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Schizophrenia: Psychosocial Dysfunction

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When breaking apart the word schizophrenia, you end up with “schizo” meaning split and “phrenia” which refers to the mind. Schizophrenia does not refer to a split personality but rather a scattered or fragmented pattern of thinking (Desai, 2016). The symptoms of schizophrenia are divided into three major areas: positive symptoms, negative symptoms, and cognitive symptoms. Positive symptoms are psychotic symptoms, which are: delusions, hallucinations disorganized speech, disorganized behavior, and catatonic behavior.

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Delusions are false beliefs that the patient feels very strongly about, so much so that they won’t change their mind, even if you give them evidence against it. Hallucinations can be any kind of sensation that is not actually there, including auditory and visual. Disorganized speech is a random jumbling of words. Disorganized behavior is when bizarre or silly behaviors are exhibited and are out of context. Catatonic behaviors relate to movements, posture, and responsiveness. Negative symptoms are a decrease in emotions, or a loss of interest in things they once found interesting. One type of negative symptoms is called flat affect, where they don’t respond with an emotion or reaction that would seem appropriate, like if they saw something very unexpected like a small monkey playing in their living room, they might simply sit and watch idly as if nothing was happening (Desai, 2016). Cognitive symptoms include things like not being able to remember things, learn new things, or understand others easily. Cognitive symptoms are subtle and are harder to recognize. People with schizophrenia tend to cycle through three phases, typically in order (Desai, 2016).

During the prodromal phase, patients tend to become withdrawn. During the active phase, patients experience more severe symptoms like delusions, hallucinations, disorganized speech and behavior, or catatonic behavior. In the last phase, the residual phase the patient may not be able to concentrate. For an official diagnosis of schizophrenia, patients need to be diagnosed with two of the following symptoms: delusions, hallucinations, disorganized speech, disorganized behaviors, catatonic behaviors, or negative symptoms and at least one of them has to be delusions, hallucinations, or disorganized speech. (Desai, 2016) Symptoms must also be ongoing for at least 6 months and there must be at least one month of active-phase symptoms.

Treating schizophrenia can be difficult, but the use of antipsychotics can be very helpful in reducing symptoms but they often come with a lot of additional considerations to keep in mind, like cost and the potential for unwanted side effects like tolerance, withdrawal, and dependence. (Desai, 2016) “Occupational therapy intervention can provide social skills training, which may improve specific behaviors such as making eye contact, initiating a conversation, and responding to questions” (Early, 2017, p. 157). “Persons with severe and long-term schizophrenia may perform poorly in basic and instrumental activities in daily living. Hygiene, dressing, and grooming can be coached and retaught; behavioral and cognitive-behavioral methods are generally used” (Early, 2017, p. 157).

According to (Najy, 2017), It is important to remain client centered when treating someone with schizophrenia and focus on what the client needs and loves. I do believe that remaining client centered is very important when treating someone with schizophrenia. I believe “person first, diagnosis second” is very important to remember. These clients who are experiencing schizophrenia have no control over what they are experiencing and deserve the help and treatment that will allow them to live to the best of their ability.

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