Question

Respond to questions 1 through 6 in your initial post on the discussion board. Provide rationales, when appropriate.

You are working on an inpatient psychiatric unit and are to do an initial assessment on 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 Last semester his grades began declining, and he became very withdrawn.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 may go days without bathing. For several weeks before admission, he insisted on keeping all of the blinds and curtains in the house closed. 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.

1. What symptoms would indicate that R.B. has paranoid schizophrenia?

2. Why is it important to know R.B.'s history, before he was diagnosed with schizophrenia?

3. What diagnostic screening would be important in evaluating R.B.?

4. What medications are commonly used to treat the symptoms of schizophrenia? Organize your answers according to typical and atypical antipsychotics. 5. What types of psychosocial treatments may be used to treat R.B.'s schizophrenia?

6. What would be the most important initial interventions in treating R.B.?

Answer 1

1).

The five different types of schizophrenia are,

1. Paranoid schizophrenia
2. Disorganized schizophrenia
3. Catatonic schizophrenia
4. Childhood schizophrenia
5. Schizoaffective disorder

The symptoms of schizophrenia are classified into positive or negative symptoms.

• Positive symptoms – Abnormal behaviours that have been gained. Examples include, hallucinations, auditory delusions, and disordered thought processes
• Negative symptoms – Abnormal behaviours that have been lost. Examples include, flat effect, social withdrawal, reduced motivation, catatonia, poor focus on tasks, and alogia.

The patient in the given case is presenting both the positive and negative symptoms, but the positive symptoms are predominant than the negative symptoms. Paranoid schizophrenia is a subtype of schizophrenia with more positive symptoms (talking to someone when no one is there, hallucinations, and distorted thought process). Thus, the patient’s subtype of schizophrenia is, “paranoid schizophrenia.”