Analysis and Case Analysis of Paranoid Schizophrenia - Essay Example

Paranoid Schizophrenia Introduction This is the most common form or type of schizophrenia. This is a chronic disorder that often requires treatment for life (Mayo Clinic). It is a disorder of the brain that interferes with an individual’s ability to act, and think. The disorder interferes with the way an individual expresses their emotions and their perception of reality is distorted. The degree of distortion varies and depends on the severity of the condition. Individuals with this condition have difficulty in social interactions including relationships. Unfortunately it’s a lifelong disease with no treatment. The only form of intervention involves the use of chemotherapeutic agents to control it and psychotherapy (Mayo Clinic). Case Description A sixteen year old teenage was brought in with symptoms that the parents do not understand. The parents are concerned that their daughter has all of a sudden become delusional. She claims that her teacher wants to kill her. As a result of this fear, she refuses to go to school. When she goes to school, her peers note that she is very hot tempered. They note that she sometimes speaks of things that they do not understand. They also mention that she is very argumentative and intolerable. They give an example where she borrowed a black pen form a colleague whoa gave her a blue one because he did not have a black one. She really got mad about this and could not understand why the colleague gave her a blue pen instead of a black pen. Despite the fact that the colleague tried to explain why he gave her a blue pen, she could not take it. She initiated a verbal exchange and got personal with the colleague. This got her into trouble with the school administration and she nearly got suspended. That day when she came home, she was so worked up. When her father inquired form her how school was, she got into a violent outburst and complained that life was unfair to her. She even mentioned that she was tired of living and was going to kill herself. While at home, her behavior is weird. The parents note that at one time they found her screaming and claiming that her teacher has come to kill her. Occasionally, she would be very anxious, and she would be shaking terribly while at the sweating. She would really get made if she went to the fridge to get food and failed to get the particular food she was looking for. She would be mad at he father for not ensuring that the food is present. In one particular day the mother notes that she was unable to speak coherently. She was mentioning words that were not related and did not make sense. It was difficult to comprehend what she was saying and even get an idea of what was going on through her mind. The parents also mention that her boyfriend often complains that she keeps hearing voices which he does not hear. They mentioned that the boyfriend has noticed that she has become increasingly violent and it’s difficult to understand what she wants. Because of this behavior the boyfriend is on the verge of dumping her. This series of events has got the parents very worried. On assessing the patient, generally the patient comes across as healthy normal teenager. It takes a bit more of assessment to discover the problem. When the patient was asked about the teacher in school who wants to kill her, a sense of fear gripped her and she was scared. She became very anxious and started to mention things that do not make sense. She moved very close to her mother and started to yell that she is coming. Further assessment reveals that she has difficulty in thinking. She was very defensive during the assessment and felt that her parents did not believe in her and that is part of the reason she wanted to kill herself. She strongly felt that she was under attack by her teacher and her parents don’t believe her. She felt let down and finds no value in life. During the assessment, she kept insisting that her teacher is threatening her. She wondered why we did not hear her teacher talk to her. Based on the assessment and the history given by the parents, the teenage girl can be said to be suffering from paranoid schizophrenia. Discussion Based on the detailed history given by the parents of the girl, and the assessment, it is possible to pinpoint some symptoms that are closely associated with paranoid schizophrenia. The parents had mentioned that their daughter had been screaming that her teacher had come to kill her. At the assessment she claimed that her teacher was threatening her. This is an indication of auditory hallucinations. While in school, the parents noted that students had noticed that she had become very argumentative and in some cases instigated violence and easily got angry. Her parents were also deeply concerned that their daughter had threatened to kill herself. During the assessment she was anxious in several occasions especially when her teacher was mentioned. The parents had note that her boyfriend was concerned that she was hearing non-existent voices and was becoming increasingly violent. She sometimes had difficulty in communication and it was difficult to understand what she was thinking. The patient’s summary of symptoms includes auditory hallucinations, anxiety, violence, suicidal tendencies and thoughts, argumentativeness, intolerance, and anger. According to the Mayo clinic, key symptoms of patients who suffer from paranoid schizophrenia include delusions, and auditory hallucinations. Other common symptoms include violence, argumentativeness, anxiety, emotional distance, self-importance, suicidal behavior and thoughts, and anger. Based on this profile it is agreeable to conclude that the patient is suffering from paranoid schizophrenia. Schizophrenia is a chronic disease that has an onset at around late teenage though it varies among regions. It is the most common of the subtypes of schizophrenia. About 50-60% of the schizophrenia is paranoid schizophrenia (Raymond, 1151). It is a disorder that is characterized by disturbances in emotions, cognition, motor behavior and perceptions. The National Institute of Health in the year 2010 estimated the number of Americans to be suffering from this disorder to be about 2.2 million. Paranoid schizophrenia has been associated with viruses, and genetics as potential triggers (Mickey, 14). Knowledge of its biochemistry may give an explanation on what the causes may be. Dopamine and glutamate receptors have been closely associated with paranoid schizophrenia. In a study conduced among individuals who were schizophrenic and those who were non schizophrenic, it was noted that there increased levels of dopamine in their CSF (cerebral spinal fluid). On the other hand certain anesthetics that are used by surgeons block the glutamate receptors and could potentially trigger paranoia like symptoms (Napier). Paranoid schizophrenia is a mental disorder that is treatable. It is important that this condition be discovered early because any delay in its early detection results in a prognosis that is worsening. The degree of effectiveness of the treatment is highest when the disorder has been discovered early. Several intervention strategies have been employed in the management of paranoid schizophrenia. They include chemotherapy, psychotherapy, hospitalization, and electroconvulsive therapy. Medication when administered to a patient, it doesn’t cure the disorder. The medication only helps in controlling the disease and limiting the symptoms. The chemotherapeutic agents used in most cases have an influence/effect on the brain neurotransmitters. Controlling the neurotransmitters in the brain reduces the delusions and hallucinations to a great extent. Examples of such chemotherapeutic agents are neuroleptics. The neuroleptics block transmission of neurons at the level of receptors and can be very useful in managing acute episodes of paranoid schizophrenia. These agents are used in an effort to stabilize the patient and not for long term use (Pataracchia, 93). Another chemotherapeutic agent often used in the treatment of schizophrenia is aripiprazole. This agent has been approved by the relevant regulatory agencies for treatment of schizophrenia. The agent/ drug is a partial dopamine agonist. It has a high affinity for serotonin receptor 5HT2A. This drug is considered to be a dopamine stabilizer. It acts by simply decreasing the activity of dopamine when it has gone too high and increasing it when it has gone too low. This drug is able to reduce schizophrenia symptoms with much of the extra pyramidal effect. The drug is also a serotonin antagonist and therefore a suitable antipsychotic agent (Citrome, 427). These chemotherapeutic agents can be very beneficial when it comes to medical intervention for the patient. Either of them can be prescribed for use by the patient. It is of great importance that the patient is given a schedule that presents her therapy sessions. Therapy is very important if the disorder is to be effectively controlled. It is necessary that the patient visits the therapist as planned in order to allow for progress evaluation and any changes that need to be made. Psychotherapy is critical and essential when it comes to reducing the effects that are associated with paranoid schizophrenia long term. This form of therapy can be done on an individual basis whereby the patient is with the therapist alone or it can be done in family members presence. Psychotherapy that has been focused on cognitive behavioral therapy is a vital treatment plan. This approach allows for the treatment of the symptoms associated with paranoid schizophrenia. Cognitive behavioral therapy is critical as it makes use of behavioral experiments to treat delusions and hallucinations (Hagen, Nordahl, 299). In this case, the people close to the patient had noted the change in the behavior of the teenager h just recently. This means that the patient’s likelihood to have a good outcome from the treatment is high because the condition has been detected early. Psychotherapy is to be initiated in the earliest time possible in order to eliminate delaying the onset of therapeutic interventions. In patients who have a fully developed disorder, it is often advisable that they are hospitalized. This will allow the patients to receive therapy and supportive care in a controlled environment. This action is often taken to protect the patient from harming other people and themselves. Electroconvulsive therapy uses electrical current to cause seizures in the brain thereby changing the brain mechanisms. In this way, symptoms and effects of paranoid schizophrenia are reduced (Paranoid schizophrenia treatment). Hospitalization in this case may not be necessary because the condition was discovered early. Cases of hospitalization are those that have undergone the full cycle of development. Conclusion Paranoid Schizophrenia is a chronic disease that cannot be cured and is a lifetime disorder. The earlier it is diagnosed the better the treatment outcomes. Methods of its management include medication, psychotherapy, and ECT. Medications include us of drugs that act on the brain neurotransmitter system and result in a reduction in the symptoms of paranoid schizophrenia. Psychotherapy is also important as it utilizes cognitive behavioral experiments that reduced effects and symptoms of the disorder. Work Cited Citrome, Leslie.”A Review of Aripiprazole in the Treatment of Patients with Schizophrenia of Bipolar 1 Disorder.”Neuropsychiatric Disease and Treatment.2.4. (2006): 427-443. Hagen, Roger and Nordahl, Hans. “Behavioral experiments in the Treatment of Paranoid Schizophrenia.”Cognitive and Behavioral Practice.15.3. (2008): 296-305.Print. Raymond, Charles. “Hypothesis: Grandiosity and Guilt Cause Paranoia: Paranoid Schizophrenia is a Psychotic Mood Disorder: A Review.” Schizophrenia Bulletin . 34.6. (2008):1151- 1162. Print. Mickey, Valda. “From Paranoid Schizophrenia to Hearing Voices- and other Class Distinctions.” International Journal of Narrative Therapy & Community Work. 3. (2003):13-17. Print. “Schizophrenia & Dopamine and Glutamate”livestrong.com. 2 June 2011.web.17 Apr 2012. Pataracchia, Raymond. “Optimal Dosing for Schizophrenia.” Journal of Orthomolecular Medicine. 20.2.(2005): 93-99. “Paranoid schizophrenia treatment”paranoidschizophreniasymptoms.net. Paranoid Schizophrenia Symptoms. n.d.web. 17Apr 2012. “Paranoid schizophrenia”mayoclinic.com. Mayo Clinic. 16 Dec.2010.web.17 Apr.2012. Read More