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15.1 Schizophrenia

Schizophrenia is a disorder usually beginning when a person is in their late teens or early twenties. The etiology of the condition is unknown, although there are a range of theoretical perspectives, and it is thought to involve neurotransmitter signal disruption. The client can pass through acute, stabilization, and maintenance phases when experiencing the disorder. There is no one characteristic for schizophrenia, but clients can experience symptoms such as delusions, hallucinations (usually auditory), incoherence, catatonic or hyperactive behavior, and flat effect. Symptoms are categorized as being positive and negative. Treatment is often dependent on medications that can have serious side effects, with psychosocial techniques also being used to help the client return to their role in society.

15.2 Schizophrenia Spectrum Disorders

Schizophrenia spectrum disorders include schizoaffective disorder, schizophreniform disorder, brief psychotic disorder, medication and substance-induced psychotic disorder, catatonia, and psychotic disorder due to another medical condition. The key to understanding the differences between these disorders is the timing and duration of symptoms and precipitating events. Treatment for most of them include removing offending agents, treating the underlying condition, and managing psychosis with second-generation antipsychotic medications, therapy, and psychosocial techniques.

15.3 Delusional Disorder

Delusional disorders differ from other psychotic disorders because the clients may not appear to be functionally impaired. Types of delusions include jealous, somatic, grandiose, erotomaniac, and persecutory. Treatments for delusional disorders remain relatively unaltered from treatments for clients with schizophrenia. Clients are offered medication management in conjunction with psychosocial therapy, family therapy, cognitive behavioral therapy, and consultation and collaboration with general health providers and legal professionals in some cases. Successful outcomes depend on medication adherence, decreased behaviors involving the legal system, and continued communication with other health-care and team members.


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