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Schizoaffective Disorder

Schizoaffective Disorder

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Introduction

This paper will present a case study of a 30-year old male identified as G.H suffering from schizoaffective disorder. While presenting the case study, we will compare the client’s assessment date with the information obtained in the Psychiatric Mental Health Nursing textbook by Sheila Videbeck. This paper will delve into details the signs and symptoms of schizoaffective disorder, its medication, therapy alternatives as well as developmental level as demonstrated by Erickson’s development stages.

Client Assessment with Textbook comparison

Schizoaffective disorder

Schizoaffective disorder refers to a serious mental infirmity comprising of two varied conditions-schizophrenia, and a mood (affective) disorder caused by bipolar disorder or depression (Goldberg, 2014). Schizophrenia is a brain disorder that alters a person’s way of thinking, acting, expression of emotions, perceptions of reality as well as how he or she relates to other people. On the other hand, depression is characterized by feelings of hopelessness, sadness, worthlessness, as well as difficulties in remembering and concentrating. Lastly, bipolar disorder is illustrated with mood changes, severe lows (depression) and highs (mania). Some of the symptoms of schizoaffective effective include hallucinations, disorganized thinking, as well as delusions (Vildebeck, 2014). Psychotic signs in schizoaffective disorder may occur when mood symptoms are absent and they may be presented when an individual’s inability to differentiate between real and imagined thoughts. It is a common fact that schizoaffective symptoms vary from one patient to another (Vildebeck, 2014).

During the medical observation of G. H, he showed several signs similar to those of the textbook depression. When he was taken to the emergency department, he presented auditory hallucinations, paranoia euphoria, as well as grandiose claims. His auditory hallucinations comprised of utterances that, “I am jealous of you.” He was not able to identify which individual he was jealous of; however, he explicated that he was jealous of some individuals from some big corporations who were going to help me acquire massive dollars. The attempts by the psychiatrist to give him medications were problematic because he thought the psychiatrist wanted to sedate him so that they could take away secrets from him. He presented grandiose delusions regarding his intelligence, potential wealth, as well as his connections to the rich and mighty. He was also preoccupied sexually since kept on saying that women were following him because he was going to be extremely wealthy. In as much as he had no suicidal threats, he posed danger to the hospital staff. His toxicology screen was negative. The same also applied to other essential routine laboratory screens except for alcohol and cigarettes. The tests showed that G.H is a substance abuser. According to Vildebeck, “substance abuse refers to the using of drugs in a manner that is not consistent with social or medical norms despite the negative effects (Vildebeck, 2014).” He dinks a lot of alcohol and smoke lots of cigarettes in a day. G. H also showed a history of several failed trials of quitting smoking and drinking alcohol.

Treatment

If signs of schizoaffective disorder are discovered just like in G.H’s case, then the doctor should perform a comprehensive physical and medical history exam. In as much as there is no laboratory tests designed to specifically diagnose schizoaffective disorders, doctors occasionally use certain tests such as blood tests and brain imaging so as to rule out physical sickness as the main cause of the symptoms. If there are no physical reasons detected for the symptoms, then the doctor may refer to the patient to a psychologist, psychiatrist or mental health professionals qualified to diagnose and treat mental diseases (Goldberg, 2014).

When G. H was brought the emergency department, he was given an injection of 10gm of haloperidol. This drug normally used in emergency departments when they have patients who are extremely impatient. Ziprasidone is one of the atypical agents in the IM formulation. A 20mg dose of IM is highly effective since after fifteen minutes of its injection, a patient starts to get sedated. The sedation can last up to four hours. However, if a 10mg dose is administered, it can be repeated after two hours up to 40 mg within twenty four hours (Berman & Snyder, 2012). The 20mg dosage can be repeated after every four hours. G.H’s alcohol and cigarettes use was taken into consideration before being given drugs. This is ascribed to the fact that some drugs prescribed for schizoaffective disorder can have adverse damages to the liver. An example of such drug is lorazepam. If this drug is given to G. H, he may have severe respiratory depression (Berman & Snyder, 2012). Therefore, it was necessary for the doctors to conduct tests in order to ascertain his alcohol levels.

Group therapy in an established Medical Center would also be beneficial to G.H. This is ascribed to the fact that group therapies help a great deal in assisting people to socialize and co-operate with individuals. G.H having shown withdrawal signs and lack of interest in talking to people would benefit so much. In addition, group therapies discuss a myriad of issues ranging from drug abuse, relationship, coping skills, just to mention but a few. By interacting with other people and sharing experiences, G.H will also learn how to address his alcoholism and smoking problems.

Growth and development

G. H is thirty years old and is in the stage of early adulthood. According to Erikson’s stages of psychosocial development, G. H is in the sixth stage known as ‘Intimacy vs Isolation stage.’ In this sage people are expected to develop their personal relationship with people. Erikson believes that those who manage to develop successful and committed relationship with others during this stage will have long lasting and meaningful relationships. In this stage, the relationship are bound by love and being true to one another. Lastly, Erikson also believes that those who fail to have meaningful and successful relationships at this stage are most likely to suffer from loneliness, isolation and depression (Berman & Snyder, 2012).

As for G.H, he is suffering from depression and isolation since he has not established meaningful relationship with other people. While observing the medical history, it was ascertained that he spends most of his time locked up in his room. While at work, he does not freely mingle or share his experiences with his colleagues. He has remained closed to himself even if his colleagues try to reach out to him. In this way, he clearly manifests the psychosocial theory as fronted by Erikson (Berman & Snyder, 2012). In this regard, the group therapy will be beneficial to him since he will meet several people with whom they will share experiences and establish meaningful and successful relationships. These relationships will go a long way in offering him emotional support when he needs a shoulder to lean on.

Discharge Planning

G. H lives with his family and they will play an integral role towards his recovery. His brother and sister will give him the emotional support that he needs even though he likes spending most of his free time in his room. Families are always there for us since they understand us better than anybody else. They will ensure that G. H takes his meds on time.

G. H will also attend routine group therapy sessions as a follow up to ensure that he learns how to socialize and co-operate with individuals. As already demonstrated, group therapies encourage discussions of several topics ranging from drug abuse, relationship, and coping skills. Therefore, the group therapy will help G. H. improve his personal relationships with his family and colleagues. Consequently, the group therapies ill help him in addressing his alcohol and cigarettes problem.

It will also be important for G. H to undergo individual psychotherapy sessions as well as psychiatric rehabilitation. In these forums, they will monitor his condition and recovery process. They will ascertain whether the drugs he is taking are helping him manage his condition. N the other hand, the psychiatrist, psychiatric nurse, psychologist and the psychiatric social worker involved in his recovery process will have an easy time keeping track of his recovery process. Lastly, G. H will have to ensure that he takes his medicines as prescribed and that he attends all the therapy sessions without failure. By observing maximum compliance to his treatment measures, his condition will be managed and he will be able to lead a good life. Since schizoaffective disorder has no cure, he has to take his meds and follow all the psychiatrist instructions if he has to lead to a normal life.

References

Berman, A., & Snyder, S. (2012). Kozier & Erb's Fundamentals of Nursing Concepts, Process, and Practice (9th ed.). Upper Saddle River, NJ: Pearson Education.

Goldberg, J. (2014). Schizophrenia and Schizoaffective Disorder. Retrieved from Schizophrenia Health Center: http://www.webmd.com/schizophrenia/guide/mental-health-schizoaffective-disorder

Videbeck, S. (2014). Psychiatric-Mental Health Nursing (6th ed.). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.


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