Treatment of Schizophrenia

1 Treatment of Schizophrenia Schizophrenia is a critical mental disorder that disrupts normal thinking, relationships, emotions, and decision making. Due to its psychologically disabling nature, schizophrenia negatively affects the patients’ lives and their families. Schizophrenia usually affects adults.

However, children and adolescents can be diagnosed with the early onset of schizophrenia. Since no cure is available for this condition, nurses start treatment early to manage the illness and reduce the symptoms.

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2 Treatment is, thus, centered on the management of symptoms. Medications and psychotherapy are the primary treatment options for this disorder. Although treatment aims to achieve similar outcomes, it may vary from one age group to another. This exercise compares the types of treatment for schizophrenia used in adults and children or adolescents.

Therapists use cognitive behavioral therapy (CBT) or Assertive Community Treatment for schizophrenia among adults. CBT is used to guide the client to develop positive thinking patterns and change his/her behavior. A change of thinking patterns is essential for overcoming voices and hallucinations. Assertive Community Treatment is used when a person presents with symptoms that negatively affect his/her ability to engage in community activities. In this treatment approach, a team of professionals working together helps the client manage the symptoms, comply with medications, and participate in social activities, including employment.

Adults are also treated with antipsychotic medications such as Risperidone. Evidence shows that Risperidone is efficacious against negative symptoms presented in schizophrenia (Dhanda et al., 2019).

Although similar treatment approaches are employed for pediatric and adult schizophrenia, in adolescents and children, treatment requires a more aggressive approach to reduce the severity of the symptoms, improve the child’s quality of life and prevent the disease from progressing to critical stages (Grover & Avasthi, 2019). Lee, Kronsberg, and Findling (2020) noted that pharmacological agents form the first line of treatment for pediatric schizophrenia. Young people are administered antipsychotic medications such as clozapine. As denoted by Lee, Kronsberg and Findling (2020), these medications demonstrate superior efficacy in improving psychotic symptoms even in treatment-resistant clients. Cognitive-behavioral therapy can also be integrated into the treatment plan for younger people. CBT in this population

3 is vital for identifying the thinking patterns leading to unwanted feelings and inappropriate behavior. A therapist guides the child to change the thinking patterns with more rational and beneficial thoughts (Hargrave & Arthur, 2015).

Despite its mental health benefits, the treatment for pediatric schizophrenia with medications elicits a series of ethical concerns. These concerns include wrong diagnosis and wrong treatment. Pediatric schizophrenia is challenging to diagnose since the presenting symptoms may resemble normal developmental processes or typify other mental health disorders. Misdiagnosis is, therefore, not uncommon in younger populations (Goldsmith & Roberts, 2016). Misdiagnosis may lead to the administration of antipsychotics among individuals who do not need these drugs. Another ethical issue associated with the use of antipsychotic medications among children is that research studies on these medications are performed on adult subjects (Goldsmith & Roberts, 2016). The findings are generalized to younger people without little considerations of potential side effects.

Nurses can apply critical thinking skills and the critical steps of ethical decision-making to make appropriate clinical decisions in the treatment of schizophrenia in children and adolescents. Consultation with pediatricians and other care professionals can help identify underlying health conditions in children besides ruling other disorders.

4 References Dhanda, R., Varghese, D., Nadipelli, V. R., Fava, M., Joshi, N., Solem, C. T., Graham, J. A., Learned, S. M., & Heidbreder, C. (2019). Patient-reported outcomes in schizophrenia patients treated with once-monthly extended-release risperidone in a long-term clinical study. Patient Preference and Adherence, 13, 1037–1050. https://doi.org/10.2147/PPA.S202173 Giles, L., & Martini, D. (2016). Challenges and promises of pediatric psychopharmacology.

Academic Pediatrics, 16(6), 508-518. http://doi:10.1016/j.acap.2016.03.011 Goldsmith, M., & Roberts, L. W. (2016). Ethical issues in child and adolescent psychiatry.

Focus, 14(1), 64- 67. http://dx.doi.org/10.1136/jme.13.1.5 Grover, S., & Avasthi, A. (2019). Clinical practice guidelines for the management of schizophrenia in children and adolescents. Indian Journal of Psychiatry, 61(Suppl 2), 277–293. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_556_18 Hargrave, T. M., & Arthur, M. E. (2015). Teaching child psychiatric assessment skills: Using pediatric mental health screening tools. International Journal of Psychiatry in Medicine, 50(1), 60-72.

Lee, E. S., Kronsberg, H., & Findling, R. L. (2020). Psychopharmacologic treatment of schizophrenia in adolescents and children. Child and Adolescent Psychiatric Clinics, 29(1), 183-210. https://doi.org/10.1016/j.chc.2019.08.009