Schizophrenia Essay Paper
Schizophrenia Essay Paper
Assignment 1: Early Onset Schizophrenia
Children and adolescents with schizophrenia have more difficulty functioning in academic or work settings, and significant impairment usually persists into adulthood. They may have speech or language disorders and in some cases borderline intellectual functioning. These individuals are more likely to complete suicide attempts or die from other accidental causes. Schizophrenia is characterized by positive and negative symptoms. Positive symptoms include hallucinations, delusions, and behavior disturbance. Negative symptoms include blunted affect and attention, apathy, and lack of motivation and social interest.
In this Assignment, you compare treatment plans for adults diagnosed with schizophrenia with treatment plans for children and adolescents diagnosed with schizophrenia. You also consider the legal and ethical issues involved in medicating children diagnosed with schizophrenia.
Learning Objectives
Students will:
Compare evidence-based treatment plans for adults versus children and adolescents diagnosed with schizophrenia
Analyze legal and ethical issues surrounding the forceful administration of medication to children diagnosed with schizophrenia
Analyze the role of the PMHNP in addressing issues related to the forceful administration of medication to children diagnosed with schizophrenia
To Prepare for this Assignment: Schizophrenia Essay Paper
Early onset schizophrenia
Compare at least two evidence-based treatment plans for adults diagnosed with schizophrenia with evidence-based treatment plans for children and adolescents diagnosed with schizophrenia.
Schizophrenia occurs in both children and adults, with the diagnosis being dependent on the patient’s age. Incidence among adolescents is identified as early onset schizophrenia while incidence among children less than 13 years of age is termed very early onset schizophrenia. The treatment target will depend on the diagnosis, taking into consideration the stage of the disorder as well as the patient’s age. Still, there are commonalities for all patients irrespective of age. Firstly, all forms of treatment for schizophrenia focus on resolving the noted symptoms through pharmacological and psychosocial approaches, identifying the factors that contributed to the condition, and providing the patient with a safe environment that prevents self-harm as well as harm to others. Secondly, treatment focuses on clarifying the diagnosis, establishing a rapport with the family and patient, and providing them with psycho-education (Stahl, 2014). Thirdly, treatment looks at effectiveness of the antipsychotic interventions as well as how to manage the side effects associated with the treatment. Fourthly, once treatment has resolved the immediate acute episode, treatment emphasis then shifts to preventing a relapse through ongoing treatment using antipsychotics. Besides antipsychotics, patients are subjected to psychosocial interventions that focus on treatment adherence, stressors management, and return to normal daily activities. Finally, the later stages of treatment provide rehabilitation that seeks to optimize the treatment interventions and outcomes through continued vigilance to prevent relapse and maintaining the patient’s health for the long-term (American Nurses Association, 2014).
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Despite the similarities between schizophrenia treatment for adults, adolescents and children, there are unique differences. Firstly, treatment for adults does not consider the patient’s development stage whereas treatment for children and adolescents considers the patient’s developmental stage along with family dynamics and perspective. The second difference is that treatment for adults includes psycho-education for both the patient and support structures while treatment for children includes psycho-education for the patient and family, along with other support structures if present. In fact, schools are often included in the treatment of children and adolescents since the condition is accompanied by intellectual impairment that is best addressed through involving the school (Sperry, 2016). The third difference is that while treatment for adults includes control of treatment side effects through diet and exercise, treatment for children and adolescents goes a step further in negotiating the crucial development tasks necessary for transitioning from childhood to adolescents and from adolescents to adulthood. This additional component of treatment for children and adolescents looks at the vocational and social development factors that can be addressed through individual support (Sadock, B., Sadock, V. & Ruiz, 2014). In this respect, schizophrenia treatment for adults, and treatment for adolescents and children have distinctive similarities and differences.
Explain the legal and ethical issues involved with forcing children diagnosed with schizophrenia to take medication for the disorder and how a PMHNP may address those issues.
Forced treatment of children has both legal and ethical implications. The law is clear that persons suffering from psychiatric disorders can be forced to receive treatment if the disorder is severe and requires immediate treatment, or if the patient presents an imminent danger to himself/herself or to others within the same environment. In this case, treatment can be forced if the patient lacks autonomous decision-making capacity as is the case with children who do not have the ability to communicate, reason, appreciate and understand. For that matter, the law allows for children to be subjected to involuntary psychiatric treatment when they meet the set conditions for risk for harm, diminished decision-making capacity and severity of the condition (Miller & Hanson, 2016).
While the law allows for forced treatment of children, this approach raises some ethical concerns since the patient is treated against his or her will. Firstly, there is a concern about respect for autonomy since the patient is manipulated and coerced to receive treatment. Still, it can be argued that forcing the patient to receive treatment is justified since it is intended to restore autonomy. Secondly, forced treatment does not respect the patient’s preferences and values, contrary to accepted ethical standards that every individual should have equal recognition irrespective of having a psychiatric disorder. Thirdly, psychiatric treatment is not an exact science and there is a possibility that the treatment could aggravate the condition instead of providing relief. This is a concern when it is considered that antipsychotics change the brain chemistry, and this could end up causing more harm in the long run (American Nurses Association, 2014).
As a PMHNP and given a situation in which the child is subjected to forced treatment, I should be more concerned with protecting the patient from harm and practicing beneficence rather than considering the patient’s ability to make autonomous decisions about treatment. Also, the issue should be addressed through considering the patient’s attitudes towards treatment and the need for treatment, social circumstances, expected consequences, and follow-up routines. Given that the patient has a right to reject treatment and this right can be restricted, then the decision by medical on forced treatment should be guided by three principles. Firstly, the patient must refuse treatment when recommended and be deemed incapable of making an autonomous decision on whether or not to accept treatment. Secondly, the patient must have an imperative need for the treatment. Finally, the prognosis for the disorder must be serious with unfavorable consequences if left untreated. These three steps should help the PMHNP in addressing the issues concerning forced treatment of children (Miller & Hanson, 2016).
References
American Nurses Association (2014). Psychiatric-mental health nursing: scope and standards of practice (2nd ed.). Washington, DC: Author.
Miller, D. & Hanson, A. (2016). Committed: the battle over involuntary psychiatric care. Baltimore, MD: Johns Hopkins University Press.
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
Sperry, L. (2016). Handbook of diagnosis and treatment of DSM-5 personality disorders: assessment, case conceptualization, and treatment (3rd ed.). New York, NY: Routledge.
Stahl, S. M. (2014). Prescriber’s guide: Stahl’s essential psychopharmacology (5th ed.). New York, NY: Cambridge University Press. Schizophrenia Essay Paper
