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Part 2- L8.docx

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Gareth Treharne

Part 2- L8 Schizophrenia What can clinical psychologists do for schizophrenia patients? Psychological assessment - Presentation o 27 year old male, Caucasian, unkempt (messy) appearance, strong Australian accent o Labile and frank, expressing sensitive matter with little reserve o Attention and concentration were good, even when hallucinating o When hallucinating, physical tension, restlessness and distress increased - Presenting problems o Increased suicidal ideation, stemming from frequent, daily auditory hallucination o Sense of emotions fragility and emptiness o 3 female voices from inside his head, derogatory, critical, offensive, conversing with him as well as making commands o Identities were people he associated with as a child. Neighbour: Kellie  Mid-teens shows infatuation with Kellie but no relationship came out of this. o Misconstrue (misinterpret) events out in public o Beliefs about voices: identity, intention and power  Kellie × Most prominent × Least malevolent (malicious), ambivalent (unsure)  Charlie × Most hateful, least frequent  Kathleen × Not well known by patient  Intentions × Mostly malevolent (malicious) × One voice sometimes ambivalent (unsure)  Power × Omnipotent (all-mighty) × Intentions enacted by third parties × Psychic knowledge × Spiritual capacity - Functional analysis o Antecedents (experiences, things that made it worse)  Anxiety > increases voices > increases distress  Alcohol  Relationship issues o Consequences  Distraction, talking back, rub forehead, distress, anxiety, tension, depressed affect, sleep disturbances misconstrues - Course and part interventions o 19 years old  First signs of psychosis  Accompanied by significant stressors  No intervention o 22 years old  First admission  Coincided with a break up with long-time girlfriend o 22 year- present  Persistent symptoms × Voices, affect, social withdrawal  Multiple antipsychotic medications  Course of ECT at 26 - Current intervention o Chlorpromazine, haloperidol and clozapine are three of the most commonly used drugs o Clozapine  Antipsychotic  preferred medication  also has most side effects × Experience more drowsiness, hyper salivation or temperature increase × weight gain × white blood cell death × Need frequent blood tests (fortnightly)  May be at risk of agranulocytosis × Can cause death o Zopiclone  Hypnotic o Electroconvulsive therapy  Short-term red
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