Question

CASE STUDY.

You are working on an inpatient psychiatric unit and need to do an initial assessment of R.B., who has just been admitted. He has a diagnosis of schizophrenia, paranoid type. He is 22 years old and has been attending the local university and living at home with his parents. He has always been a good student and has been active socially. Last semester his grades began declining and he became very withdrawn. He spends most of his time alone in his room. His grooming has deteriorated; he can go days without bathing. For several weeks before admission, he insisted on keeping all of the blinds and curtains in the house closed. He refuses to join family gatherings and games. For the past 2 days he has refused to eat, saying, "They have contaminated the food." As you approach R.B., you note that he appears to be carrying on a conversation with someone, but there is no one there. When you talk to him, he looks around and answers in a whisper but gives you little information. He states, "They are watching me and told me not to cooperate.

1. Explain what a negative symptom of schizophrenia is, and identify at least three negative

symptoms of schizophrenia that R.B. might be experiencing.

2. Explain what a positive symptom of schizophrenia is, and identify at least two positive

symptoms of schizophrenia that R.B. might be experiencing

3. What are the most important initial interventions in treating R.B.?

Answer 1

Schizophrenia is a psychotic condition characterized by a disturbance in thinking, emotions, volitions and faculties in the presence of clear conciousness, which usually leads to social withdrawal. Paranoid schizophrenia had the delusions of persecutions, delusions of reference etc.

Most of the patients recover from the illnes, some progress to the chronic phase, during which the main feature are negative symptoms. It include lack of initiative, attentional impairment, lack of speech.

A postive symptoms are experienced mostly in acute phase. It include delusions, hallucinations, agitation, ideas of reference, suspiciousness etc. Here the patient shows delusion of persecution, delusions of reference, etc.

The initial management include build a rapport with patient. Then only the patient cooperate with us.

Observe behaviour pattern, posturing, psychomotor, appearence, hygiene etc.

Identify the type of disturbance that the patient have.

Assess the theme and content of delusion.

Note the effect and emotional tone of the patient.