Assessment and Intervention Plan

Student’s Name

Institutional Affiliation

Assessment and Intervention Plan

case study代写 Individuals found to have this disorder should receive treatment to reduce the effects of the disorder.

Schizophrenia is a disorder that can be genetically inherited from other family members. case study代写

Individuals found to have this disorder should receive treatment to reduce the effects of the disorder. They should also avoid various risk factors such as stress or drug abuse, which may worsen their condition. The paper addresses the case study of Barbara who is suffering from schizophrenia. The paper covers the procedures and processes for assessment, pharmacodynamics and pharmokinetics, DSM-4 diagnostics, mental health issues, etiology, dual diagnosis, treatment, relapse and finally, ethical and legal issues in the treatment of schizophrenia.

Overview of Case Study case study代写

The case study is about Barbara, who suffers from schizophrenia. To her friends and family, she seems to be odd, and her mother relates her behavior to that of her father, who suffered from the same disorder. The discrimination did not affect Barbara since she liked being different from everyone else (The Louis de la Parte Florida Mental Health Institute, 2002).

She lost her mother at the age of 17, being left alone to take care of herself. This proved to be difficult for Barbara since she was unable to maintain a steady job. Soon she was overwhelmed by bills, which caused a lot of stress. She then started contemplating about killing herself as well as her boss. The driving force was an inner voice that was urging her to do so.

The symptoms of schizophrenia that are observed in Barbara include bizarre beliefs. Thus, she thinks that the FBI was monitoring her because of the cat which she kept in her apartment. Moreover, it is a sign that she is suffering from schizoaffective disorder, which has a manic component (Lewandowski, Cohen, Keshavan, & Öngür, 2011).

She was also undergoing auditory hallucinations that made her contemplate about killing her boss and later committing a suicide. The risk factors in the case of Barbara are the family history of schizophrenia, high stress she is experiencing after the loss of her mother, and the history of having experienced symptoms, which were low level at first as she used to feel that she has always been odd.

Procedures and Processes for Assessment and Diagnosis case study代写

The assessment and diagnosis of schizophrenia primarily focuses on ruling out other disorders that are related to mental health as well as determining that the symptoms are not due to other medical condition, medication that the patient receives, or due to drug abuse. Some of the assessment procedures include:

1.Physical examination of the patient. The general body health of the patient is inspected to rule out other diseases and problems. Furthermore, the assessment helps to establish complications that are related to schizophrenia as well as opportunistic diseases.

2.Carrying out tests and screening. Because of the nature of the disorder, it is possible to confuse the symptoms of the disease with those of other diseases. Some of the tests include CT scans and MRI, which help to rule out other conditions that may have similar symptoms to the disorder. Furthermore, there is a need to carry out screening for drugs and alcohol because drug abuse oftentimes propels the prevalence of the condition.

3.Carrying out psychiatric evaluation. A mental health professional evaluates the mental status of the patient by checking their demeanor and physical appearance. Furthermore, the practitioner needs to go a step ahead and ask the patient about their mood, hallucinations, delusions, potential for committing suicide or violence, and substance abuse. Family is an integral part of any individual; it is therefore necessary to establish the personal history of the patient and their family relationships.

4.Carrying out diagnostic criteria for the disorder. The health professional utilizes the criteria which are established in the Diagnostic Manual of Mental Disorders (DSM-5)to assess the patient (Hasin et al., 2013). The DSM-5 is used as the basis for all psychiatric diagnoses as well as treatment options for the patients.

Pharmacodynamics and Pharmacokinetics case study代写

The substance used by the patient in the case study was barbiturates. The pharmacodynamics of the substance is as follows. The drug binds itself to the molecular components of the GABA receptor, which is contained in the neuronal membrane in the central nervous system (CNS). The GABA usually functions as a channel for the chloride ions. It is therefore referred to as the chloride channel complex (“Barbiturates: Lesson Plan: ACSAP – Barbiturates,” 2005). Hence, barbiturates work on GABA receptor’s binding site.

Barbiturates usually enable the actions of GABA at various sections of CNS by increasing the actual time of GABA-chloride channels and their openings. Barbiturates have a high impact on the chloride channels as compared to other substances such as benzodiazepines (“Barbiturates: Lesson Plan: ACSAP – Barbiturates,” 2005).

However, they cause tolerance, psychological and physical dependence. Therefore, their use needs to be limited to anti-epileptic and anesthesia purposes. The pharmacodynamic effects depend on the dose. A small dose relieves tension in the individuals, while a large one causes blurred vision, staggering, drowsiness, slurred speech, slowed reflexes, reduced sensitivity to pain and breathing problems. An overdose of the substance may cause a coma, unconsciousness or even death.

Pharmacokinetics of Barbiturates case study代写

When the drug is taken orally, it is readily absorbed from the gastrointestinal tract. The drug is then distributed in the body by first crossing the blood–brain barrier (BBB), with high levels being distributed to the kidney, brain and liver. The drug is lipid-soluble and is redistributed to the muscles. Extra amounts of the drug are stored in the adipose tissue. The human body is said to recover when the plasma levels are lowered.

High amounts of the drug cause side effects such as drowsiness because it recirculates in the body from storage. Repeated uptake of the dose leads to intensive circulation in the body, which, in turn, causes depression of the Central Nervous System. Further uptake of the dose causes accumulation, and once these storages are saturated, there is occurrence of depression on the cardiovascular system and the respiration system. After utilization of the drug in the body, it is excreted in the renal system and by oxidation in the hepatic sites.

DSM-5 Diagnosis case study代写

Health practitioners used various diagnostic features in DSM-5 to determine whether an individual has schizophrenia. Firstly, the patient must show two or more signs of delusions, disorganized speech, hallucinations, negative symptoms or catatonic behavior. Secondly, the functioning of their bodies must have declined. Thirdly, the body signs must have persisted for a long period of time say 6 months. Fourthly, depression, bipolar disorder and schizoaffective disorder have to be ruled out. Finally, substance abuse has also been ruled out.

In the case study, the diagnosis for the patient based on DSM-5, the patient has showed signs of auditory hallucinations, where she hears an inner voice talking to her; she is also facing phobia, as she fears for her own life and feels that the FBI is watching over her. This is coupled with anxiety, manic behavior and inappropriate emotions. The level of the disorder of Barbara based on her symptoms is mid-level (mild condition).

Mental Health Issues in the Case Study case study代写

Substance abuse victims might show symptoms that are similar to those of schizophrenia. Consequently, it is easy to mistake patients of schizophrenia with those who have been affected by drugs. Existing research does not show that substance abuse can cause schizophrenia (Franken & Hendriks, 2001). Patients with schizophrenia are however very likely to suffer from a related substance abuse problem as compared to other people.

The effect of substance abuse is that it makes treatment for schizophrenia difficult and less effective. This is because patients with this disorder are less likely to follow medical plans. Secondly, some of the substances such as cocaine, amphetamines and marijuana may worsen the symptoms of schizophrenia.

This is related to the potential links associated to drug abuse to various aspects of human life which include genetic vulnerability, the effects of medication as well as psychosocial factors. Cannabis users for instance, are more prone to have more hostility scores as well as a high thought disturbance. This may affect their response to medication. Furthermore, the use of cocaine may have an influence on their heterogeneity, which makes their treatment program further complicated.

Patients suffering from this disorder require special intervention and treatment due to their drug abuse related complications (Franken & Hendriks, 2001). Furthermore, medical facilities are less experienced in dealing with this medical condition. Consequently, they may end up not receiving commensurate care for their condition, and therefore, their condition worsens.

Etiology of the Case Study case study代写

In genetic consideration of schizophrenia, studies have shown that there are variations which are associated with the disorders. The understanding of this problem is mainly based on biological factors in the human body. Consequently, the issue at hand is called by variations. The variations are as a result of deletions that are associated with the presence of schizophrenia.

Furthermore, there are Single Nucleotide Polymorphisms (SNPs) that are associated with schizophrenia. Research findings show that there may be evidence to support the assertion that there is polygenic inheritance that relates to the disorder. Therefore in the case study, the disorder could have been inherited from Barbara’s father. Furthermore, Barbara was raised in a family that accepted her situation.  Rather than helping her out by finding professional help from a psychiatrist.

Her mother confirms this because the family especially her mother felt that she was suffering from a condition similar to that of her father (Ham & Hope, 2003). The associated trauma, negligence and solitude might have played a part in developing the illness. Furthermore, her mother does not reveal to her the condition that she might be suffering from. Failing to reveal this to her is denying her the right to know her condition and know the treatment options that are available to her.

Environmental elements might have an impact in the case study. The death of Barbara’s mother was a stressful situation for her because she had to fend for herself. It was during this period that she started experiencing auditory hallucinations and even contemplating harming her boss and herself. The risk factors in this case include stress and trauma because she finds herself in unknown grounds.

The associated shock worsens her condition. Research findings show that environmental factors such as stressful situations have the potential of causing schizophrenia, which might have a mild level (Ham & Hope, 2003). This is due to the physical and hormonal changes that occur and triggered by stress.

Dual Diagnosis case study代写

In co-occurring disorder treatment it is important to adopt an integrated care program. Treating psychiatry as well as addiction is likely to lower relapse from addicts, reduce the number of people who are likely to commit suicides as well as fostering abstinence from drug abuse. One treatment option is the residential treatment programs (Ham & Hope, 2003). Such a program are well structured and well supervised to guide the individual through rehabilitation. Since the individuals are removed from the daily stresses of life, the patients are able to concentrate on their treatment.

The second option is outpatient treatment options. This is a rehabilitation program that is an alternative for individuals who do not require round the clock supervision. This treatment option is best for teenagers, parents or people who have work commitments. This method enables patients to lead normal lives without interruptions on their daily routines.

The third recommendation is individual therapy.

This method focuses on identifying thoughts that are geared at self-defense, build self-motivation as well as adopting positive behavior. It establishes self-worth in these individuals and in the long run prevent relapse. The fourth recommendation is peer support groups. Withdrawing from society is a result of mental health disorders.

When drugs are added to the mix, the situation becomes worse. Peer groups put away such fear and you are able to team up with other people to fight the isolation. Finally, there is need for counseling and education for families that might have one of its members suffering from a co-occurring disorder. The disorder may be heart-breaking for the family however support for such a family through education would enable them to understand the situation of one of their own as well learning various skills that can enable them to support their member who has a disorder.

Treatment options in the case study case study代写

In the treatment of schizophrenia there is need for a lifelong treatment method even after the symptoms have subsided. The best treatment method is a combination of psychotherapy and medications. With extreme cases calling for hospitalization of these individuals, health practitioners involved in this treatment are a psychologist, psychiatric nurse and a social worker.

Medications lay the basis for schizophrenia treatment. The treatment method uses antipsychotic medications. This type of medication is prescribed by a medical practitioner (Hughes, Furr, Sood, Barmish, & Kendall, 2009). These drugs control the symptoms of schizophrenia by controlling dopamine which is a neurotransmitter in the brain.

The medicine manages the signs of the disease using the least possible dose (Lewandowski et al., 2011).

The medical practitioner may therefore try various doses, different drugs or different combinations of drugs. Other types of drugs can be used in the treatment are anti-anxiety and anti-depressants.

Psychotherapy methods of treatment include individual therapy. This method, normalizes their thought pattern, helps them to cope with stressful situations and is able to identify relapse cases. The second form of therapy is training on social skills. This form of therapy is aimed at improving their social interactions as well as their ability to participate in their day to day activities.

The third form of therapy is family therapy. It provides support for families that have to deal with schizophrenia. The final type of therapy is vocation rehabilitation. The focus here is to find employment for people living with the disorder and helping them to maintain these jobs.

Risk Factors in the Case Study case study代写

In the case study, the risk factors are trauma, stress and lifestyle. Trauma arises in the case study after Barbara loses her mother. The loss is quite traumatic on her and this leads to her having difficulty supporting herself because she had trouble maintain a steady job. Consequently, she was unable to pay her bill. This led to stressful situations and the pressure was too much on her life. She also started experiencing auditory hallucinations that made her feel hopeless and this made her have a negative perception about other people.

The third risk factor was her lifestyle. Her mother had noted that Barbara had symptoms similar to those that affected his father yet she took no action to remedy the problem that was affecting her daughter. Her lifestyle choices also made it difficult for her to be stable in her jobs. Therefore she was unable to pay for most of her bills. Consequently, she experienced stressful situations that escalated her condition.

The protective factor in this case is mainly her family. Barbara’s mother had played an integral part in her life by offering her support be it emotional or financial support. This form of support ensured that she was able to keep of factors or conditions that would have escalated the disorders such as what happened after she lost her mother.

case study代写
case study代写

Relapse Prevention and Treatment Plan case study代写

Relapse is very common problem for recovering patients of the disorder. Most patients might find their condition worsening. One way to do this is to join a support group. Interacting with other people on a regular basis offers moral support and one is able to fight risk factors such as stress that may lead to relapse. This is because, support groups reduce stressful situations through social interactions, individuals are able to develop friendships and finally these individuals are able to empower themselves as well as develop control.

The second way to prevent relapse is to monitor risk factors and warning signs. Therefore physicians need to monitor factors that cause relapse. These factors include social situations, emotional triggers as well as physical changes. Some of the triggers include financial changes, loss of a loved one, loss of employment, social pressures, marital problems and health issues.

The third method is to create a relapse prevention plan that has an index card.

The card should contain plans to turn to healthy actions when faced by periods of stress and trauma which are the major risk factors. Some actions include social activities, attending recovery meetings and participating in physical exercises. The card may also contain information about support members of society such as friends, family and counselors. These individuals may guide the individual in preventing them to relapse.

A final relapse prevention strategy is maintaining a positive quality. Such a lifestyle involves support from family and friends. These people need to understand the current state of the individual’s life and make efforts to maintain positive energy for the individual. Such efforts will make the individual feel appreciated and will go a long way in ensuring they live a healthy life that is free of risk factors.

Ethical Legal Issues in the Case Study case study代写

In the case study the ethical issues that arise is lack of care on children with schizophrenia and discrimination. Barbara’s mother should have taken care of her daughter as soon as she realized that she had disorder. This would have guide Barbara to lead a normal life. Furthermore, it was her right to know the condition which she was suffering from. So that in future she would know the risk factors that she had to avoid as well as know how to handle stressful situations in her life.

In the case study Barbara is also discriminated because of her condition. She felt that she was odd to many of her friends and family. These individuals were not accommodative of her situation thus she ended up living in solitude. People living with this disorder should not be discriminated rather they should be accommodated in the community so that they can live in cohesion with these members who support them through their daily lives.

Conclusion 

Schizophrenia is a condition that affects many individuals in society. The condition’s risk factors include drug abuse, trauma and stress. Therefore, individuals suffering from the condition need to avoid these factors and be guided through their recovery journey by friends and family. The DSM-5 provides symptoms that can enable health practitioners to diagnose the condition since the disorder is easily confused with other conditions. Relapse is also a major concern in the treatment of the disorder. Consequently, conditions that may cause relapse need to be avoided.

case study代写
case study代写

References case study代写

American Psychiatric Association. (2016). Anxiety disorders: DSM-5 selections. Arlington, VA: American Psychiatric Association.

Barbiturates: Lesson Plan: ACSAP – Barbiturates – 02/10/2005. (2005). PsycEXTRA Dataset. doi:10.1037/e640632011-001

Franken, I. H., & Hendriks, V. M. (2001). Screening and diagnosis of anxiety and mood disorders in substance abuse patients. American Journal on Addictions10(1), 30-39. doi:10.1080/105504901750160448

Ham, L. S., & Hope, D. A. (2003). Alcohol and anxiety: Subtle and obvious attributes of abuse in adults with social anxiety disorder and panic disorder. Depression and Anxiety18(3), 128-139. doi:10.1002/da.10130

Hasin, D. S., O’Brien, C. P., Auriacombe, M., Borges, G., Bucholz, K., Budney, A., … Grant, B. F. (2013). DSM-5 criteria for substance use disorders: Recommendations and rationale. American Journal of Psychiatry170(8), 834-851. doi:10.1176/appi.ajp.2013.12060782

Hughes, A. A., Furr, J. M., Sood, E. D., Barmish, A. J., & Kendall, P. C. (2009). Anxiety, mood, and substance use disorders in parents of children with anxiety disorders. Child Psychiatry and Human Development40(3), 405-419. doi:10.1007/s10578-009-0133-1

Lewandowski, K. E., Cohen, B. M., Keshavan, M. S., & Öngür, D. (2011). Relationship of neurocognitive deficits to diagnosis and symptoms across affective and non-affective psychoses. Schizophrenia Research133(1-3), 212-217. doi:10.1016/j.schres.2011.09.004

The Louis de la Parte Florida Mental Health Institute. (2002). Co-occurring disorders treatment workbook. Tampa, FL: University of South Florida. Retrieved from http://scholarcommons.usf.edu/cgi/viewcontent.cgi?article=1593&context=mhlp_facpub

 


评估和干预计划
学生的名字
机构隶属关系

评估和干预计划
精神分裂症是一种可以从其他家庭成员遗传继承的疾病。被发现患有这种疾病的个体应接受治疗以减轻该疾病的影响。他们还应避免各种压力因素,例如压力或药物滥用,这些因素可能会使他们的病情恶化。本文针对的是患有精神分裂症的芭芭拉的案例研究。该论文涵盖了评估,精神动力学和药代动力学,DSM-4诊断,精神健康问题,病因,双重诊断,治疗,复发以及精神分裂症治疗中的道德和法律问题的程序和过程。
案例研究概述
该案例研究涉及患有精神分裂症的芭芭拉。对于她的朋友和家人来说,她似乎很奇怪,她的母亲将她的行为与遭受相同疾病的父亲的行为联系起来。歧视并没有影响到芭芭拉,因为她喜欢与其他人有所不同(路易斯·德拉·Parte佛罗里达心理健康研究所,2002)。她在17岁时失去了母亲,独自一人照顾自己。事实证明,这对芭芭拉来说很困难,因为她无法维持稳定的工作。不久,她就被账单所淹没,这引起了很大的压力。然后,她开始考虑杀死自己和老板。推动力是一种内在的声音,敦促她这样做。
在芭芭拉观察到的精神分裂症的症状包括怪异的信念。因此,她认为联邦调查局正在监视她,因为她把猫留在了自己的公寓里。此外,这表明她患有精神分裂症,患有躁狂症(Lewandowski,Cohen,Keshavan和Öngür,2011)。她还经历了幻听,使她沉思要杀死老板并随后自杀。芭芭拉(Barbara)的危险因素是精神分裂症的家族病史,母亲失去母亲后承受的高压力以及经历过症状的历史,起初该水平很低,因为她过去常常觉得自己一直很奇怪。
评估和诊断的程序和过程
精神分裂症的评估和诊断主要集中在排除与精神健康有关的其他疾病,以及确定症状不是由于其他医学状况,患者所接受的药物或药物滥用引起的。一些评估程序包括:
对患者进行身体检查。检查患者的总体健康状况以排除其他疾病和问题。此外,评估有助于确定与精神分裂症和机会性疾病有关的并发症。
进行测试和筛选。由于疾病的性质,可能使疾病的症状与其他疾病的症状混淆。其中一些测试包括CT扫描和MRI,可帮助排除可能具有与该疾病相似症状的其他疾病。此外,有必要进行药物和酒精的筛查,因为药物滥用通常会加速该病的流行。
进行精神病学评估。精神卫生专业人员通过检查患者的举止和身体外表来评估患者的心理状况。此外,从业者需要向前迈一步,向患者询问他们的情绪,幻觉,妄想,自杀或暴力的可能性以及药物滥用。家庭是任何个人的组成部分;因此,有必要建立患者的个人病史及其家庭关系。
制定该疾病的诊断标准。卫生专业人员利用《精神障碍诊断手册》(DSM-5)中确立的标准来评估患者(Hasin等人,2013)。 DSM-5被用作所有精神病学诊断以及患者治疗选择的基础。

药效动力学和药代动力学

病例研究中患者使用的物质是巴比妥酸盐。该物质的药效学如下。该药物将自身与GABA受体的分子成分结合,该成分包含在中枢神经系统(CNS)的神经元膜中。 GABA通常充当氯离子的通道。因此,它被称为氯化物通道配合物(“巴比妥类药物:教学计划:ACSAP-巴比妥类药物”,2005年)。因此,巴比妥类药物在GABA受体的结合位点起作用。
巴比妥酸盐通常通过增加GABA氯化物通道及其开放的实际时间来使CNS各个部位的GABA发挥作用。与其他物质(例如苯二氮卓类)相比,巴比妥酸盐对氯离子通道的影响很大(“巴比妥酸盐:教学计划:ACSAP-巴比妥酸盐”,2005年)。但是,它们导致宽容,心理和身体依赖性。因此,它们的使用需要限于抗癫痫和麻醉的目的。药效学效应取决于剂量。小剂量可减轻个体的紧张感,而大剂量则可引起视力模糊,蹒跚,嗜睡,言语含糊,反射减慢,对疼痛和呼吸问题的敏感性降低。药物过量可能导致昏迷,神志不清甚至死亡。
巴比妥类药物的药代动力学
口服时,它很容易从胃肠道吸收。然后通过首先穿过血脑屏障(BBB)将药物分配到体内,其中高水平分配给肾脏,大脑和肝脏。该药物是脂溶性的,并重新分配到肌肉。多余的药物存储在脂肪组织中。当血浆水平降低时,据说人体会恢复。大量的药物会引起嗜睡等副作用,因为它在储存后会在体内循环。重复摄取该剂量会导致体内强烈循环,进而引起中枢神经系统的沮丧。进一步吸收剂量会导致累积,一旦这些储存饱和,就会在心血管系统和呼吸系统上产生抑郁感。在体内使用该药物后,它会在肾脏系统中排泄,并通过肝部位的氧化而排泄。

DSM-5诊断

卫生从业人员使用DSM-5中的各种诊断功能来确定个人是否患有精神分裂症。首先,患者必须表现出两个或多个妄想,言语混乱,幻觉,消极症状或紧张行为的迹象。其次,他们身体的机能一定下降了。第三,身体征兆必须持续很长一段时间,例如6个月。第四,必须排除抑郁,双相情感障碍和精神分裂性情感障碍。最后,药物滥用也被排除在外。
在该案例研究中,根据DSM-5对患者进行的诊断是,患者表现出幻听的迹象,在此她听到内在的声音在与她交谈。她还害怕恐惧,因为她担心自己的生命,并感到联邦调查局在监视她。这伴随着焦虑,狂躁的行为和不适当的情绪。基于她的症状的芭芭拉疾病的水平为中度(轻度)。
案例研究中的心理健康问题
药物滥用受害者可能会显示出与精神分裂症相似的症状。因此,容易将精神分裂症患者误认为受药物影响的患者。现有的研究并未表明药物滥用会导致精神分裂症(Franken&Hendriks,2001)。然而,与其他人相比,精神分裂症患者极有可能遭受相关的药物滥用问题。
滥用药物的后果是使精神分裂症的治疗困难且效果较差。这是因为患有这种疾病的患者不太可能遵循医疗计划。其次,可卡因,苯丙胺和大麻等某些物质可能会使精神分裂症的症状恶化。这与滥用毒品与人类生活各个方面的潜在联系有关,其中包括遗传脆弱性,药物作用以及社会心理因素。例如,大麻使用者更容易产生更多的敌意分数以及很高的思想干扰。这可能会影响他们对用药的反应。此外,可卡因的使用可能对其异质性有影响,这使得其治疗程序更加复杂。
由于与药物滥用相关的并发症,患有这种疾病的患者需要特殊的干预和治疗(Franken&Hendriks,2001)。此外,医疗机构在处理这种医疗条件方面经验不足。因此,他们可能最终没有得到与其状况相称的照料,因此,他们的状况恶化了。
案例研究的病因学
在精神分裂症的遗传学研究中,研究表明存在与疾病相关的变异。对这个问题的理解主要基于人体中的生物学因素。因此,变化会引起眼前的问题。变异是与精神分裂症的存在相关的缺失的结果。此外,存在与精神分裂症相关的单核苷酸多态性(SNP)。研究发现表明,可能有证据支持存在与该疾病有关的多基因遗传的论断。因此,在案例研究中,该疾病可能是从芭芭拉的父亲那里继承的。此外,芭芭拉在一个接受她的处境的家庭中长大。而不是从精神病医生那里寻求专业帮助来帮助她。她的母亲之所以确认这一点,是因为家庭,尤其是她的母亲感到她正遭受与父亲相似的疾病(Ham&Hope,2003年)。相关的创伤,疏忽和孤独可能在疾病发展中起到了一定作用。此外,她的母亲没有向她透露她可能正在遭受的痛苦。未能向她透露这是剥夺了她了解她的病情和知道她可以使用的治疗方案的权利。

环境因素可能会对案例研究产生影响。芭芭拉(Barbara)母亲的去世对她来说是一个压力很大的情况,因为她必须自生自灭。正是在这段时间里,她开始经历幻听,甚至打算伤害她的老板和她自己。这种情况下的危险因素包括压力和创伤,因为她发现自己处于未知的境地。相关的休克使她的病情恶化。研究发现表明,环境因素(例如压力环境)有可能导致精神分裂症,其水平可能较轻(Ham&Hope,2003年)。这是由于压力引起的身体和荷尔蒙变化。

双重诊断

在同时发生的疾病治疗中,采用综合护理计划很重要。治疗精神病和成瘾可能会降低成瘾者的复发率,减少可能自杀的人数,并促进戒毒。一种治疗选择是住宅治疗计划(Ham&Hope,2003年)。此类程序的结构和监督得当,以指导个人进行康复。由于使个人摆脱了日常的生活压力,因此患者能够集中精力进行治疗。
第二种选择是门诊治疗选择。这是一项康复计划,是不需要全天候监督的个人的替代方案。此治疗选项最适合青少年,父母或有工作承诺的人。这种方法使患者能够过上正常的生活,而不会影响他们的日常工作。第三个建议是个体疗法。这种方法侧重于识别适合自卫,建立自我动机以及采取积极行为的思想。它可以在这些个体中建立自我价值,从长远来看可以防止复发。第四个建议是同伴支持小组。退出社会是精神健康失调的结果。当将药物添加到混合物中时,情况变得更糟。同行团体消除了这种恐惧,您可以与其他人合作来对抗隔离。最后,有必要为可能会有其成员之一患有共同疾病的家庭提供咨询和教育。这种疾病对家庭来说可能是令人心碎的,但是通过教育对这样一个家庭的支持将使他们能够了解自己的情况,并学习各种技能,使他们能够为患有疾病的成员提供支持。

案例研究中的治疗选择

在精神分裂症的治疗中,即使症状消失,也需要一种终生的治疗方法。最好的治疗方法是心理治疗和药物治疗相结合。在极端情况下,要求这些人住院治疗,参与这种治疗的卫生从业人员是心理学家,精神病护士和社会工作者。
药物为精神分裂症的治疗奠定了基础。该治疗方法使用抗精神病药。这类药物由医生开具处方(休斯,弗尔,苏德,巴米什和肯德尔,2009年)。这些药物通过控制大脑中的神经递质多巴胺来控制精神分裂症的症状。该药物使用尽可能少的剂量来控制疾病的症状(Lewandowski等,2011)。因此,医生可以尝试各种剂量,不同的药物或药物的不同组合。可用于治疗的其他类型的药物是抗焦虑药和抗抑郁药。
心理疗法的治疗方法包括个体疗法。这种方法可以规范他们的思维方式,帮助他们应对压力大的情况,并能够识别复发病例。治疗的第二种形式是社交技能培训。这种治疗形式旨在改善他们的社交互动以及参加日常活动的能力。治疗的第三种形式是家庭治疗。它为必须应对精神分裂症的家庭提供支持。最后一种疗法是职业康复。这里的重点是为患有疾病的人找到工作,并帮助他们维持这些工作。

案例研究中的风险因素
在案例研究中,危险因素是创伤,压力和生活方式。案例研究中,芭芭拉失去母亲后出现创伤。损失对她来说是很痛苦的,这导致她难以维持自己的生活,因为她在维持稳定的工作上遇到困难。因此,她无法支付账单。这导致压力很大,她的生活承受了太大的压力。她还开始经历幻觉,这使她感到绝望,这也使她对他人产生了负面的看法。
第三个危险因素是她的生活方式。她的母亲指出,芭芭拉的症状与影响父亲的症状相似,但她未采取任何措施来纠正影响女儿的问题。她的生活方式选择也使她很难稳定工作。因此,她无法支付大部分账单。因此,她经历了压力大的情况,病情不断升级。
在这种情况下,保护因素主要是她的家人。芭芭拉(Barbara)的母亲通过情感或经济上的支持向她提供了支持,在她的生活中扮演了不可或缺的角色。这种形式的支持确保她能够保留可能加剧疾病的因素或条件,例如失去母亲后发生的事情。
复发预防和治疗计划
对于使该疾病的患者康复,复发是非常普遍的问题。大多数患者可能会发现病情恶化。一种方法是加入支持小组。定期与他人互动可以提供道义上的支持,并且能够抵抗可能导致复发的压力等危险因素。这是因为,支持团体通过社交互动减少了压力感,个人能够发展友谊,最后这些人能够增强自己的能力并发展控制力。
防止复发的第二种方法是监视风险因素和警告信号。因此,医生需要监视引起复发的因素。这些因素包括社交情况,情感触发因素以及身体变化。一些触发因素包括经济变化,失去亲人,失去工作,社会压力,婚姻问题和健康问题。第三种方法是创建具有索引卡的预防复发计划。该卡应包含计划,当面临压力和创伤(这是主要危险因素)时,应采取健康行动。一些行动包括社交活动,参加康复会议和参加体育锻炼。该卡还可能包含有关社会支持成员的信息,例如朋友,家人和辅导员。这些个体可以指导个体预防其复发。
最终的预防复发策略是保持积极的质量。这种生活方式需要家人和朋友的支持。这些人需要了解个人生活的现状,并努力保持个人的正能量。这些努力将使个人感到赞赏,并将在确保他们过上没有危险因素的健康生活方面大有帮助。

案例研究中的道德法律问题
在案例研究中,出现的伦理问题是对患有精神分裂症和歧视的儿童缺乏照顾。芭芭拉(Barbara)的母亲一意识到女儿患有疾病,就应该照顾她。这将引导芭芭拉过上正常的生活。此外,了解自己遭受的状况是她的权利。这样,将来她就会知道自己必须避免的危险因素,并且知道如何应对生活中的压力情况。
在该案例研究中,芭芭拉也因她的病情而受到歧视。她觉得自己对她的许多朋友和家人都很陌生。这些人不适应她的处境,因此她最终独自生活。不应歧视患有这种疾病的人,而应将他们安置在社区中,以便他们与支持他们一生的这些成员保持凝聚力。

结论
精神分裂症是一种影响社会上许多个体的疾病。该病的危险因素包括药物滥用,创伤和压力。因此,患有这种疾病的人需要避免这些因素,并在朋友和家人的指导下进行康复。由于该疾病很容易与其他疾病混淆,因此DSM-5提供的症状可以使医疗从业人员诊断该疾病。复发也是该疾病治疗中的主要关注点。因此,需要避免可能导致复发的情况。

References

American Psychiatric Association. (2016). Anxiety disorders: DSM-5 selections. Arlington, VA: American Psychiatric Association.

Barbiturates: Lesson Plan: ACSAP – Barbiturates – 02/10/2005. (2005). PsycEXTRA Dataset. doi:10.1037/e640632011-001

Franken, I. H., & Hendriks, V. M. (2001). Screening and diagnosis of anxiety and mood disorders in substance abuse patients. American Journal on Addictions10(1), 30-39. doi:10.1080/105504901750160448

Ham, L. S., & Hope, D. A. (2003). Alcohol and anxiety: Subtle and obvious attributes of abuse in adults with social anxiety disorder and panic disorder. Depression and Anxiety18(3), 128-139. doi:10.1002/da.10130

Hasin, D. S., O’Brien, C. P., Auriacombe, M., Borges, G., Bucholz, K., Budney, A., … Grant, B. F. (2013). DSM-5 criteria for substance use disorders: Recommendations and rationale. American Journal of Psychiatry170(8), 834-851. doi:10.1176/appi.ajp.2013.12060782

Hughes, A. A., Furr, J. M., Sood, E. D., Barmish, A. J., & Kendall, P. C. (2009). Anxiety, mood, and substance use disorders in parents of children with anxiety disorders. Child Psychiatry and Human Development40(3), 405-419. doi:10.1007/s10578-009-0133-1

Lewandowski, K. E., Cohen, B. M., Keshavan, M. S., & Öngür, D. (2011). Relationship of neurocognitive deficits to diagnosis and symptoms across affective and non-affective psychoses. Schizophrenia Research133(1-3), 212-217. doi:10.1016/j.schres.2011.09.004

The Louis de la Parte Florida Mental Health Institute. (2002). Co-occurring disorders treatment workbook. Tampa, FL: University of South Florida. Retrieved from http://scholarcommons.usf.edu/cgi/viewcontent.cgi?article=1593&context=mhlp_facpub