Eric is physically healthy considering his age and weight and the fact that he has fair hygiene and normal posture. He is also alert and fully oriented which means he knows his name, his current location, the date, and the time. In seeking therapy, Eric says that he hears voices of what he terms as cats that say abusive things to him. Eric also believes that his colleagues are plotting to bury him alive. He has a steady job for the past three years. His anxiety about heights is a condition that has existed since childhood and they sometimes affect his concentration and social life and also affect his choices on the kinds of places he can be comfortable in. His family situation is that he lives with his mother and brother whom he feels are constantly attacking him. He is on medication for hypertension and has no known allergies.This paper is going to consider Erics treatment recommendations based on the symptoms presented and associated actions regarding his condition.
Based on Erics symptoms, I would recommend psychiatric evaluation. A psychiatric evaluation refers to a defined manner of testing patients concerning their behaviors. In this respect, the process entails gathering information concerning an individuals mental health with the aim of making a diagnosis pertaining to the patient. Eric would be subject to a psychiatric evaluation owing to the symptoms he presents with as they are not normal or cannot be considered normal for a mentally healthy patient. An evaluation is normally the first step in the process of treatment and includes social information, observations, biographical information, and information gathered from a series of psychological examinations. An evaluation would lead to the establishment of a diagnosis and consequently formulation of the patients problems, which helps in the planning of treatment and care.
Anxiety is a disorder in some cases especially if it affects the quality of life of a patient. Erics anxiety is worth evaluation as it affects his concentration at work and his social life. In this respect, anxiety is a disorder when symptoms are chronic and cause interference in daily life and someones ability to function in everyday situations. The symptoms associated with chronic anxiety include fear, confusion, constant worrying and poor concentration all of which are exhibited by Eric. It would thus be better to evaluate his anxiety to rule out the possibility of an anxiety disorder.
The second disorder worth evaluating in Eric is Schizophrenia. The disorder is a mental disorder, which is characterized by at least two of the symptoms listed. Delusions, hallucinations, incoherence, or disorganized speech, catatonic behavior, agitation among other bizarre behavioral symptoms. In this respect, Eric presents with delusion, which is a belief in something that is out of the ordinary despite the fact that the situation is not true. He has delusions of persecution sometimes referred to as paranoia. He believes that his colleagues are planning to harm him by burying him alive. This is in line with believing that people are out to get him. Delusions associated with schizophrenia often involve strange ideas such as Erics strange idea of being buried alive. He is also deluded in believing that he hears voices of what he refers to as cats insulting or disparaging him.
Hallucinations are sensory perceptions experienced by an individual without relevant outside provocation or stimulus. This means an individual experiences something that does not exist and only exists in their mind. Erics hallucinations are auditory as he is hearing voices. This kind of hallucinations are consistent with schizophrenia as schizophrenic patients often present with hallucinations of voices that are either abusive, vulgar or critical. A psychiatric evaluation would help in diagnosing Eric in relation to schizophrenia as a mental disorder.
The DSM-IV criteria for schizophrenia is the diagnosis used for the illness according to the Diagnostic and Statistical manual of mental disorders. This criteriafor diagnosis defines the negative and the positive symptoms associate with the disease. These symptoms are present for a duration of at least one month to six months. Positive symptoms refer to the presence of what are termed active symptoms which include delusions and, or hallucinations. Negative symptoms are loss of maybe emotion, speech or even motivation. The disease is said to exist in a continuum, which means that it may present in a mild form to severe form. This criteria for diagnosis identifies a number of types of the disease in which both positive and negative symptoms are noted. These types of schizophrenia include catatonic, disorganized, paranoid, residual, undifferentiated, and schizoaffective among the many types of schizophrenia (DSM-IV Criteria for Schizophrenia :: DNA Learning Center. 2016).
In this respect, Erics symptoms have been there for a month, which fit the criteria for the diagnosis, the symptoms presented are also consistent with the direction of the diagnosis as the patient present with two of the noted symptoms, which are hallucination and delusions. Paranoid schizophrenia is noted as one in which the patient has preoccupied with delusion and frequent hallucinations of an auditory nature. It worth giving Eric an evaluation to consider the possibility of paranoid schizophrenia.It is important to specify if with marked stressors, symptoms occur shortly after an in apparent response to events that in either a singular or multiple manners, would be a stressful to anyone in similar situation in the individuals culture.
According to Lehman et al (2008), it is also important to note if the symptoms and the disturbance is not related to or cannot be accounted for by another disorder such as a mood disorder and is also not due to direct physiological aspects such as drug or substance abuse or some medical condition.
Since the treatment of schizophrenia is a lifelong process, it will need medication for a considerable of extended period and sometimes treatment may also be taken for life. The treatment options I would recommend for Eric as a patient would be consistent with typical treatments instituted for schizophrenic patients. In mental health disorder cases, individuals respond to medications in a different manner and as such, it may require a period of testing with different medications to come up with a regimen that is suitable to Eric as an individual.
A diagnosis of Schizophrenia will normally be treated with antipsychotic medications even though medication is just one aspect of the treatment regimen. Since many people presenting with symptoms associated with schizophrenia will need a lifetime of medicine and treatment, the goal of the treatment is to ensure that the symptoms are kept under control while having the least of side effects from the medication. This is because every individual reacts differently to the various medication and as such, the antipsychotic medications have to be tailored to an individual. This can be done by reducing or increasing the dosage while observing the patient reactions, the psychiatrist can also use a combination of different medications or one after another while adjusting the dosages to determine the best regimen that can be individualized to fit the needs of Eric as a patient (Bentall, 2013).
The two main groups of medications that are used for the treatment of Schizophrenia include atypical and typical antipsychotic medication. Typical antipsychotic medication are the oldest forms of medication geared towards the treatment of mental disorders. These medicines have been known to be effective in the treatment of paranoia and hallucinations among other psychotic symptoms. However, these drugs are known to also have adverse neurological side effects which include restlessness, stiffness of the muscle, pacing, temporary paralysis, muscle spasms and changes in the heart rate among other side effects. Atypical antipsychotic medication are newer forms of drugs that work differently and have fewer side effects.
I would recommend the use of atypical antipsychotic drugs, as they are suitable for the first line of treatment of schizophrenia (Adler et al. 2014) The side effects of these drugs include lack of motivation, a feeling of sedation, drowsiness; weigh gain, and sexual dysfunction among other side effects.
It is important to take into consideration pre-existing conditions in Erics case before recommending treatment. Eric is taking medication for hypertension and as such, the typical antipsychotic regimen as a treatment option will most likely affect the pressure of his blood owing to this being an already existing condition. It is also important to consider f the drugs will interact with his medication for hypertension and how the interaction can be countered for the best possible outcome.
DSM-IV Criteria for Schizophrenia :: DNA Learning Center. (2016). Dnalc.org. Retrieved 26 April 2016, from https://www.dnalc.org/view/899-DSM-IV-Criteria-for-Schizophrenia.html
Lehman, Anthony F., Donald M. Steinwachs, and Co-Investigators of the PORT Project. "Translating research into practice: the Schizophrenia Patient Outcomes Research Team (PORT) treatment recommendations."Schizophrenia Bulletin 24.1 (2008): 1-10.
Andreasen, N. C., Berrios, G. E., Bogerts, B., Brenner, H. D., Carpenter, W. T., Crow, T. J., ... &Lewine, R. R. J. (2012). Negative versus positive schizophrenia.Springer Science & Business Media.
Bentall, R. P. (Ed.). (2013). Reconstructing schizophrenia. Routledge.
Adler, L. E., Olincy, A., Cawthra, E. M., McRae, K. A., Harris, J. G., Nagamoto, H. T., ... & Ross, R. G. (2014). Varied effects of atypical neuroleptics on P50 auditory gating in schizophrenia patients. American Journal of Psychiatry.
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