Diagnostic and Statistical Manual of Mental Disorders: DSM 5

Abstract

This paper is a case study of an individual suffering from Schizophrenia and his history with it. The paper looks at the symptoms of schizophrenia attributed by the individual and the diagnosis based on Diagnostic and Statistical Manual of Disorders (DSM 5). The individual diagnosed with schizophrenia has a major symptom that qualifies him to be schizophrenic according to DSM 5, example, hallucinations, improper speech and paranoia. The paper speculates some of the causes of the maladaptive behavior which include; heredity, environment and triggers such as stress and drug abuse. There are two main forms of treatment for schizophrenia i.e. medication and psychosocial treatment. Lastly, the paper tries to review some of the outcomes and prognosis of the client which fall under two main categories i.e. functional re mission and symptomatic remission.

 

Presenting Concerns

        The following is a case study of a young male client, Xavier, suffering from Schizophrenia.  Schizophrenia is a genuine issue which influences how an individual considers, feels and acts. Somebody with schizophrenia, such as Xavier may experience issues recognizing what is genuine and what is fanciful; may be lethargic or withdrawn; and may experience issues communicating typical feelings in social circumstances. 

In opposition to open discernment, schizophrenia is not part identity or various identities. The dominant parts of Xavier were not brutal and didn’t represent a peril to others. In his diagnosis, his Schizophrenia was not created by adolescence encounters, poor child rearing or absence of a determination, and the indications were not indistinguishable from every individual.

The reason for Xavier’s schizophrenia was not found. A few speculations about the reason for his ailment include hereditary qualities, the unevenness in the cerebrum’s chemistry and conceivable viral diseases.’

The symptoms that were evident to diagnose Xavier with schizophrenia include; disorganized speech, lack of response to external stimuli, he did not actively relate to the environment, delusions, non-directed movements, hallucinations and mimicking other peoples’ movement and speeches.

Diagnostic Perspective of Case Conceptualization

This segment exhibits a brief patient appraisal, including a case history of the customer considered in the study. Xavier, dainty proportioned and almost six feet tall, is a twenty-five-year-old American. He has been engaged to his wife, Sarah, for one year now, and they would like to have kids soon. 

 

At ten years old, Xavier’s dad passed away, which allowed his mom to sit unbothered to bring up three youngsters. Xavier was the eldest. After his dad’s demise, Xavier felt committed as “man of the house” to financially bolster his family. These troublesome times constrained him to stop school, and he discovered a full-time work at an area library. Xavier had been a fantastic student in school; he particularly missed writing his creative stories. Xavier discovered his employment amazingly exhausting; along these lines, he kept himself possessed perusing anything he discovered fascinating in the library to relax. Xavier returned to class when his siblings were mature enough to work and help monetarily bolster whatever remained of the family, this permitted everyone to work and go to class. Xavier excitedly proceeded with and finished his training at a neighborhood college. 

In the wake of working for around six months, at an electronic store, Xavier started to hear voices that let him know he was awful. He additionally started to accept that his supervisor was planting little camcorders in the returned tapes to catch him committing errors. Xavier became progressively fomented at work, especially amid occupied times and started “talking abnormally” to clients. For instance, one client requested a camcorder to be reserved, and Xavier demonstrated that that camcorder might not be accessible because it had surveillance videos of him that were being reviewed by the police. 

After about a year and a half Xavier quit his job one night, hollering at his supervisor that he couldn’t take the steady ill-use of being observed by all the TV screens in the store and even in his particular home. Xavier Jack lived with his wife around then. He became progressively confounded and fomented. His wife took him to a health center where he was admitted. He was given Thorazine by his specialist; this is an intense psychotropic drug. Notwithstanding, he had agonizing bending and compressions of his muscles. He was changed to Haldol and had fewer symptoms. Occasionally Xavier quit taking his Haldol, and the voices and concerns of being viewed got to be stronger. 

Amid the previous four years, Xavier was hospitalized three times. He requisitioned and now gets supplementary security income, and with the support of a case manager has moved into his own particular flat. He is currently an individual from a clubhouse for individuals with maladjustment. He goes to the clubhouse two times each week. He answers the telephone, and aides compose the clubhouse pamphlet. He has a couple of companions at the clubhouse, and his wife is very supportive with all he does.  Xavier told his wife he might want to land a position so he can procure more cash and possibly purchase a car. 

With time, Xavier started to show a problem with his speech even though it was not major. He would sometimes mimic his wife’s speech and actions. Xavier is extremely agonized over searching for work. He doesn’t know how to disclose his issue to a potential business, and he is perplexed about getting to be overpowered. He loves motion pictures and might want to work with them in some way.

Schizophrenia has a tendency to run in families and that an individual acquires a propensity to build up the sickness. Schizophrenia might likewise be activated by ecological occasions, for example, viral contaminations or profoundly distressing circumstances or a mix of both. Like some other hereditarily related diseases, schizophrenia shows up when the body experiences hormonal and physical changes, similar to those that happen amid pubescence in the teenager and youthful grown-up years. Hereditary qualities help to decide how the cerebrum utilizes certain chemicals. Individuals with schizophrenia have a compound irregularity of cerebrum chemicals which are neurotransmitters. The lopsidedness of these chemicals influences the way an individual’s mind responds to stimuli, which clarifies why an individual with schizophrenia may be overpowered by tactile information e.g. bright lights, which other individuals can without much of a stretch handle (Klotter, 2010). 

 Individuals with schizophrenia are more inclined to have encountered inconveniences before and during their birth, for example, a low conception weight, asphyxia or premature conception. It might be that these things have an unpretentious impact on mind health. The principle mental triggers of schizophrenia are distressing life occasions, for example, a loss, losing your occupation or home, a separation or the end of a relationship, or physical, sexual, passionate or racial misuse. These sorts of encounters, however distressing, don’t bring about schizophrenia, yet can trigger its improvement in somebody officially defenseless against it. 

Drugs don’t specifically cause schizophrenia, yet drug abuse expands the danger of creating schizophrenia or a comparative disease. Certain medications, especially cannabis and LSD, may trigger indications of schizophrenia in individuals who are helpless. Use of LSD can prompt psychosis and can bring about a relapse in individuals recouping from a prior scene.

Goals and Interventions

A lifelong treatment is required for schizophrenia, notwithstanding when manifestations have died down. Treatment with medicines and psychosocial treatment can help deal with the condition. Amid emergency periods or times of serious manifestations, hospitalization may be important to guarantee wellbeing, fitting sustenance, satisfactory slumber, and essential cleanliness. A specialist experienced in treating schizophrenia normally administers treatment. A full-group, consisting of; a psychiatric nurse, social worker, case manager, and a psychologist, may be accessible in centers with mastery in schizophrenia treatment.

Antipsychotic drugs are frequently used to treat the side effects of schizophrenia. These prescriptions don’t cure schizophrenia, yet they can enhance your capacity and your personal satisfaction. Every individual reacts differently to distinctive antipsychotic drugs. You may need to attempt a few prescriptions before discovering the particular case that works best for you. Antipsychotic prescriptions are used in treating intense psychosis and diminishing the danger of future maniacal scenes (Beaumont, 2000). The treatment of schizophrenia, therefore, has two primary stages: an intense stage, when higher measurements may be important to treat maniacal manifestations, trailed by a support stage, which is typically long lasting. Amid the upkeep stage, a dose is regularly slowly lessened to the base needed to counteract further scenes and control between scene manifestations. In the event that indications return or decline on a lower measurement, an increment in measurements may be important to help avoid further relapse. 

Indeed, even with constant treatment, a few patients experience relapse. The most well-known reason for relapse is halting drug intake. The huge dominant part of schizophrenia patients experience change when treated with antipsychotic medications. A few patients don’t react to drugs, and a couple may appear not needing them at all. Since it is hard to anticipate which patients will fall into what bunches, it is important to have follow-ups, so that the treatment can be balanced, and any issues tended to expeditiously.

 

The most used antipsychotic drugs are Thorazine, Prolixin, Mellaril, Navane, Trilafon, Loxapine, Stelazine, and Haldol, and these medications are powerful in treating positive side effects, they can bring about intellectual dulling and involuntary movements, among other symptoms. These more seasoned pharmaceuticals likewise are not all that compelling against purported negative manifestations, for example, disregard, diminished motivation, and absence of enthusiastic expressiveness.

Clozaril is the main medication that has demonstrated to be powerful where different antipsychotics have fizzled. It is not connected with the reactions specified above, but rather it does produce other symptoms, including weight addition, changes in glucose and cholesterol, and conceivable lessening in the quantity of disease battling white blood cells. Blood need to be checked consistently amid the initial six months of treatment and afterward at regular intervals and inevitably once a month inconclusively to catch this reaction early in the event that it happens. Other atypical antipsychotics incorporate Saphris, Abilify, Invega, Zyprexa, Risperdal, Seroque land Latuda. Imperatively, every single atypical antipsychotic convey the conceivable danger for bringing on weight gains and raising glucose and triglyceride levels, which must be intermittently checked amid treatment. A few antipsychotics can bring about heart rhythm issues that may oblige observing by a specialist. 

Since the danger of relapse is higher when antipsychotic medications are taken unpredictably or suspended, it is imperative that individuals with schizophrenia take a treatment arrangement in collaboration with their specialists and with their families. The treatment arrangement will include taking the endorsed medicine in the right sum and at the times prescribed, going to follow up arrangements, and taking after other treatment suggestions.

Various types of psychosocial treatment are accessible for individuals with schizophrenia, and most concentrate on enhancing the patient’s social life. Extensively characterized, recovery incorporates a wide cluster of nonmedical intercessions for those with schizophrenia. Recovery project/rehabilitations stress social and professional preparing to help patients and previous patients overcome troubles in these territories. Projects may incorporate professional advising, employment preparing, critical thinking and cash administration abilities and use of public transportation, these methodologies are essential for the accomplishment of the group focused treatment of schizophrenia, because they furnish released patients with the skills important to lead beneficial lives outside the protected mental facility.

Rubin (2010) notes that psychotherapy involves routinely booked talks between the patient and mental health specialist. The sessions may concentrate on present or past issues, encounters, musings, sentiments or connections. By sharing encounters to a prepared empathic individual, discussing their reality with somebody outside it, people with schizophrenia might slowly come to see all the more about themselves and their issues. They can likewise figure out how to deal with the genuine from distorted.

Regularly, patients with schizophrenia are released from the health facility into the hands of their family; it is imperative that relatives realize everything they can about schizophrenia and comprehend the challenges and issues connected with the ailment. It is likewise useful for relatives to learn approaches to minimize relapse, for instance, by use of distinctive treatment adherence techniques, and to be mindful of the different sorts of outpatient and family benefits accessible in the period after hospitalization. Family education that incorporates showing different adapting procedures and critical thinking abilities may help families bargain all the more adequately with the schizophrenic patient and may add to an enhanced result for the patient.

Self-help groups for individuals and families managing schizophrenia are getting to be progressively normal. Albeit not drove by an expert specialist, these gatherings may be remedial because individuals give moral support and also comfort in realizing that they are not the only one in the issues they confront. Self-improvement gatherings might likewise serve other imperative capacities. Families cooperating can all the more successfully serve as promoters for required research and group treatment programs. Patients who are going about as a gathering instead of exclusively may be better ready to dissipate stigma and attract open thoughtfulness regarding such discrimination of the schizophrenic kind. Family and companion backing and support gatherings are extremely dynamic and give helpful data and aid to patients and groups of patients with schizophrenia and other mental issues.

Conclusion

Recovering from schizophrenia can either be functional or symptomatic remission. Some of the functional remissions include; Work/training: Returning to work/school/homemaking, the satisfaction of obligations: children being supportive, assisting with housework, and going to get-togethers. What’s more, spouses financially are supporting their families, and wives dealing with their youngsters and doing the normal home chores, free working: Taking consideration of their own needs without being reliant on or having the help/aid of others, and social working: Socializing and having important interpersonal connections: having social aptitudes, having companions to converse with or invest energy with; going to and taking an interest in family and social capacities; getting engaged; being brought together with or repairing broken associations with life partners and relatives.

The symptomatic remissions include; Indication control: Eliminating hallucinations, negative feelings, and the throbbing painfulness brought on by schizophrenia, Psychological Capacity: Overcoming intellectual disability: being less befuddled; having the capacity to recall things and being less careless, having the capacity to focus on or pay consideration on their work, family errands or to discussions with other individuals; and being cautious, with a sharp personality, Self-consideration: Taking consideration they could call their wellbeing and keeping up great cleanliness rehearses. Illustrations incorporate taking drugs all alone without being influenced or reminded to; advising others when feeling unwell; resting soundly and having adhering to a good diet propensities, washing frequently and being clean; dealing with individual and family possessions; not smoking cigarettes or breathing in tobacco; and keeping up a slick and prepped appearance by brushing one’s hair and dressing properly, overcoming adverse identity attributes, being less socially withdrawn and heartless; being more fearless; being less suspicious; not having hard or feeling exploited and decreased reactions (Schenkel, 2004).

 

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