Early Onset Schizophrenia Sample

Early Onset Schizophrenia Sample

Comparing evidence-based treatment plans for adults versus adolescents and children diagnosed with schizophrenia

Based on the present literature, atypical antipsychotics are the first-line medication for treatment of early-onset schizophrenia. Based upon adult literature, a combination of psychotherapeutic interventions and antipsychotic treatment might be a greatly inclusive treatment plan. According to Barlett (2014), the primary type of treatment for schizophrenia, entailing childhood-onset schizophrenia, is antipsychotic medication. Atypical or second-generation antipsychotics are generally the first drugs for the treatment of children and adolescents diagnosed with schizophrenia because they have fewer side effects compared to typical antipsychotics. Clozapine, olanzapine, and risperidone are the most commonly researched and prescribed atypical antipsychotics for treating schizophrenia (Barlett, 2014). Early Onset Schizophrenia Sample

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Pagsberg et al (2017) point out that, although treatment with antipsychotics medications is an ingrained intervention in early-onset schizophrenia, the proof for their tolerability and efficacy is limited in comparison with the adult field. Available evidence shows that antipsychotic medication is effective in adolescents and children who have been diagnosed with schizophrenia, but convoluted by a minimal treatment response along with a greater profile of adverse incidents when compared to adults.  Like in adults, resistance to treatment in early-onset schizophrenia is treatable with clozapine, which seems relatively secure and effective in adolescents and children with close monitoring (Pagsberg et al, 2017). Early Onset Schizophrenia Sample

According to Vyas and Gogtay (2015), adult literature supports individualized psychological and psychosocial treatments. A review of literature established that psychosocial therapies, mainly cognitive behavioral therapy, social skills training, cognitive remediation and family intervention are efficacious pharmacological interventions in the treatment of adults with schizophrenia. For instance, the aim of cognitive behavioral therapy is to deal with dysfunctional beliefs, strategies of coping with these beliefs, tuning of cognitive capabilities as well as behavior modification through connecting and then assessing feelings and thoughts on the manifestation of clinical symptoms, which subsequently aims at improving patient’s mental state (Vyas & Gogtay, 2015).

A recent randomized controlled trial was performed on youngsters demonstrating an early prodromal psychotic state, to examine the efficiency of cohesive psychological interventions (entailing cognitive behavioral therapy, cognitive remediation therapy, multi-family psycho-education and group skills training) along with supportive counseling on aversion of mental illness. Vyas and Gogtay (2015) point out that the results revealed that the cohesive psychological intermediation was highly efficacious in deferring the onset of mental illness over a two year follow up duration.

These surveys recommend that psychotherapeutic interventions might be a crucial strategy for alleviating psychotic relapse, medication compliance, and re-admission. Additionally, cognitive enhancement therapy has proved to be efficacious in the improvement of neurocognitive functioning in patients with schizoaffective disorder or early onset schizophrenia. Psycho-education, social skills training, and family therapy have also demonstrated to improve clinical symptoms in adolescents and children newly diagnosed with schizophrenia (Vyas & Gogtay, 2015).

Analyzing ethical and legal issues involved with forceful administration of medication to children diagnosed with schizophrenia

There are several legal and ethical issues surrounding the forceful administration of medication to children diagnosed with schizophrenia. Whether it is permissible to force children diagnosed with schizophrenia to take medication is a basic in medical law and ethics.  According to Sjostrand et al (2015), the forceful administration of medication to patients touches on ethical and legal issues of the insight, autonomy, and competence of the patient. In the ethical dimension, forceful administration of medication might be seen as a breach of the patient’s competency to assent to treatment.    Early Onset Schizophrenia Sample

In the legal dimension, treatment without patient’s consent is allowed only in instances where a common statute or law offers such authority. Respect for patient’s autonomy is a core standard in healthcare ethics. Respect for autonomy means that patients shouldn’t be manipulated or forced into treatment if they have the ability to make independent decisions on their treatment and care. Legally, forceful treatment is justified only in instances when patients lack the ability to make autonomous decisions (Sjostrand et al, 2015).

How a PHMNP may address legal and ethical issues involved with forceful administration of medication to children diagnosed with schizophrenia

A PMHNP can address legal and ethical issues involved with the forceful administration of medication to children diagnosed with schizophrenia by evaluating decision making capability of the patients to make a decision on their treatment. According to Hostiuc et al (2016), the process of evaluating the capability of potential subjects in clinical trials and treatment is a moral duty and a legal necessity, since it is crucial in showing respect for their autonomy. This matter is particularly significant in patients who have been diagnosed with schizophrenia. Schizophrenia patients are regarded to have less capability to offer a suitable consent for medical procedures because they have decreased capability of understanding, retaining and processing pertinent information (Hostiuc et al2016).

Nevertheless, several studies commend that numerous patients with schizophrenia are intellectually capable of making decisions like normal people. Therefore, it is the moral and legal obligation of a PMHNP to make multiple analysis on the decision-making capacity of children with schizophrenia before initiating treatment.  Shared decision making is another scheme a PHMHNP can use with children diagnosed with schizophrenia. Through this approach, the PMHNP provides more information to the patients and engages them in decisions concerning treatment.  The aim of shared decision making is to lessen the power and informational imbalance between the patients and the psychiatrist through enhancing patients’ information and authority over medication decisions (Hostiuc et al, 2016). Early Onset Schizophrenia Sample

References

Barlett, J. (2014). Childhood-onset schizophrenia: what do we really know? Health Psychology and Behavioral Medicine, (1): 735- 747.

Hostiuc, S., Rusus, M., Negoi, I., & Drima, E. (2018). Testing decision-making competency of schizophrenia participants in clinical trials. A meta-analysis and meta-regression.  BMC Psychiatry, 18 (1): 2-13.

Pagsberg, A., Tarp, S., & Glintbor, D et al. (2017). Antipsychotic treatment for children and adolescents with schizophrenia spectrum disorders: protocol for a network meta-analysis of randomized trials. BMJ Open, 4(10): e005708.

Sjostrand, M., Sadman, L., & Karlsson, P et al (2015). Ethical Considerations about involuntary treatment: interviews with Swedish Psychiatrists, BMC Medical Ethics 16: 37

Vyas, N., & Gogtay, N. (2015). Treatment of Early Onset Schizophrenia: Recent Trends, Challenges and Future Considerations. Frontiers in Psychiatry, 3: 29-36.

Early Onset Schizophrenia Sample