Sally is a young girl
suffering from schizophrenia. Schizophrenia is a psychotic disorder, or a group
of disorders represented by a severe impairment of individual thought process,
and behavior (TheFreeDictionary, 2012). According to Meyer, Chapman, and Weaver
(2009) “it may be more accurate to refer to schizophrenia as a family of
disorders rather than a singular disorder.” (p. 90). Untreated patients suffering
from schizophrenia are normally unable to filter various sensory stimuli, and
exhibit enhanced perception of color, sound, and other environmental factors.
In most cases, a patient suffering from schizophrenia will gradually withdraw
from personal interactions, and loose the ability to care for his or her
individual basic needs (TheFreeDictionary, 2012). Schizophrenia is considered
to be one of the top ten illnesses resulting in long-term disability, and
accounts estimate that approximately 1% of the world population is affected by
the illness (TheFreeDictionary, 2012).
The following
analysis is designed to provide and analysis of the patient’s history, and
events that resulted in her hospitalization. The analysis will provide the
specifics of the patient’s biological, behavioral, cognitive, and emotional
components that factor into her illness.
Schizophrenia
Schizophrenia
includes three different subtype, and two over subtypes. The main subtypes
include the classifications of paranoid, disorganized, and catatonic, and each
of these subtypes displays unique characteristics or symptoms (Hansell, &
Damour, 2008). Patients suffering from paranoid schizophrenia will usually
display symptoms of hallucinations or delusions. Patients suffering from disorganized
schizophrenia are subject to an inappropriate effect, and disorganized speech
patterns. Patients suffering from catatonic schizophrenia display symptoms of
strange or bizarre sensory motor function (Hansell, & Damour, 2008).
Individuals who display symptoms of schizophrenia but lack any symptoms of the
three primary classifications are likely to be diagnosed into one of two
alternate classifications: residual or undifferentiated schizophrenia (Hansell,
& Damour, 2008). Symptoms of schizophrenia are classified into two primary
categories. These two categories relate to positive and negative symptoms.
Patients displaying positive symptoms exhibit pathological excesses including
hallucinations, irrational thinking, and irrational behaviors, whereas patients
displaying negative symptoms will exhibit pathological deficits including
withdrawal and isolation from social interactions, and poverty of speech
capabilities ((Hansell, & Damour, 2008).
Schizophrenia is a
complex illness that affects both men and women on an equal level. The illness
usually starts around the age of ten, or in young adulthood. However, cases of
childhood-onset schizophrenia indicates that the illness can start as young as
five years of age. This is a more rare case of schizophrenia that can difficult
to diagnose in relation to other childhood developmental problems
(PubMedHealth, 2012). While researchers have yet to discover the cause of
schizophrenia, many suspect genetics to be a major contributor (PubMedHealth,
20120).
Patient History
The patient’s case
study indicates that she has a history of eccentricity. Medical notations
indicate that the patent's mother was an avid smoker, consuming approximately
two packs of cigarets daily before and during pregnancy. Further notations
include that the patient’s mother suffered from a very severe case of the flue
during her fifth month of pregnancy. As a child, the patient showed signs of
slower developmental skills, and was diagnosed as suffering from hyperactivity
in early childhood. Records indicate that the patient experienced a turbulent
home life because of ongoing conflicts between her parents that resulted in
separation, and reconciliation. Because of her apparent developmental
disabilities, her parents devoted time to the patient however, the patient did
receive criticism from her father for her behavioral dysfunctions.
As the patient
matured, she displayed signs of being socially awkward and isolated from her
peers, and in early adulthood started to display worsening symptoms like
talking to herself, and displaying unusual behavior like stating at the floor
for long periods. Her first documented schizophrenia episode requiring
hospitalization occurred shortly after the additional symptoms started to be
displayed. During her examination, the patient displayed signs of
unresponsiveness, and waxy flexibility that allowed her limbs to be easily
positioned (Meyer, Chapman, & Weaver, 2009). After the initial
hospitalization, the patient was returned home to facilitate a quicker
recovery. that was short lived because the patient failed to follow the
prescribed treatment regimen which, resulted in a secondary episode shortly
after her return to college. Further home-based treatments proved unsuccessful
as the patient slowly declined, resulting in unresponsiveness, and displaying
hebephrenic symptoms like unprovoked giggling, and rocking movements (Meyer,
Chapman, & Weaver, 2009).
The patient’s second
hospitalization and treatments started to show positive results, and she was
taken back to her home environment. She was able to obtain a part-time position
at work, and maintain daily household chores. However, the patient failed to
follow the prescribed treatment regimen. Following the death of her father, and
additional stressors resulting from her mother’s added dependency, the patient
suffered from a third regression of the illness. Her third hospitalization
resulted from local law officials discovering her walking in a local pond while
incoherently mumbling to herself.
Components of the
Schizophrenic Episodes
The primary component
of the patient’s episodes appear to be related to stress as the primary factor.
However, biological factors resulting from her mother’s illness and smoking
during pregnancy, and a genetic predisposition related to her grandfather's
eccentricity are viable underlying factors resulting in the patient’s illness.
In addition to the primary stressor, and the underlying genetic and biological
factors, it is possible that the emotions of the patient also contributed to
her condition. Further documentation indicates that interfamilial expressed
emotion, and communication deviance are probably contributors that appear to be
operative in the patient’s case (Meyer, Chapman, & Weaver, 2009). The first
of these factors, expressed emotion would be explained by the turbulent
relationship, combined with her mother’s over protective nature conflicting
with her father’s over critical reactions to the patient’s behavioral issues
(Meyer, Chapman, & Weaver, 2009). The second of these factors, communication
deviance resulted from the patient’s inability to focus and maintain normal
dialog with others (Meyer, Chapman, & Weaver, 2009).
Cognitive factors are
a viable consideration for this patient’s case. Meyer, Chapman, and Weaver
(2009) suggest that prodomal pruning theory may be one example of a cognitive
factor. Prodomal pruning theory suggests that the human brain deletes
unnecessary synapses to allow the brain to function properly during the change
from adolescence to adulthood (Meyer, Chapman, & Weaver, 2009). Behavior is
another factor relating to the patient’s repeated hospitalization. The patient
displayed behavior deficiencies in regard to compliance to prescribed treatment
regimens, and involvement in situations that could produce high level stressors
in her life.
Conclusion
Because illnesses
like schizophrenia relate to various and different factors, each person
effected by the illness will show differences in ability to function in a
normal environment. The various classifications of schizophrenia, ability to
receive treatments, and the consideration of various influences and base-line
factors help researchers determine what classification a patient falls into. In
this particular case, the patient displays symptoms of catatonic schizophrenia.
She is able to function in environments that do not produce high levels of
demand or stress on the individual. However, the underlying assumptions would
indicate that the combination of outlined biological, emotional, cognitive, and
behavioral were in-place, and waiting for the appropriate stressor to trigger
her symptoms.
