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PSY410 Abnormal Psychology : About Mental Disorder

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Differentiate the diagnosis of this disorder from those of the other disorders within the same diagnostic category.

Comment on culturally bound syndromes, cultural biases, or the interplay between assessment and diagnosis and culture.

Answer:

Schizophrenia may be defined as the chronic and severe disabling mental disorder which mainly occur showing symptoms of thought processes, perception and also emotional responsiveness. They may be both positive and negative symptoms and often exhibit delusions, hallucinations and though disorders. Person suffering from the disorder also shows lack of desire as well as motivation to accomplish goals, lack of social mingling skills and blunted emotions (Simeone et al., 2015). Current data shows that about 1.1% of the world’s population regardless of racial, ethnic or economic background is suffering from the disorders. About 3.5 million people in the United States are diagnosed with the disorders. Three quarters of the person who are suffering from schizophrenia are between the ages of 16 to 25. Studies have also shown that 25% of the patients recover completely whereas 50% are improved over a ten year period and 25% people do not improve at all. Treatment and other financial investments associated with the patients suffering from the disease are huge like about $32.5 to $65 billion annually. Therefore it is mostly seen form the studies that 50% of the patients diagnose with schizophrenia do not receive any treatment (Swets et al., 2014).

Diagnosis of schizophrenia needs to be conducted by eminent doctors and specialists. They especially usually look for two important symptoms that denote them to be suffering from schizophrenia. These involve delusions where the patients develop false beliefs which they do not want to give up even when they get proves that their thinking is not correct. Secondly, the doctors also look for hallucinations which are the hearing as well as seeing of things which do not exist in reality. Such patients also show symptoms like disorganized speech as well as behaviors (Jerrell et al., 2017). The faster the diagnoses of the patients, the better the treatment will help to recover from the disorders. Apart from carrying out the physical examination to rule out the complications of the disorders, the professional may also conduct screenings and tests to help rule out conditions with similar symptom. Imaging such as MRI or CT scan also proves to be helpful. Specially, doctors use the important criteria for Diagnostic and Statistical Manual of Mental Disorders (DSM-5) which is published by American Psychiatric association.

Treatment of schizophrenia is done by the use of first generation medicines and the second generation medication where the later has lesser side effects. The main goal of the antipsychotic medication is the effective management of the signs and symptoms of the lowest possible dose mainly by modifying the secretion of neurotransmitter dopamine form the brain. Some of the second generation medications include Aripiprazole, Iloperidone, Quetiapine and several others. There are other therapies as well as like the cognitive behavioral therapy that provides the best effects (Nathan & Gorman, 2015). It is conducted in an environment where the patients feel safe and challenging delusions re avoided. This therapy helps to implement natural implement coping therapies. They mainly provide help on developing rational thoughts and perspectives about thoughts and delusions and help them come back to reality in their lives. Personal therapy is another technique which is very much like CBT and contains one on one session that include working on each of the individual disorders and symptoms. It mainly helps by focusing on affective dysregulation and also ability to adapt to stressors of the illness.. It differs from CBT in its utilization of the phases as they correspond to the patients recovery and depends on the degree to which patient improves as it is a long term treatment plan. compliance theory is mainly helpful in acute phases of the disorder and is carried for short phase like for 4 to 6 session where the main goals remains medication adherence and also getting the patient to take medicines after discharge as well (Fusar-Poli et al., 2014). There is high controversy in its efficiency. Acceptance and Commitment Therapy (ACT)is another therapy which mainly consists of attempts to eliminate stress associated with the delusions and hallucinations. As the patients do not force themselves, to suppress, judge or control their emotions, they themselves get freed from the stress and as a result major stressor is removed. Supportive therapy is also present which involves the counseling of the patient at the same tome of the patients dealing with life issues due to the disorder with proper reassurance, clarifications and general assistance.

Some of the important disorders which are often confused with the symptoms of schizophrenia are the schizoaffective disorders. The differentiating symptoms are the combination of psychosis and affective symptoms which are totally independent of each other. It can be known by clinical diagnosis. Substance induced psychotic disorders can be known by urine drug screen where the causative drug may be identified. In order to cut out the chances of dementia with psychosis, CT or MRI of the head may be conducted to reveal characteristics signs (Lysaker & Dimanigo, 2014). Depression with psychosis, bipolar disorder with psychosis, malingering and factitious disorders are known by clinical diagnosis. Organic psychosis can be known by laboratory studies such vitamin B12 level, as, HSV-PCR in CSF fluid, copper urine level, ceruloplasmin in blood and RPR, HIV test.

Culturally bound syndromes usually refer to cultural bound syndromes which refer to any of the number of recurrent as well as different locality-specific patterns of aberrant behavior and experiences which do not match with that of the Western psychiatric diagnostic categories. In many culturs it is seen that traditional ways of handling the symptoms are more preferred than western healthcare system mainly due to the cultures’ skepticism in the Eastern practices (Kendler, 2017). Researchers have stated that there are many African cultures where they face stigmas when depicting the patient as sufferer form schizophrenia. Hey prefer them to be called by sufferers of amafufunyana. They have characteristics this as patients who speak in string muffled voice and show unpredictive behavior. They believe that they are possessed by spirits or are under sorcery. They also call it ukuthwasa when the patients show social withdrawal, restlessness, and appearing to respond to auditory hallucinations, irritability (Heine, 2015). Again it has been seen that in Anglo Americans, this disorder is taken as a condition where the patients’ character is implicated. Asian countries take this disorder as the amok along with sudden rampage, homicide and also suicide that ends with exhaustion and amnesia .European countries take this as transient psychosis with elements of dream states.

Schizophrenia symptom management is therefore often becomes difficult as professionals have to keep in mind a large number points while they treat their patients. They need to ponder over the cultural preferences and have to be free from any cultural biasness. Moreover, they have to conduct differential diagnosis to cut out the chance of other similar ailments. Moreover, they also have to introduce important therapies which would suit best for the patient according to the stage of schizophrenia. Therefore, a professional should thoroughly conduct proper treatment to give a proper quality life to the patients.

References:

Fusar-Poli, P., Papanastasiou, E., Stahl, D., Rocchetti, M., Carpenter, W., Shergill, S., & McGuire, P. (2014). Treatments of negative symptoms in schizophrenia: meta-analysis of 168 randomized placebo-controlled trials. Schizophrenia bulletin, 41(4), 892-899.

Heine, S. J. (2015). Cultural Psychology: Third International Student Edition. WW Norton & Company.

Jerrell, J. M., McIntyre, R. S., & Deroche, C. B. (2017). Diagnostic clusters associated with an early onset schizophrenia diagnosis among children and adolescents. Human Psychopharmacology: Clinical and Experimental, 32(2).

Kendler, K. S. (2017). Introduction to “Description and explanation of the culture-bound syndromes”. Philosophical Issues in Psychiatry IV: Classification of Psychiatric Illness, 149.

Lysaker, P. H., & Dimaggio, G. (2014). Metacognitive capacities for reflection in schizophrenia: implications for developing treatments. Schizophrenia Bulletin, 40(3), 487-491.

Nathan, P. E., & Gorman, J. M. (Eds.). (2015). A guide to treatments that work. Oxford University Press.

Simeone, J. C., Ward, A. J., Rotella, P., Collins, J., & Windisch, R. (2015). An evaluation of variation in published estimates of schizophrenia prevalence from 1990? 2013: a systematic literature review. BMC psychiatry, 15(1), 193.

Swets, M., Dekker, J., van Emmerik-van Oortmerssen, K., Smid, G. E., Smit, F., de Haan, L., & Schoevers, R. A. (2014). The obsessive compulsive spectrum in schizophrenia, a meta-analysis and meta-regression exploring prevalence rates. Schizophrenia Research, 152(2), 458-468.


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