Assignment task:
APA Citation and References
Respond to at least two of your colleagues' postings in one or more of the following ways:
Address a colleague's analysis and evaluation of the topic(s).
Expand or remark upon a colleague's integration of relevant resources.
Answer question(s) posed by your colleague for further discussion.
Link a colleague's posting to other postings or to course materials and concepts, where appropriate and relevant.
Extend or constructively challenge your colleague's work.
Otherwise expand upon your colleagues' postings.
1-STEFANIE-
Differentiation
Schizophrenia and other psychotic disorders have abnormalities in one or more of the five areas: delusions, hallucinations, disorganized thinking/speech, abnormal motor behaviors, and negative symptoms (APA, 2022). For Schizophrenia, a client must meet two or more of these symptoms consistently for a one-month period and at least one must be delusions, hallucinations, or disorganized speech (APA, 2022). Additionally, abnormal motor behavior and negative symptoms, such as diminished emotional expression are more prevalent in schizophrenia than any other psychotic disorder (Osborne et al., 2020).
Bipolar Disorder with psychotic features differentiates from schizophrenia in that it is characterized by episodes of mania and depression. Those experiencing bipolar disorder with psychotic features experience delusions and hallucinations during a manic or major depressive episode (APA, 2022). It differentiates from schizophrenia, because psychosis is not consistent.
Major Depressive Disorder (MDD) differentiates from Bipolar because a manic episode never occurs. MDD is mood disorder characterized by a depressed mood and loss of pleasure (APA, 2022). The psychotic features in MDD are not consistent and typically only occur during a major depressive episode. MDD with psychotic features can include hallucinations and delusions only during a depressive episode (APA, 2022). When the episode ends, the psychosis ends, as well.
The key differential between schizophrenia and mood disorders is that psychosis in schizophrenia is consistent, whereas psychosis in Bipolar and MDD only occurs during manic or depressive episodes.
Schizoaffective disorder is characterized by an uninterrupted period of either a manic episode or major depressive episode along with two or more of the criteria for Schizophrenia, where one must be delusions, hallucinations, or disorganized speech (APA, 2022). Unlike the specifier "with psychotic features," schizoaffective disorder must have delusions or hallucinations for at least two weeks in the absence of a manic or depressive episode. The episode may end, but the psychosis continues.
Impact of Misdiagnosis
A misdiagnosis can result in delayed interventions, medication issues, and inappropriate treatment that can negatively impact the client's well-being. A misdiagnosis can impact the level of treatment, and the duration of treatment. A Schizophrenia diagnosis has psychosis for a longer duration than Major Depressive Disorder (MDD) with psychotic features (APA, 2022). If a client is misdiagnosed with MDD and should have been diagnosed with Schizophrenia, this could impact treatment duration, level of treatment, and prescribed medication.
To prevent misdiagnosis, it is essential to seek further information from clients and examine their symptoms across the life span. Being knowledgeable on the various forms of psychosis can prevent misdiagnosis and ineffective treatment. Understanding the various disorders with psychosis supports clinicians in the development of diagnostic summaries and effective treatment plans. To best support clients it is essential to enhance comprehension of psychosis and the specifier "with psychotic features." It will reduce misdiagnosis, reduce overdiagnosis, and support assessment and treatment plan development.
Additionally, a misdiagnosis can lead to further worsening of the disorder and can impact client's perception of those in the medical/mental health field. Trust and feelings toward healthcare can be diminished with a misdiagnosis.
Cultural Influence
Societies do not have different rates of mental illness, but the response to it varies (Vovou & Petrides, 2021). Mental health literacy has been linked to help-seeking behaviors and in some cultures, such as Greece associate disorders with personality traits (Vovou & Petrides, 2021).
Culture impacts auditory hallucinations contributed by schizophrenia. In the United States, auditory hallucinations are often hostile and aggressive, whereas in India and Ghana, the hallucinations are positive (Bower, 2015). This notes that culture impacts how disorders present and can impact whether clients seek treatment for the disorder. In the US, hostile hallucinations would lead to seeking treatment, whereas in other countries, if the hallucinations are positive, treatment may not be seen as necessary. It is important to note that learned cultural expectations encourages Americans to pay more attention to negative "voices" and among those with schizophrenia, most were religious (Bower, 2015). Expanding on religion, some cultures perceive hallucinations as spiritual experiences and do not believe hallucinations to be related to mental disorders. This can discourage some populations from seeking treatment due to cultural beliefs.
Culture is a determinant of a client's mental state and help-seeking behaviors (Sommers-Flanagan & Sommers-Flanagan, 2015). It is essential to understand the influence of culture. Knowledge of culture prevents misdiagnosis, enhances identification, provides useful clinical information, improves rapport, and guides research (APA, 2022).
References:
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (DSM-5-TR) (5th ed., text rev.).
Bower, B. (2015, January 24). Culture affects tones of voices: Schizophrenia's hallucinations tend to positive in some places. Science News, 187(2), 10.
Osborne, K. J., Walther, S., Shankman, S. A., & Mittal, V. A. (2020). Psychomotor slowing in Schizophrenia: Implications for endophenotype and biomarker development. Biomarkers in Neuropsychiatry
Sommers-Flanagan, J., & Sommers-Flanagan, R. (2015). The mental status examination. In Clinical interviewing (5th ed., pp. 287-328). Wiley.
Vovou, F., Hull, L. & Petrides, K. V. (2021). Mental health literacy of ADHD, autism, schizophrenia, and bipolar disorder: A cross-cultural investigation. Journal of Mental Health, 30(4), 470-480.
2-RAQUEL-
Explain how you differentiate among the following disorders despite all of them having psychosis as a symptom.
Schizophrenia - The patient will have delusions, hallucinations, and/or disorganized speech paired with negative symptoms and or disorganized/catatonic behaviors, lasting for 1 month
Bipolar with psychotic features - There is a presence of a manic episode in addition to the delusions or hallucinations. However, bipolar does not have negative symptoms
Major depressive disorder with psychotic features - these symptoms are tied to feelings of sadness, emptiness, and hopelessness. There is an addition of hallucinations or delusions that are current in the most recent episode; There is also a lack of pleasure.
Schizoaffective disorder - A major mood episode is paired with criteria A of schizophrenia for an uninterrupted period.
Each of these diagnoses has similar symptoms. However, each disorder has specific qualifications that eliminate the others if certain criteria are present or not present.
Explain how misdiagnosis of these disorders can affect clients.
A misdiagnosis can affect clients because the wrong medication can be given and could enhance the current symptoms instead of extinguishing them. For example, bipolar disorder is defined by having a manic episode, which includes having periods of feeling superior and having high self-esteem. But if you focus on just the hallucinations and miss the signs of the manic episode. you could assume they have major depression with psychotic features because you may only have seen the depressive episode of their disorder. If you were to medicate a client with medication made to uplift their mood, their emotions during their manic episode could be affected. And their lack of sleep could be increased.
Explain how culture influences understanding of the diagnosis of the disorder.
What we consider delusional or not can be influenced by cultural background (American Psychiatric Association, 2022). Some cultures believe in spirits and that if you pray to a specific god they can bring you luck or heal you of your ailments. While some cultures would see this as everyday practice, others would find people delusional and not accept it as a reasonable practice. Need Online Tutoring?
References:
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (DSM-5-TR) (5th ed., text rev.).