Schizophrenia: Diagnosis and Treatment

Introduction

The provided case contains sufficient information to diagnose the patient with schizophrenia. According to the National Alliance on Mental Illness (NAMI, n.d.), the presence of signs such as hallucinations, delusions, cognitive issues, and negative symptoms is a marker of developing schizophrenia. Based on the information given in the summary, it is possible to state that Chris clearly shows all of the mentioned conditions. The following breakdown of evidence will support the diagnosis statement.

Hallucinations

This condition includes the patient hearing voices, seeing things, or smelling scents that others cannot perceive. According to information from the case, the patient “occasionally laughs abruptly and inappropriately” and sometimes “stops speaking mid-sentence, looking off in the distance as though he sees or hears something.” It is quite apparent that people around Chris do not see or hear anything strange. For instance, his friends tell him that he “is not making sense.”

Delusions

Delusion can be described as a false belief that is deeply entrenched within the person’s mind. In the case of Chris, he firmly believes that he is being watched by the campus security and local police. In addition, he also believes that somebody can be monitoring his phone and computer and repeatedly shares his concerns. This persecution mania is delusional and serves as another evidence that points to developing schizophrenia.

Cognitive Issues

Cognitive issues can manifest themselves in patients struggling to remember things, organize their thoughts, or complete assigned tasks. In addition, people diagnosed with schizophrenia commonly display anosognosia — “the lack of insight” (NAMI, n.d.). That condition makes the patients unaware of their illness and provokes a negative response if they are told otherwise. Chris shows a clear case of anosognosia because his tone becomes hostile when someone questions his delusional beliefs.

Negative Symptoms

Negative symptoms may have various manifestations, but they ultimately result in diminished patient’s abilities, making them disconnected from reality. In the case of Chris, his persecution mania resulted in crippling anxiety, which has begun getting in the way of his ability to complete schoolwork. Therefore, the inability to follow through with daily activities combined with the evident hallucinations, delusions, and cognitive issues creates a clear clinical picture of developing schizophrenia.

Treatment Proposal

Schizophrenia cannot be fully cured; this mental illness requires lifelong treatment. However, combined use of medications and psychotherapy can improve the patient’s quality of life significantly. According to Mayo Clinic (2020), medications are the most important aspect of schizophrenia treatment, and the most commonly prescribed drugs are antipsychotics. Since the patient from the case summary developed a standard case of schizophrenia, the proposed treatment strategy will also be conservative. However, an initial hospitalization may be necessary to ensure the patient’s safety.

Medications

As stated in the previous section, a prescription of antipsychotics is necessary. Mayo Clinic (2020) supports a conservative approach by suggesting managing the symptoms with the lowest possible dose. A psychiatrist should remember that antipsychotics may cause serious side effects. Therefore, it would be better to prescribe second-generation antipsychotics, such as clozapine or risperidone, since they are safer for the patient (Mayo Clinic, 2020). In addition, medical personnel should exercise patience because the improvement of symptoms may not happen quickly.

Psychotherapy

Various types of psychotherapy exist, and the therapists can switch between them depending on the patient’s case. Since Chris had developed delusional beliefs of persecution, it seems reasonable to address them with cognitive behavioral therapy (CBT). According to NAMI (n.d.), CBT can be used for uncovering unhealthy patterns of thought and how they may cause self-destructive beliefs. As a result, Chris would test his delusions of persecution and realize that he is safe.

Conclusion

The case of Chris appears to present a standard clinical picture of schizophrenia. Since the situation looks quite usual for this mental condition, a conservative treatment strategy is advised. A combination of the lowest possible dose of second-generation antipsychotic and CBT seems to be an optimal choice. However, the patient’s hostility stated in the case summary may create a necessity for hospitalization before any other interventions.

References

Mayo Clinic (2020). Schizophrenia — diagnosis and treatment. Web.

National Alliance on Mental Illness. (n.d.). Psychotherapy. Web.

National Alliance on Mental Illness. (n.d.). What is schizophrenia? . Web.

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StudyCorgi. 2023. "Schizophrenia: Diagnosis and Treatment." January 4, 2023. https://studycorgi.com/schizophrenia-diagnosis-and-treatment/.

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