Schizophrenia: Treatment – Psychiatry | Lecturio


[Music] some prognostic factors that tell us whether or not a patient with schizophrenia is going to do really well or not so well our things such as the onset of the illness okay if somebody is presenting with an illness a little bit older they’re gonna have a better prognosis than if they’re presenting at a very young tender age also having good social supports from family friends psychiatrists primary care providers all of these things are gonna lead towards a better prognosis and when it comes to symptomatology we know that having positive symptoms so things like paranoia hallucinations delusions thought disorder these things actually all trend towards a better prognosis we think of them as a little bit easier to treat than somebody who has negative symptoms that leads to a little bit of a worse prognosis somebody who has mood symptoms is also going to have a better prognosis than somebody without mood symptoms mood disorder can be treated and therefore if that’s targeted a person can have a good outcome and usually females tend to do a little bit better than males in terms of prognosis and any patient who is diagnosed with schizophrenia will probably experience and hopefully experience remissions from their disorder however relapses are possible but for those patients who have very few and far between relapses they’re going to do much better in the long run than a patient who’s having very frequent relapses of their disorder and another key variable is what the premorbid functioning was for a patient so somebody say like mr. B who is doing really well before their symptoms in college engaged with their family having hobbies etc that person’s going to be more likely to do really well and have a good prognosis overall here’s an important question for you our patients with schizophrenia more likely to be violent actually no individuals with schizophrenia are more likely to be victims of violence than perpetrators a very important point to remember so when you think about mr. B what is your prognosis for him this young college student who has found himself diagnosed with schizophrenia well he actually shows some really good prognostic factors and these are very important to emphasize to both him and his family so some of the factors supporting a favorable outcome for him include being enrolled at college this indicates he has a high intelligence and a good premorbid functioning beyond that there’s the presence of his supportive family which is very hopeful and this appears to be mr. B’s first episode of psychosis and with the right treatment and compliance he might not have many future episodes and can actually do very well despite his illness let’s talk about the behavioral therapy treatment in schizophrenia this is aimed to improve a patient’s ability to do well and actually function within society so therapy is aimed at developing social skills self-sufficiency and also an ability to act appropriately in public and this is all the aim of behavioral therapy there can be cognitive problems associated with schizophrenia can you think of what any of those are well deficits and processing of complex information can occur maintaining a steady focus of attention working memory can be impaired distinguishing between relative and irrelevant stimuli can also happen and abstract thinking can also be disrupted when it comes to social skills training what limitations are there in training persons with schizophrenia well there is a difficulty in generating information learned or sorry there is a difficulty in generalizing information learned into real-life settings for some patients the best approach in terms of being a therapist and working with a patient who has schizophrenia is to be direct and straightforward take an active and assertive posture to provide structure and when it comes to group therapy note that it’s not very well tolerated and individuals with psychosis because of the over stimulation only very high-functioning and stable persons can tolerate insight oriented groups some other syndromes that are important to be aware of are as follows Capgras syndrome this is the delusion that imposters have replaced familiar people for goalies syndrome is a delusion that a persecutor is taking on a variety of faces like an actor like Anthropy is a delusion of being a werewolf Judis copy is a false belief that one has a double guitard syndrome this is the delusional belief that an individual has lost everything including their body organs and if all you do is a shared psychotic disorder or shared delusion between more than one person this summarizes schizophrenia and some other related psychotic disorders very important to note the history background epidemiology the causes of schizophrenia and the treatment [Music]

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