Case Study: C.Z.
Purpose:Analyze and apply critical thinking skills in the psychopathology of mental health patients and provide treatment and health promotion while applying evidence-based research.Scenario:
C.Z. is a 20-year-old Caucasian male who is in his second year of college. He is seeking treatment due to persistent fears that campus security and the local police are tracking and surveilling him. He cites occasional lags in his internet speed as evidence that surveillance devices are interfering with his electronics. His intense anxiety about this has begun getting in the way of his ability to complete schoolwork, and his friends are concerned – he says they have told him, “you’re not making sense.”
C.Z. occasionally laughs abruptly and inappropriately and sometimes stops speaking mid-sentence, looking off in the distance as though he sees or hears something. He expresses concern about electronics in the room (phone, computer) potentially being monitored and asks repeatedly about patient confidentiality, stating that he wants to be sure the police won’t be informed about his treatment. His beliefs are fixed, and if they are challenged, his tone becomes hostile.
Questions:
Remember to answer these questions from your textbooks and NP guidelines. At all times, explain your answers.
Discuss the etiology, course, and the structural/functional abnormalities of schizophrenia.
Discuss the evidence-based pharmacological and nonpharmacological treatment for this patient using the US Clinical Guidelines.
Expert Solution Preview
Introduction:
Schizophrenia is a chronic mental health disorder characterized by a range of symptoms, including hallucinations, delusions, disorganized thinking, and emotional dysregulation. It is essential to understand the etiology, course, and structural/functional abnormalities associated with schizophrenia to provide effective treatment. Additionally, evidence-based pharmacological and nonpharmacological interventions play a crucial role in the management of this condition. In this response, we will discuss these aspects in the context of the presented case study.
Answer:
1. Discuss the etiology, course, and structural/functional abnormalities of schizophrenia:
Etiology: The exact cause of schizophrenia is unknown, but it is believed to result from a complex interaction between genetic, environmental, and neurodevelopmental factors. Family studies suggest a hereditary component, as individuals with a first-degree relative with schizophrenia have an increased risk of developing the disorder. Additionally, disruptions in brain development during early prenatal stages or early childhood, viral infections, and obstetric complications are also considered potential risk factors.
Course: Schizophrenia typically has an onset during late adolescence or early adulthood, as seen in the case study with C.Z., a 20-year-old college student. The course of the illness is often characterized by episodes of active symptoms (referred to as psychotic episodes) interspersed with periods of partial or complete remission. The duration and frequency of episodes can vary among individuals.
Structural/Functional abnormalities: Structural and functional abnormalities in various brain regions have been associated with schizophrenia. Neuroimaging studies have shown reduced gray matter volume in the prefrontal cortex, hippocampus, and temporal lobes. Dysfunction in the dopaminergic neurotransmitter system is thought to play a role in the development of psychotic symptoms. Additionally, abnormalities in glutamate, GABA, and other neurotransmitter systems have also been implicated.
2. Discuss the evidence-based pharmacological and nonpharmacological treatment for this patient using the US Clinical Guidelines:
Pharmacological treatment: According to the US Clinical Guidelines, antipsychotic medications are the primary treatment for schizophrenia. The patient, C.Z., may benefit from atypical antipsychotics such as risperidone, aripiprazole, or olanzapine. These medications help alleviate the positive symptoms of schizophrenia, such as hallucinations and delusions. Regular monitoring for side effects, including metabolic and movement disorders, is essential.
Nonpharmacological treatment: In addition to medication, nonpharmacological interventions play a crucial role in managing schizophrenia. Psychosocial treatments, such as cognitive-behavioral therapy (CBT), individual psychotherapy, family therapy, and supported employment or education, can be beneficial. CBT can help address C.Z.’s fixed beliefs, anxiety, and help improve his ability to complete schoolwork. Family therapy can involve the patient’s support system to provide education, improve communication, and manage stress. Other interventions, such as social skills training and assertive community treatment, may also be considered.
It is important to note that treatment plans should be individualized based on the patient’s specific needs and preferences. Multidisciplinary collaboration involving psychiatrists, psychologists, and other healthcare professionals is crucial for optimal patient care.
Remember to cite specific references from textbooks and NP guidelines in your assignments.
