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Case study: Early-episode psychosis as the onset of paranoid schizophrenia and the direction toward holistic and client-centered occupational therapy

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documents in English
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case study
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7 pages
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  1. Introduction
  2. Summary of clinical issues
  3. The case study
    1. Diagnosis
    2. The treatment given
    3. Canadian Model of Occupational Performance (CMOP)
  4. Occupational therapy process
  5. The concept of recovery in psychiatric rehabilitation
  6. The outcome of the program
  7. Conclusion
  8. Bibliography

The following paper will present a clinical assessment of the subject, provided by a Mental State Examination (MSE), in order to produce a diagnosis consistent with the current ICD-10 and DSM-IV-TR classifications of psychiatric disorders. After determining a diagnosis of the patient's mental disorder, and presenting a summary of the clinical issues surrounding it, it will proceed to explore the developmental concerns associated with the client before determining an effective model of service delivery. Subsequently, the Canadian Model of Occupational Performance (CMOP), developed by the Canadian Association of Occupational Therapists, will be applied to the case study. The paper will outline and describe the proposed plan of clinical intervention for the patient, and will conclude with observations on the expected effectiveness and applicability of treatment.

Adrian is a nineteen year old Australian male displaying symptoms consistent with the onset of early-episode psychosis. He has reportedly become increasing withdrawn in the past six months, displaying an erratic and declining attendance at his university studies and a failing to attend his examinations. Adrian has demonstrated stable, paranoid delusional thoughts, including auditory hallucinations, claiming that Australian Security Intelligence Organization (ASIO) agents were conspiring to assume his identity and to kill him.

[...] He reports to using alcohol 2-3 times per week, and to consuming cannabis nearly daily reporting the use of 3-4 cones Diagnosis By the ICD-10 definitions for mental and behavioral disorders, Adrian is demonstrating symptoms which could be classified as indicators for paranoid schizophrenia. ?Paranoid schizophrenia is dominated by relatively stable, often paranoid delusions, usually accompanied by hallucinations, particularly of the auditory variety, and perceptual disturbances? [ICD-10, 2007]. While many disorders possess psychotic symptoms, the DSM-IV-TR lists nine formal psychotic disorders. [...]


[...] Concomitantly, Adrian should be continued on the Risperidone under appropriate medical supervision, as the effects and consequences of the medication ought to be sufficiently monitored as a means of treatment toward managing his acute early episode psychosis. As such, a psychiatric doctor ought to be available to assist him with developing a dosage schedule and to monitor and prescribe a regiment of psychotropic medications, and to review their side-effects and results in conjunction with his rehabilitation efforts. As Adrian is at present living with his parents, he is not in immediate risk of requiring direct housing intervention as a result of being unable to support and shelter himself. [...]


[...] For instance, Adrian's withdrawal from study and examinations need to be established as, either the consequence of his disorder and the manifestation of his onset paranoid schizophrenia or the effect of a genuine lack of interest and desire to follow this particular course of educational pursuit. Recording his daily impressions on these activities will assist in allowing Adrian to formalize goals and objectives, and will draw him of himself? that is, provide him with an activity which necessitates the focus on external affairs and occurrences not associated with his delusional fantasies. [...]

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