Assessing and Diagnosing Patients With Schizophrenia
Week 7: Schizophrenia and Other Psychotic Disorders; Medication-Induced Movement Disorders
Assignment: Assessing and Diagnosing Patients With Schizophrenia, Other Psychotic Disorders, and Medication-Induced Movement Disorders
-case chosen -Training Title 24
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Psychotic disorders and schizophrenia are some of the most complicated and challenging diagnoses in the DSM. The symptoms of psychotic disorders may appear quite vivid in some patients; with others, symptoms may be barely observable. Additionally, symptoms may overlap among disorders. For example, specific symptoms, such as neurocognitive impairments, social problems, and illusions may exist in patients with schizophrenia but are also contributing symptoms for other psychotic disorders.
For this Assignment, you will analyze a case study related to schizophrenia, another psychotic disorder, or a medication-induced movement disorder.
To Prepare:
• Review this week’s Learning Resources and consider the insights they provide about assessing and diagnosing psychotic disorders. Consider whether experiences of psychosis-related symptoms are always indicative of a diagnosis of schizophrenia. Think about alternative diagnoses for psychosis-related symptoms.
• Download the Comprehensive Psychiatric Evaluation Template, which you will use to complete this Assignment. Also review the Comprehensive Psychiatric Evaluation Exemplar to see an example of a completed evaluation document.
• By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports”
•
Case history -Training Title 24 Name: Ms. Jess Davies Gender: female Age: 30 years old T- 98.6 P- 86 R 20 120/70 Ht 5’2 Wt 126lbs Background: Jess is brought for evaluation by her 2 roommates who are concerned with behaviors. She had some issues with depression after aunt died but worsened in the 12 days after she witnessed her brother killed via GSW in a gas station burglary. She is estranged from her parents and her brother was her only sibling. She is only sleeping 2 hours/24hrs; she will only eat canned foods. She smokes cannabis daily since she was 17 and goes out on weekdays couple times with her roommates and has couple drinks of beer. She was prescribed alprazolam 1mg twice daily as needed by her PCP for 15 days. She works in a bakery. Allergies: medical tape Symptom Media. (Producer). (2016). Training title 24 [Video]. https://video-alexanderstreetcom.ezp.waldenulibrary.org/watch/training-title-24
• document, keeping the requirements of the evaluation template in mind.
• Consider what history would be necessary to collect from this patient.
• Consider what interview questions you would need to ask this patient.
• Identify at least three possible differential diagnoses for the patient.
By Day 7 of Week 7
Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.
Incorporate the following into your responses in the template:
• Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
• Objective: What observations did you make during the psychiatric assessment?
• Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5-TR criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
• Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
rubric
Create documentation in the Comprehensive Psychiatric Evaluation Template about the patient you selected.
In the Subjective section, provide:
• Chief complaint
• History of present illness (HPI)
• Past psychiatric history
• Medication trials and current medications
• Psychotherapy or previous psychiatric diagnosis
• Pertinent substance use, family psychiatric/substance use, social, and medical history
• Allergies
• ROS–
Excellent 18 (18%) – 20 (20%)
Good 16 (16%) – 17 (17%)
Fair 14 (14%) – 15 (15%)
Poor 0 (0%) – 13 (13%)
In the Objective section, provide:
• Physical exam documentation of systems pertinent to the chief complaint, HPI, and history
• Diagnostic results, including any labs, imaging, or other assessments needed to develop the differential diagnoses.–
Excellent 18 (18%) – 20 (20%)
Good 16 (16%) – 17 (17%)
Fair 14 (14%) – 15 (15%)
Poor 0 (0%) – 13 (13%)
In the Assessment section, provide:
• Results of the mental status examination, presented in paragraph form.
• At least three differentials with supporting evidence. List them from top priority to least priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5-TR criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.–
Excellent 23 (23%) – 25 (25%)
Good 20 (20%) – 22 (22%)
Fair 18 (18%) – 19 (19%)
Poor 0 (0%) – 17 (17%)
Reflect on this case. Discuss what you learned and what you might do differently. Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), social determinates of health, health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).–
Excellent 9 (9%) – 10 (10%)
Good 8 (8%) – 8 (8%)
Fair 7 (7%) – 7 (7%)
Poor 0 (0%) – 6 (6%)
Provide at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines that relate to this case to support your diagnostics and differential diagnoses. Be sure they are current (no more than 5 years old).–
Excellent 14 (14%) – 15 (15%)
Good 12 (12%) – 13 (13%)
Fair 11 (11%) – 11 (11%)
Poor 0 (0%) – 10 (10%)
Written Expression and Formatting—Paragraph development and organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.–
Excellent 5 (5%) – 5 (5%)
Good 4 (4%) – 4 (4%)
Fair 3.5 (3.5%) – 3.5 (3.5%)
Poor 0 (0%) – 3 (3%)
Written Expression and Formatting—English writing standards:
Correct grammar, mechanics, and punctuation–
Excellent 5 (5%) – 5 (5%)
Good 4 (4%) – 4 (4%)
Fair 3 (3%) – 3 (3%)
Poor 0 (0%) – 2 (2%)
Total Points: 100
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