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Psychosis: The Patient’s Clinical History

Akin’s clinical history strongly implies that he might have psychosis. Although it is not evident if it is the main diagnosis and there is room for something else, analyzing its features and comparing them with the case might clarify the issue. This essay will address the current definition of psychosis, explain its primary aspects, and highlight the relation between the diagnosis and the patient’s clinical history.

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Psychosis has a long history, but its name is relatively recent. It was known as insanity, later described as a “defect in reality testing,” until redefined as something that interferes with one’s ability to “meet ordinary demands of life” (Moscowitz et al., 2019, p. 10). The recent definition of psychosis links it with the presence of certain symptoms, which include hallucinations, delusions, and thought disorder (APA, 2016). Hallucinations can vary from visual to tactile, affecting all five senses, while delusions are deeply rooted beliefs with a varying degree of plausibility (Tsola & Anastassiou-Hadjicharalambous, 2012). Thought disorder is associated with planning problems, attention switching, and working memory deficits (Meaden & Hacker, 2010). Thus, these are the key symptoms of psychosis that allow the clinician to identify it.

Several facts from Akin’s history reflect the features of psychosis. For example, he’s talking to himself could be an auditory hallucination. The patient’s belief that he is controlled by energy waves from the television is an instance of delusion. His thought process might also be affected, which is apparent from his poor work performance and could be further established during the interview. The patient’s heavy use of cannabis may suggest susceptibility to psychosis (Soneson et al., 2020). However, psychosis does not manifest by itself; it is indicative of another mental disorder, such as schizophrenia (Moscowitz et al., 2019). Still, it appears that delusions and hallucinations may be common among people without psychosis (Wright et al., 2014). Therefore, a thorough analysis of the clinical history is required to determine whether the patient is indeed mentally ill.

To summarize everything, this paper presented psychosis and its general features, through which it is defined. They are hallucinations, delusions, and thought disorders that should all be present to give a proper diagnosis. The patient’s record indicates that he is affected by all of the aspects of psychosis, which allows the clinician to suspect a psychosis disorder. In the end, the patient might suffer from any illness from the group, including schizophrenia.

References

American Psychiatric Association. (2016). Supplement diagnostic and statistical manual of mental disorders: Fifth edition. Web.

De Sousa, A., & Shrivastava, A. (2020). Among patients with schizophrenia: A learning curve for psychiatrists. In A. Shrivastava & A. De Sousa (Eds.), Schizophrenia treatment outcomes: An evidence-based approach to recovery (pp. 3-8). Springer.

Kern, R. S., Horan, W. P., Glynn, S. M., Reddy, L. F., Holden, J., Granholm, E., Turner, L. R., Sullivan, M. E., & Spaulding W. D. (2014). Psychosocial rehabilitation and psychotherapy approaches. In P. G. Janicak, S. R. Marder, R. Tandon, & M. Goldman (Eds.), Schizophrenia: Recent advances in diagnosis and treatment (pp. 275-314). Springer.

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Kruse, M., & Schulz, S. C. (2014). Overview of schizophrenia and treatment approaches. In S. C. Schulz, M. F. Green, & K. J. Nelson (Eds.), Schizophrenia and psychotic spectrum disorders (pp. 3-22). Oxford University Press.

Lin, C.-H., Huang, C.-L., Chang, Y.-C., Chen, P.-W., Lin, C.-Y., Tsai, G. E., & Lane, H.-Y. (2013). Clinical symptoms, mainly negative symptoms, mediate the influence of neurocognition and social cognition on functional outcome of schizophrenia. Schizophrenia Research, 146(1-3), 231–237. Web.

Lotterman, A. (2015). Psychotherapy for people diagnosed with schizophrenia: Specific techniques. Routledge.

Marder, S. R. (2014). Schizophrenia. Oxford University Press.

Meaden, A., & Hacker, D. (2010). Problematic and risk behaviours in psychosis: A shared formulation approach. Routledge.

Miller, A. H., Haroon, E., Raison, C. L., & Felger, J. C. (2013). Cytokine targets in the brain: impact on neurotransmitters and neurocircuits. Depression and Anxiety, 30(4), 297–306. Web.

Miller, G. A., & Rockstroh, B. S. (2016). Progress and prospects for endophenotypes for schizophrenia in the time of genomics, epigenetics, oscillatory brain dynamics and the research domain criteria. In T. Abel & T. Nickl-Jockschat (Eds.), The neurobiology of schizophrenia (pp. 17-38). Academic Press.

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Moscowitz, A., Heinimaa, M., & van der Hart, O. (2019). Defining psychosis, trauma, and dissociation: Historical and contemporary conceptions. In A. Moscowitz, M. J. Dorahy, & I. Schäfer (Eds.), Psychosis, trauma and dissociation: Evolving perspectives on severe psychopathology (pp. 9-29). Wiley Blackwell.

Müller, N., Weidinger, E., Leitner, B. & Schwarz, M. J. (2016). The role of inflammation and the immune system in schizophrenia. In T. Abel & T. Nickl-Jockschat (Eds.), The neurobiology of schizophrenia (pp. 179-193). Academic Press.

Nickl-Jockschat, T., & Abel, T. (2016). Historical and clinical overview: implications for schizophrenia research. In T. Abel & T. Nickl-Jockschat (Eds.), The neurobiology of schizophrenia (pp. 3-13). Academic Press.

Pogarell, O., Koch, W., Karch, S., Dehning, S., Müller, N., Tatsch, K., Poepperl, G., & Möller, H.-J. (2012). Dopaminergic neurotransmission in patients with schizophrenia in relation to positive and negative symptoms. Pharmacopsychiatry, 45(1), 36–41. Web.

Shea, S. C. (2016). Psychiatric interviewing: The art of understanding. Elsevier.

Soneson, E., Perez, J., & Jones, P. B. (2020). Principles of risk, screening, and prevention in psychiatry. In A. D. Thompson & M. R. Broome, Risk factors for psychosis: paradigms, mechanisms, and prevention (pp. 11-43). Academic Press.

Szymańska, K., Kuśmierska, K., & Demkow, U. (2015). Inherited disorders of brain neurotransmitters: Pathogenesis and diagnostic approach. In M. Pokorski (Ed.), Neurotransmitter interactions and cognitive function (pp. 1-8). Springer.

Tasman, A., Kay, J., Lieberman, J. A., First, M. B., & Maj, M. (Eds.). (2013). The Psychiatric Interview: Evaluation and Diagnosis. Willey-Blackwell.

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Tsola, M.-E., & Anastassiou-Hadjicharalambous, X. (2012). Psychotic symptomatology: Clinical features, assessment and differential diagnosis. In X. Anastassiou-Hadjicharalambous (Ed.), Psychosis: causes, diagnosis and treatment (pp. 1-24). Nova.

Wright, N. P., Turkington, D., Kelly, O. P., Davies, D., Jacobs, A. W., & Hopton, J. (2014). Treating psychosis: A clinician’s guide to integrating acceptance and commitment therapy, compassion-focused therapy, and mindfulness approaches within the cognitive behavioral therapy tradition. New Harbinger Publications.

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