aripiprazole, Quetiapine, and Ziprasidone. Other injectables include Abilify Maintena, Haldol decanoate, and Paliperidone. Psychological and social therapy is helpful with pharmacological agents (Mayo Clinic, 2020). Schizophrenia requires long-term treatment and antipsychotic drugs are effective in preventing relapse of symptoms of psychosis but due to the side effects such as weight gain, sedation, and movement disorders, most patients do not adhere to treatment and this results in suicidal attempts or thoughts, anxiety disorders, social isolation, depression, and other health and medical problems (Mayo Clinic, 2020). Schizophrenia if left untreated can disable a person therefore, when a timely, and coordinated treatment is initiated, a person can function effectively in society and have a quality of life.
2) second response to the following, little more that ¼ a page. Two citations
Schizophrenia is defined by Patel, et al. (2014) “a complex, chronic mental health disorder characterized by an array of symptoms, including delusions, hallucinations, disorganized speech or behavior, and impaired cognitive ability.”
A diagnosis of schizophrenia is reached through continued assessment of patient-specific signs and symptoms. The Diagnostic and Statistical Manual of Mental Disorders (APA, 2013) identifies “the diagnostic criteria include the persistence of two or more of the following active-phase symptoms, each lasting for a significant portion of at least a one-month period: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and negative symptoms.” Additionally, at least one of the qualifying symptoms must be delusions, hallucinations, or disorganized speech (Patel et al.)
Treatment for schizophrenia encompasses both psychotherapy and pharmacologic therapy. The two work together to help the schizophrenic patient remain stable. Psychotherapy fills in the gaps where pharmacologic therapy leaves off. Many patients are not compliant with medications; therefore, therapy helps with the treatment. Antipsychotics are the mainstay of pharmacologic treatment. According to the American Psychiatric Association, second-generation (atypical) antipsychotics (SGAs)—with the exception of clozapine—are the agents of choice for first-line treatment of schizophrenia. The Texas Medication Algorithm Project (TMAP) has provided a six-stage pharmacotherapeutic algorithm for the treatment of schizophrenia (Patel et al.).
Patel et al. recognize that both subjective and objective data must be collected to evaluate the improvement/recovery of schizophrenia. Objective dimensions of recovery include the remission of symptoms and the patient’s return to full-time work or enrollment in college (Patel et al.) The Brief Psychiatric Rating Scale (BPRS) and the Positive and Negative Syndrome Scale (PANSS) can be used for evaluation of the improvement. Clinicians may also choose to use four-item instruments such as the Positive Symptom Rating Scale and the Brief Negative Symptom Assessment.
Subjective dimensions of recovery are measured by the patient in terms of his or her life satisfaction, hope, knowledge about his or her mental illness, and empowerment (Patel et al.).
Even with continual therapeutic advances, the life expectancy of patients with schizophrenia is reduced by approximately 10 to 25 years compared with that of healthy individuals (Patel et al.). The increased mortality among patients with schizophrenia has been attributed to behaviors such as: unhealthy lifestyles common among this population (i.e., lack of exercise, unhealthy diet, and excessive smoking and alcohol intake), treatment-related adverse events, the suboptimal treatment of concomitant physical illnesses, and suicide (Patel et al.). Capsi et al. (2004) found that “between one-third and one-half of the individuals who meet diagnostic criteria for schizophrenia remain actively ill despite optimal pharmacological treatment.”
Although prognosis seems bleak, continued pharmacological therapy with psychotherapy is the best option for schizophrenia. Familial support to ensure compliance also helps. With all of these factors, schizophrenia can be better managed.
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