NRNP 6635: Psychopathology and Diagnostic Reasoning
Assignment: Assessing and Diagnosing Patients with Schizophrenia, Other Psychotic Disorders, and Medication-Induced Movement Disorders
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.
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” 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.
For the assignment:
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.).
Include an introduction, purpose statement, reflection, and conclusion
Learning Resources
https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/schizophrenia-and-other-psychotic-disorders
Case study
use Training title # 29 video, transcript and case history report
Training Title 29. . (2016).[Video/DVD] Symptom Media. Retrieved from https://video.alexanderstreet.com/watch/training-title-29
https://video-alexanderstreet-com.eu1.proxy.openathens.net/p/K8QGOx5Lz
https://video.alexanderstreet.com/embed/training-title-29
00:00:00TRANSCRIPT OF VIDEO FILE:
00:00:00______________________________________________________________________________
00:00:00BEGIN TRANSCRIPT:
00:00:00[sil.]
00:00:15OFF CAMERA Mr. Feldman? I understand you called us last week for an appointment.
00:00:20MR. FELDMAN My parents.
00:00:25OFF CAMERA Excuse me?
00:00:25MR. FELDMAN My parents called for the appointment.
00:00:25OFF CAMERA Oh. Do you know why your parents called for an appointment?
00:00:30MR. FELDMAN No.
00:00:35OFF CAMERA When your parents called me they said you were having some difficulty in school. Where are you in school?
00:00:50MR. FELDMAN State College.
00:00:50OFF CAMERA How long have you been at State College?
00:00:55MR. FELDMAN My freshman year.
00:01:00OFF CAMERA And how is it going?
00:01:05MR. FELDMAN Fine.
00:01:10OFF CAMERA What courses are you taking at State?
00:01:15MR. FELDMAN In high school I took advanced placement courses. Theoretical physics, advanced calculus is what I’m taking now. Although I’m thinking about double majoring in philosophy and physics.
00:01:35OFF CAMERA That’s an interesting combination.
00:01:35MR. FELDMAN Yes, the mysteries of life. The courses are mysteries, and just when you think you’ve understood it, it’s gone.
00:01:45OFF CAMERA Gone?
00:01:50MR. FELDMAN The totality of life precludes us from repeating it. I mean what’s the point?
00:02:00OFF CAMERA Do you have a roommate at state?
00:02:05MR. FELDMAN You could call him that.
00:02:10OFF CAMERA Can you tell me about him?
00:02:15MR. FELDMAN Oh no.
00:02:15OFF CAMERA Why not?
00:02:20[sil.]
00:02:25MR. FELDMAN He put a microwave in there, but I know what that means. But I won’t tell. Not a word..
00:02:35OFF CAMERA A microwave oven?
00:02:40MR. FELDMAN They had them in here too, in this building. But they’ll spare me, and they’ll spare you too, because you are with me, and what that’s about a bleeding degeneration of blood cells, bleeding the humanity from our rightful destiny… but this room spies on us.
00:03:05OFF CAMERA I don’t understand what you mean.
00:03:10MR. FELDMAN It’s in the eyes. You can hold of forever if you know how.
00:03:20OFF CAMERA Mr. Feldman, did you come here with anyone else today?
00:03:25[sil.]
00:03:30MR. FELDMAN Sssshhhh.
00:03:35OFF CAMERA Mr. Feldman, I think I may need to contact your parents.
00:03:45SymptomMedia Visual Learning for Behavioral Health www.symptommedia.com
00:03:45END TRANSCRIPT
