Apply critical thinking skills in the psychopathology of mental health patients

    Analyze and apply critical thinking skills in the psychopathology of mental health patients and provide treatment and health promotion while applying evidence-based research.Scenario: C.Z. is a 20-year-old Caucasian male who is in his second year of college. He is seeking treatment due to persistent fears that campus security and the local police are tracking and surveilling him. He cites occasional lags in his internet speed as evidence that surveillance devices are interfering with his electronics. His intense anxiety about this has begun getting in the way of his ability to complete schoolwork, and his friends are concerned – he says they have told him, “you’re not making sense.” C.Z. occasionally laughs abruptly and inappropriately and sometimes stops speaking mid-sentence, looking off in the distance as though he sees or hears something. He expresses concern about electronics in the room (phone, computer) potentially being monitored and asks repeatedly about patient confidentiality, stating that he wants to be sure the police won’t be informed about his treatment. His beliefs are fixed, and if they are challenged, his tone becomes hostile. Questions: Remember to answer these questions from your textbooks and NP guidelines. At all times, explain your answers. Discuss the etiology, course, and the structural/functional abnormalities of schizophrenia. Discuss the evidence-based pharmacological and nonpharmacological treatment for this patient using the US Clinical Guidelines.

Sample Solution

     

The etiology of schizophrenia is not fully understood, but it is thought to be caused by a combination of genetic and environmental factors. Genetic factors play a significant role, as schizophrenia tends to run in families. However, environmental factors, such as prenatal exposure to certain viruses or toxins, may also trigger the development of the disorder.

Full Answer Section

    Schizophrenia typically begins in early adulthood, with an average age of onset of around 20 years old. The course of the disorder is variable, but it is often characterized by periods of remission and relapse. During a relapse, a person with schizophrenia may experience psychotic symptoms, such as delusions and hallucinations. During a remission, the symptoms may be absent or minimal. Schizophrenia is associated with a number of structural and functional abnormalities in the brain. These abnormalities include:
  • Enlarged ventricles: The ventricles are fluid-filled cavities in the brain. In people with schizophrenia, the ventricles are often enlarged.
  • Reduced gray matter volume: Gray matter is the tissue in the brain that contains neurons. People with schizophrenia often have reduced gray matter volume in certain areas of the brain.
  • White matter abnormalities: White matter is the tissue in the brain that connects different areas of the brain. People with schizophrenia often have white matter abnormalities, such as reduced connectivity between different brain regions.
  • Dopamine dysregulation: Dopamine is a neurotransmitter that is involved in motivation, reward, and movement. People with schizophrenia are thought to have dysregulation of the dopamine system.
Evidence-Based Pharmacological and Nonpharmacological Treatment for Schizophrenia The US Clinical Guidelines for the Treatment of Schizophrenia recommend a combination of pharmacological and nonpharmacological treatment for schizophrenia. Pharmacological treatment: The first-line pharmacological treatment for schizophrenia is second-generation antipsychotics (SGAs). SGAs are more effective than first-generation antipsychotics at reducing psychotic symptoms and have a lower risk of side effects. Some of the most commonly used SGAs include:
  • Risperidone (Risperdal)
  • Olanzapine (Zyprexa)
  • Quetiapine (Seroquel)
  • Aripiprazole (Abilify)
  • Ziprasidone (Geodon)
SGAs are typically taken once daily in the form of a pill, liquid, or injection. Nonpharmacological treatment: Nonpharmacological treatments for schizophrenia include:
  • Individual therapy: Individual therapy can help people with schizophrenia to manage their symptoms, cope with the challenges of living with the disorder, and develop social skills.
  • Group therapy: Group therapy can provide people with schizophrenia with support from others who are living with the disorder.
  • Family therapy: Family therapy can help families to understand and support their loved one with schizophrenia.
  • Cognitive behavioral therapy (CBT): CBT can help people with schizophrenia to identify and challenge negative thoughts and beliefs.
  • Supported employment: Supported employment programs can help people with schizophrenia to find and maintain employment.
Treatment Plan for C.Z. The treatment plan for C.Z. would likely include a combination of pharmacological and nonpharmacological treatment. Pharmacological treatment: C.Z. would likely be started on an SGA, such as risperidone or olanzapine. These medications are effective at reducing psychotic symptoms, such as delusions and hallucinations. Nonpharmacological treatment: C.Z. would also benefit from individual therapy and group therapy. Individual therapy can help him to manage his symptoms, cope with the challenges of living with schizophrenia, and develop social skills. Group therapy can provide him with support from others who are living with the disorder. In addition, C.Z. may benefit from CBT and supported employment programs. CBT can help him to identify and challenge negative thoughts and beliefs. Supported employment programs can help him to find and maintain employment. Conclusion Schizophrenia is a serious mental health disorder, but it is treatable. With a combination of pharmacological and nonpharmacological treatment, people with schizophrenia can live full and productive lives. Disclaimer: This is a general overview of the treatment of schizophrenia. It is important to note that the specific treatment plan for C.Z. would need to be developed by a mental health professional based on his individual needs and circumstances.  

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