Scenario

Showed a medium-built male with labile affect. Oriented x3. Insight was poor. Judgment was
very poor. Behavior was hyperactive. Denies any suicidal or homicidal ideations. Denies hallucinations.
Memory appeared to be grossly intact. Cognitive functioning appeared to be impaired. Speech was
pressured and rambling. Trend of thought showed ideas of grandeur and omnipotence. Mood was
expansive but also was quick to change to anger. Intelligence was average. Reality testing appeared to
be impaired.

Patient’s Symptoms Patient Profile

Insight and judgement is poor Patient is Oriented x3

Hyperactive behavior Good Memory
Impaired cognitive functioning No suicidal tendencies
No hallucinations (State by the patient) Average intelligence
Pressured and rambling speech
Thought of grandiosity and omnipotence
Expansive mood

Reality Testing

Result: Impaired

(The lack of insight and ability to distinguish

Test Done between the external and internal world)
(Factor of Psychosis)

For example, hallucinations and delusions are

often taken as signs of a failure of reality
testing
Schizophrenia

A serious mental disorder in which people interpret reality abnormally. Schizophrenia may result in
some combination of hallucinations, delusions, and extremely disordered thinking and behavior that
impairs daily functioning, and can be disabling. (MayoClinic, 2020)

Positive symptoms  Hallucinations

(Present only with this condition)  Delusions
 Disorganized thinking (speech)
 Extremely disorganized or Abnormal
motor Behavior

Negative symptoms  Depressed verbal expressions

(Symptoms that greatly disrupt quality of life and  Reduced or lack of ability to function
can be very difficult to treat) normally (Neglect personal Hygiene)
 Difficulty expressing emotions (Doesn’t
make eye contact, absence facial
expression or Speaks in Monotone)
 Lack in interest in activities
 Socially withdrawn

People with schizophrenia often lack awareness that their difficulties stem from a mental disorder that requires medical attention. So it often
falls to family or friends to get them help.

It's not known what causes schizophrenia, but

researchers believe that a combination of
genetics, brain chemistry and environment
contributes to development of the disorder.

Causes Problems with certain naturally occurring brain

chemicals, including neurotransmitters called
dopamine and glutamate, may contribute to
schizophrenia. Neuroimaging studies show
differences in the brain structure and central
nervous system of people with schizophrenia.
While researchers aren't certain about the
significance of these changes, they indicate that
schizophrenia is a brain disease.

Risk factors  Genetics

 Some pregnancy and birth complications,
Although the precise cause of schizophrenia isn't such as malnutrition or exposure to
known, certain factors seem to increase the risk toxins or viruses that may impact brain
of developing or triggering schizophrenia, development
including:  Taking mind-altering (psychoactive or
psychotropic) drugs during teen years

Complications
Left untreated, schizophrenia can result in severe
problems that affect every area of life.
Complications that schizophrenia may cause or
be associated with include:
Diagnosis
Diagnosis of schizophrenia involves ruling out
other mental health disorders and determining
that symptoms are not due to substance abuse,
medication or a medical condition. Determining a
diagnosis of schizophrenia may include:
and young adulthood
 Suicide, suicide attempts and
thoughts of suicide
 Anxiety disorders and obsessive-
compulsive disorder (OCD)
 Depression
 Abuse of alcohol or other drugs,
including nicotine
 Inability to work or attend school
 Financial problems and homelessness
 Social isolation
 Health and medical problems
 Being victimized
 Aggressive behavior, although it's
uncommon
Physical exam
This may be done to help rule out other
problems that could be causing
symptoms and to check for any related
complications.
Tests and screenings
These may include tests that help rule
out conditions with similar symptoms,
and screening for alcohol and drugs. The
doctor may also request imaging studies,
such as an MRI or CT scan.
Psychiatric evaluation
A doctor or mental health professional
checks mental status by observing
appearance and demeanor and asking
about thoughts, moods, delusions,
hallucinations, substance use, and
potential for violence or suicide. This also
includes a discussion of family and
personal history.
Diagnostic criteria for schizophrenia
A doctor or mental health professional
may use the criteria in the Diagnostic and
Statistical Manual of Mental Disorders
(DSM-5), published by the American
Psychiatric Association.
Treatment Schizophrenia requires lifelong
treatment, even when symptoms have
subsided. Treatment with medications
and psychosocial therapy can help
manage the condition. In some cases,
hospitalization may be needed.

A psychiatrist experienced in treating

schizophrenia usually guides treatment.
The treatment team also may include a
psychologist, social worker, psychiatric
nurse and possibly a case manager to
coordinate care. The full-team approach
may be available in clinics with expertise
in schizophrenia treatment.

Medications are the cornerstone of

schizophrenia treatment, and
antipsychotic medications are the most
commonly prescribed drugs. They're
thought to control symptoms by affecting
the brain neurotransmitter dopamine.

The goal of treatment with antipsychotic

medications is to effectively manage
signs and symptoms at the lowest
possible dose. The psychiatrist may try
different drugs, different doses or
Medications combinations over time to achieve the
desired result. Other medications also
may help, such as antidepressants or
anti-anxiety drugs. It can take several
weeks to notice an improvement in
symptoms.

Because medications for schizophrenia

can cause serious side effects, people
with schizophrenia may be reluctant to
take them. Willingness to cooperate with
treatment may affect drug choice. For
example, someone who is resistant to
taking medication consistently may need
to be given injections instead of taking a
pill.
Ask your doctor about the benefits and
side effects of any medication that's
prescribed.