ILOILO DOCTORS’ COLLEGE

College of Nursing

West Avenue, Molo, Iloilo City

RUBY JANE LAQUIHON BSN 3 E ( G3)

Case Scenario 1 Schizophrenia

Jose was a 21 -year-old man who was brought to the emergency room by the campus police of the college
from which he had been suspended several months ago. A professor had called and reported that Jose had
walked into his classroom, accused him of taking his tuition money and refused to leave.

Although Jose had much academic success as a teenager, his behavior had become increasingly odd
during the past year. He quit seeing his friends and no longer seemed to care about his appearance or
social pursuits. He began wearing the same clothes each day and seldom bathed. He lived with several
family members but rarely spoke to any of them. When he did talk to them, he said he had found clues
that his college was just a front for an organized crime operation. He had been suspended from college
because of missing many classes. His sister said that she had often seen him mumbling quietly to himself
and at times he seemed to be talking to people who were not there. He would emerge from his room and
ask his family to be quiet even when they were not making any noise.

Jose began talking about organized crime so often that his father and sister brought him to the emergency
room. On exam there, Jose was found to be a poorly groomed young man who seemed inattentive and
preoccupied. His family said that they had never known him to use drugs or alcohol, and his drug
screening results were negative. He did not want to eat the meal offered by the hospital staff and voiced
concern that they might be trying to hide drugs in his food. His father and sister told the staff that Jose's
great-grandmother had had a serious illness and had lived for 30 years in a government hospital, which
they believed was a mental hospital. Jose's mother left the family when Jose was very young. She has
been out of touch with them, and they thought she might have been treated for mental health problems.

Jose agreed to sign himself into the psychiatric unit for treatment. Once admitted he was given treatment
that included psychotropic drugs, cognitive behavior therapy and others. He was prescribed with
Biperiden 2 mg 1/2 tablet twice a day, Risperidone 2 mg twice a day and Chlorpromazine 100 mg. once a
day at bedtime.

Questions:

1. What are the predisposing and precipitating factors that may contribute to the
illness of Jose?
Answer:

Predisposing Factors Precipitating Factors

Male Psychosocial Factor:

 ILOILO DOCTORS’ COLLEGE

College of Nursing

West Avenue, Molo, Iloilo City

RUBY JANE LAQUIHON BSN 3 E ( G3)

Genetic history of mental condition (grandmother

and mother) Lack of warm and nurturing attention from the
mother
Premorbid personality of being introvert
Social stressors (e.g. school and financial
stressors)

2. Based on the DSM 5, list down the positive and negative signs and symptoms of Jose's
illness.
Answer:

Positive Negative
Hallucinations Anergia
- Her sister verbalized he saw Jose - Lack of energy as showing poorly
mumbling quietly to himself and at times groomed young man and preoccupied
he seemed to be talking to people who
were not there. Anhedonia
- - Lack of interest in things he used to do
Distortion of normal function especially as he quits seeing his friends
Jose Accused his professor of taking his tuition and no longer seemed to care about his
money. appearance

Lived with several family but barely spoke to any Asociality

of them - He quit seeing his friends and no longer
seemed to care about his appearance or
social pursuits

3. Explain the importance of cognitive behavior therapy and the use of psychotropic treatment
in the management of Jose's illness.
Answer:
Cognitive Behavior Therapy (CBT) and psychotropic treatment are two effective approaches for
managing schizophrenia. CBT is a form of talk therapy that focuses on changing negative thought
patterns and behaviors. It can help individuals with schizophrenia to identify their delusions and
hallucinations as false beliefs or perceptions. CBT also teaches coping strategies to manage symptoms
such as anxiety or depression. Psychotropic medications are drugs that alter brain chemistry to reduce the
severity of symptoms associated with schizophrenia. Antipsychotic medications are the most commonly
prescribed psychotropic drugs for schizophrenia treatment. They work by blocking dopamine receptors in
the brain, which reduces the intensity of delusions and hallucinations. Both CBT and psychotropic
treatment have been shown to be effective in reducing symptom severity in individuals with
schizophrenia. However, it is important to note that each person's experience with schizophrenia is
unique, so treatment plans should be tailored to individual needs.

4. Enumerate and explain the different extrapyramidal effects that Jose might experience
when using the typical antipsychotic drugs.
Answer:
Extrapyramidal effects (EPSE) are a group of side effects that patients experience when using typical
antipsychotic drugs. These drugs are used to treat mental illnesses such as schizophrenia, bipolar disorder,
and other psychotic disorders. The EPSEs include dystonia, akathisia, parkinsonism, and tardive
dyskinesia. Dystonia is characterized by involuntary muscle contractions that cause twisting movements
or abnormal postures. Akathisia is a feeling of restlessness and an inability to sit still. Parkinsonism
includes symptoms such as tremors, rigidity, and bradykinesia (slowness of movement). Tardive
dyskinesia is a condition where patients experience involuntary movements of the face and tongue.
Different patients may experience different types of EPSEs depending on the drug they are taking and
 ILOILO DOCTORS’ COLLEGE

College of Nursing

West Avenue, Molo, Iloilo City

RUBY JANE LAQUIHON BSN 3 E ( G3)

their individual response to it. Some patients may not experience any EPSEs at all while others may have
severe symptoms that affect their daily life. It is important for healthcare providers to monitor patients
closely for EPSEs when prescribing typical antipsychotic drugs. Patients should also be educated about
the potential side effects so they can report any symptoms promptly. In some cases, switching to an
atypical antipsychotic drug may be necessary to avoid or reduce EPSEs.

5. Discuss the role of the family and the community in the recovery of the patient who suffers
from psychosis.
Answer:

The recovery process for patients suffering from psychosis can be challenging and requires the support of both
family and community. The role of the family in the recovery process is crucial as they provide emotional support,
encouragement, and motivation to the patient. They also help in monitoring medication adherence, attending
appointments with healthcare providers, and providing a safe environment for the patient. The community also plays
a significant role in supporting patients with psychosis. Community-based programs such as support groups,
vocational rehabilitation programs, and housing assistance can help patients reintegrate into society. These programs
provide opportunities for socialization, skill-building, and employment that can improve their quality of life. In
conclusion, the recovery process for patients suffering from psychosis requires a collaborative effort between family
members and the community. By providing emotional support, monitoring medication adherence and encouraging
participation in community-based programs; families and communities can play an essential role in helping these
individuals recover from this debilitating condition.