Treatments and Diagnosis of schizophrenia

Schizophrenia is a debilitating chronic brain disorder that affects millions of people world wide. There is no cure for this disease, but fortunately there are treatments available when the proper diagnosis has been determined.

The first step in getting help is recognizing there is a problem and acting on it. The patient most likely will initially refuse care because their hallucinations and delusions are real to them, and may deny that anything is wrong. If symptoms are severe, hospitalization may be required. Once medications have controlled psychotic episodes, the patient may be discharged home in the care of family members.

Diagnosis:

The next step is making an appointment with a health care professional for proper testing. Your doctor will first take a detailed health history. You may be asked for health information on close relatives and their health status.

Psychiatric evaluation — Your doctor will ask questions about your symptoms and psychiatric history, as well as family history of mental health problems.Medical history and exam:

Your doctor will need to know about your personal and family health history. He or she will also perform a complete physical examination to check for medical issues that could be causing or contributing to the problem.Laboratory tests:

Laboratory testing will not reveal schizophrenia. Lab tests on your blood are done to rule out any underlying health problems that could be causing the symptoms. Special x-rays, such as MRI or CT scan of the head may be done to rule out brain anomalies, such as tumors.

Diagnosis is made on the basis of symptoms and the length of time they have been occurring. At least two of the following symptoms must be present for four weeks or more:

• Hallucinations


• Delusions


• Disorganized speech


• Disorganized or catatonic behavior


• Negative symptoms such as emotional flatness, apathy, lack of speech


• Difficulties functioning at work or school, relationships with others, and self care abilities.


• Consecutive symptoms for at least 6 months or more, with hallucinations, delusions and other symptoms for at least 30 days.


• No evidence of other mental health disorder, health issues, or substance abuse

Schizophrenia can mimic other disorders, therefore, it is important that definitive diagnosis be made for appropriate treatment to begin.

Similar conditions that mimic schizophrenia:

Other brain disorders, such as schizoaffective disorder, schizophreniform disorder, and brief psychotic disorder
Substance abuse - Like alcohol, PCP, heroin, amphetamines, and cocaine.
Medical conditions – Such as epilepsy, brain tumors, and encephalitis, or any condition relating to the central nervous system (CNS).
Mood disorders – Such as mania and depression
Post-traumatic stress disorder (PTSD)

Treatment:

This brain disorder can be successfully treated with medications, such as typical and atypical antipsychotics, antidepressants, group and individual talk sessions with a trained mental health professional, and hospitalization.

Typical Antipsychotics:

• Trifluoperazine (Stelazine)


• Chlorpromazine (Thorazine)


• Fluphenazine (Prolixin)


• Haloperidol (Haldol)


• Loxapine (Loxitane)


• Perphenazine (Trilafon)


• Thioridazine (Mellaril)


• Thiothixene (Navane)

Atypical Antipsychotics:

• Ziprasidone (Geodon)


• Aripiprazole (Abilify)


• Clozapine (Clozaril)


• Olanzapine (Zyprexa)


• Quetiapine (Seroquel)


• Risperidone (Risperdal)

Psychosocial treatment:

This treatment form to helps the patient cope with their disease, get needed services, and become more independent. In additions, this treatment will help them to adhere to their treatment plan, which will aid in preventing relapses and hospitalization.

Therapeutic support aids in the adjustment to their disease and helps them to function in society. It also helps patients to learn problem solving skills, maintain relationships, and participate in their recovery.

Rehab:

Vocational and social rehabilitation provides for basic life skills necessary to function in their families or communities.

Family education:

Family is the closest support system people with schizophrenia have. Involving the family in the patient's recovery can lessen the incidence and severity of psychotic episodes.

by Barb Hicks, RN