Schizophrenia and Other Psychotic Disorders
case:At age 18, Rose rented her first apartment in the city. Although she had a short commute to work, Rose did not enjoy the chaos and noise of the city.
Within months, Rose left her apartment in the city for a small, rural cabin in the country. It was then that Rose began to withdraw from family and friends.
Generally, she avoided contact with others. Her co-workers noticed random, obscure drawings on scrap paper at her desk. Additionally, her co-workers
noticed other strange behaviors. Frequently, Rose would whisper to herself, appear startled when people approached her desk, and stare at the ceiling at
various times throughout the day.
For individuals with disorders such as schizophrenia and other psychotic disorders, the development of mental disorder seldom occurs with a singular,
defining symptom. Rather, many who experience such disorders show a range of unique symptoms. This range of symptoms may impede an individual’s
ability to function in daily life. As a result, clinicians address a patient’s ability or inability to function in life.
Incorporate the following into your responses in the template:
Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration
and severity of their symptoms? How are their symptoms impacting their functioning in life?
Objective: What observations did you make during the psychiatric assessment?
Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible
diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential
diagnosis and explain what DSM-5-TR criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led
you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
Reflection notes: What would you do differently with this client if you could conduct the session over?Also include in your reflection a discussion related to
legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention
taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
Sample Solution
Individuals with schizophrenia spectrum and other psychotic disorders experience a range of often debilitating symptoms that may include hallucinations, delusions, and other disorganized thinking, speech, and/or disorganized or unusual behavior. Psychotic symptoms include changes in the way a person thinks, acts, and experiences the world. People with psychotic symptoms may lose a shared sense of reality with others and experience the world in a distorted way. For some people, these symptoms come and go. For others, the symptoms become stable over time. The symptoms of schizophrenia can make it difficult to participate in usual, everyday activities, but effective treatments are available.
