Early-Onset Schizophrenia
Week 9: Early-Onset Schizophrenia
“I can’t believe he is speaking to me! I have always liked his music, but now here he is on TV speaking directly to me! When I started following him on social media, he must have seen my profile. I know he loves me. He cannot love that model I saw with him in the picture. She must be the person following me to school. I have not seen her, but I know she is there. She does not want me being with him, but I will be with him. He loves me as much as I love him.”
Kaitlyn, age 17
Early-onset schizophrenia is a rare and severe mental illness in which children interpret reality abnormally. There are a range of problems with cognitive functioning, behavior, and emotions. Perceptions may be distorted and children or their parents may report that they have difficulty distinguishing reality. This is a diagnosis that is difficult to confirm in the early stages.
This week, you compare evidence-based treatment plans for adults versus children diagnosed with schizophrenia. You analyze the legal and ethical issues involved with forcing patients with early-onset schizophrenia to take medications for the disorder. You also complete a Decision Tree concerning children with psychotic disorders.
Photo Credit: HAYKIRDI / iStock / Getty Images Plus
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
- Chapter 31, “Child Psychiatry” (pp. 1268–1283)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
- “Schizophrenia Spectrum and Other Psychotic Disorders”
Note: You will access this book from the Walden Library databases.
McClellan, J., & Stock, S. (2013). Practice parameter for the assessment and treatment of children and adolescents with schizophrenia. Journal of the American Academy of Child & Adolescent Psychiatry, 52(9), 976–990. Retrieved from http://www.jaacap.com/article/S0890-8567(13)00112-3/pdf
Giles, L. L., & Martini, D. R. (2016). Challenges and promises of pediatric psychopharmacology. Academic Pediatrics, 16(6), 508–518. doi:10.1016/j.acap.2016.03.011
Note: You will access this article from the Walden Library databases.
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. Retrieved from http://search.proquest.com.ezp.waldenulibrary.org/docview/1702699596?accountid=14872
Note: You will access this article from the Walden Library databases.
Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.
Note: All Stahl resources can be accessed through the Walden Library using the link. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear.
To access information on the following medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
Schizoaffective disorder | Schizophrenia |
---|---|
amisulpride aripiprazole asenapine carbamazepine (adjunct) chlorpromazine clozapine cyamemazine flupenthixol haloperidol iloperidone lamotrigine (adjunct) l-methylfolate (adjunct) loxapine lurasidone mesoridazine molindone olanzapine paliperidone perospirone perphenazine pipothiazine quetiapine risperidone sertindole sulpiride thioridazine thiothixene trifluoperazine valproate (divalproex) (adjunct) ziprasidone zotepine zuclopenthixol |
amisulpride aripiprazole asenapine carbamazepine (adjunct) chlorpromazine clozapine cyamemazine flupenthixol haloperidol iloperidone lamotrigine (adjunct) l-methylfolate (adjunct) loxapine lurasidone mesoridazine molindone olanzapine paliperidone perospirone perphenazine pipothiazine quetiapine risperidone sertindole sulpiride thioridazine thiothixene trifluoperazine valproate (divalproex) (adjunct) ziprasidone zotepine zuclopenthixol |
Note: Many of these medications are FDA approved for adults only. Some are FDA approved for disorders in children and adolescents. Many are used “off label” for the disorders examined in this week. As you read the Stahl drug monographs, focus your attention on FDA approvals for children/adolescents (including “ages” for which the medication is approved, if applicable) and further note which drugs are “off label.”
Required Media
Laureate Education (Producer). (2017b). A young girl with strange behaviors [Multimedia file]. Baltimore, MD: Author.
Optional Resources
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Hoboken, NJ: Wiley Blackwell.
- Chapter 57, “Schizophrenia and Psychosis” (pp. 774–794)
Assignment 1: Early Onset Schizophrenia
Children and adolescents with schizophrenia have more difficulty functioning in academic or work settings, and significant impairment usually persists into adulthood. They may have speech or language disorders and in some cases borderline intellectual functioning. These individuals are more likely to complete suicide attempts or die from other accidental causes. Schizophrenia is characterized by positive and negative symptoms. Positive symptoms include hallucinations, delusions, and behavior disturbance. Negative symptoms include blunted affect and attention, apathy, and lack of motivation and social interest.
In this Assignment, you compare treatment plans for adults diagnosed with schizophrenia with treatment plans for children and adolescents diagnosed with schizophrenia. You also consider the legal and ethical issues involved in medicating children diagnosed with schizophrenia.
Learning Objectives
Students will:
- Compare evidence-based treatment plans for adults versus children and adolescents diagnosed with schizophrenia
- Analyze legal and ethical issues surrounding the forceful administration of medication to children diagnosed with schizophrenia
- Analyze the role of the PMHNP in addressing issues related to the forceful administration of medication to children diagnosed with schizophrenia
To Prepare for this Assignment:
- Review the Learning Resources concerning early-onset schizophrenia.
The Assignment (2 pages):
- Compare at least two evidence-based treatment plans for adults diagnosed with schizophrenia with evidence-based treatment plans for children and adolescents diagnosed with schizophrenia.
- Explain the legal and ethical issues involved with forcing children diagnosed with schizophrenia to take medication for the disorder and how a PMHNP may address those issues.
Note: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.
By Day 7
Submit your Assignment.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
- Please save your Assignment using the naming convention “WK9Assgn1+last name+first initial.(extension)” as the name.
- Click the Week 9 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
- Click the Week 9 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.
- Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK9Assgn1+last name+first initial.(extension)” and click Open.
- If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
- Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:
Week 9 Assignment 1 Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 9 Assignment 1 draft and review the originality report.
Submit Your Assignment by Day 7
To submit your Assignment:
Week 9 Assignment 1
Assignment 2: Practicum: Decision Tree
Childhood psychosis is extremely rare; however, children that present with psychosis must be carefully assessed and evaluated with appropriate interviewing of parent, child, and use of assessment tools.
For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with early onset schizophrenia.
Learning Objectives
Students will:
- Evaluate clients for treatment of mental health disorders
- Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders
The Assignment:
Examine Case 3: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.
At each Decision Point, stop to complete the following:
- Decision #1: Differential Diagnosis
- Which Decision did you select?
- Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
- What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
- Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?
- Decision #2: Treatment Plan for Psychotherapy
- Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
- What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
- Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?
- Decision #3: Treatment Plan for Psychopharmacology
- Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
- What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
- Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
- Also include how ethical considerations might impact your treatment plan and communication with clients and their families.
Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.
By Day 7 of Week 10
Submit your Assignment.
Assignment 3: Board Vitals
This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.
These review questions will provide practice that is critical in your preparation for the national certification exam that’s required to certify you to practice as a nurse practitioner. These customized test questions are designed to help you prepare for your Nurse Practitioner certification exam. It is in your best interest to take your time, do your best, and answer each question to the best of your ability.
You can access Board Vitals through the link sent to you in email or by following the link below:
https://www.boardvitals.com/
By Day 7
Complete the Board Vitals questions.
Making Connections
This week, you compared evidence-based treatment plans for adults with evidence-based treatment plans for children diagnosed with schizophrenia. You analyzed the legal and ethical issues involved with forcing patients with early-onset schizophrenia to take medications for the disorder. You also completed a Decision Tree concerning children with psychotic disorders.
Next week, you work with your group again to develop a Parent Guide for a feeding, eating, or elimination disorder.