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  • Subject Name : Nursing

The Spatial Self in Schizophrenia and Autism Spectrum Disorder

Essay 1:

In a situation wherein the patient is reluctant to share information and thus is causing a hindrance to the proper diagnosis process, one should be wise enough to understand the scenario and should try and find what the patient knows already by making assumptions while talking to other nursing staff and patient these would give an insight on how to tackle the situation by further getting acquainted of the patient and his nature (Ruderfer, et al, 2018). Building a personal trust factor or rapport is very important and the doctor could talk about the patient's hobbies or passion and strike a chord wherein the patient starts trusting the care unit staff and gradually speaks out. It is important to listen carefully and try to understand the patient's perspective. It is also helpful if an effort is made to understand the patient's concern or worries or any sort of fear so that staff is able to help him or comfort him and this would help bridge the gap and the patient would speak out his thoughts and condition. It is also important to figure out the skill set of the patient as it would thus help understand the level of the imagination a patient could have. While all this, the care staff should be able to understand the patients’ concerns and barriers and would be able to plan his actions (Smeland, et al, 2020). Once such a situation is attained, it is important to keep the conversations simple and short and an effort is made to explain difficult concepts. It is important to make patients feel comfortable and it is also very important to show them proper respect and treatment as they need to relate to staff before they speak out. In case it is witnessed that patient has undergone certain trauma, it is wiser to keep simple written instructions in his room so that he can see them repeatedly and remember the instructions in his subconscious mind. Many a time it could be possible that care unit staff are running short of time but the patient is not yet in a one wherein he can speak put, there also, it is important to allow sufficient time to the patient to feel secure in speaking out his condition and in no circumstances there should be a diagnosis basis an uncertain assumption. Thus to understand, with Angelo and his medical condition it is advisable to deal him with tact and patience as he is young and had a medical history of using cannabis so he might be disoriented or at guilt within (Vancampfort, et al, 2016).

Essay 2:

Psychosis is a mental ailment wherein the patient is not able to live like a normal human being. His brain gets affected and due to which there are neuro problems wherein the patient can see, hear, or believe certain nonexistent things. Generally, psychosis is caused by extreme stress, trauma, or any other sort of mental or physical illness. Psychotic disorders include ailments like schizophrenia, bipolar disease, hallucination, and other sorts of delusions. While it is believed that psychosis does not happen all of a sudden and there is a pattern starting with a change in thought process and change in perception of an individual about himself, people around, and the semantics of the world. It could be seen by a drop in grades or job performance, lack of concentration, uneasiness, and frequent breathlessness, being isolated, sudden change of behavior, or being indifferent at all. One should also take note of situations wherein, one can see or hear certain things which others don't, believe in something which the people around do not believe in, and any other sudden change in one's behavior (Erhardt, Schwieler, Imbeault & Engberg, 2017). Many times a family or friend would also observe as if they were speaking to someone else and not the usual person they used to speak to. Such indicators require immediate attention as the psychotic problem might just aggravate with time and be incurable (Noel, 2017). A psychotic presentation is generally represented by hallucination and delusion wherein hallucination is an experience for something which is non-existent. A patient could hear sounds, noises in solace, and could be seen talking as if someone is with him. These are called auditory hallucinations. There are visual hallucinations as well wherein a patient sees a person or things that are not there at that moment and could also lead to a situation wherein the shapes and size of an object appears changed to him and he panics. There is also a situation wherein there is a strange feeling in one's mind and he is not able to make people understand the same or is not able to say anything about it. Such a situation is known as tactile hallucination (Gandal, et al, 2018).

While events of delusion are strange beliefs that do not make sense as they are based on beliefs that are not part of the culture and generally do not make sense (Dickerson, 2017). These could be situations wherein the patient feels they are being controlled by outside forces, get disturbed by small events or actions, or feel they are on a rescue mission and have supernatural power, etc.

Essay 3:

Schizophrenia can have a deep impression on a patient's mind and he can feel, act, and think differently. While Angelo could exhibit some or all of the symptoms, it is also possible that the symptoms are temporary and have a different effect than someone else (Parellada, 2017). Angelo possibly could not differentiate between his real and delusionary perceptions. To improve his situation, Angelo would need a doctor who would tell him the same. While there are medical terms for two groups of symptoms in schizophrenia namely positive and negative symptoms, there are different factors outlined as below:

Positive symptoms lead to the addition of thoughts and situations, they include hallucinations and delusions and also have repetitive movements which could be hard to control and the patient could feel it as normal action exhibited by them. Positive symptoms are extreme cases of thought processes and actions of the presence of a person's thoughts and beliefs.

While the negative symptoms are situations wherein the patient seems to be in a state of submission wherein they do not show emotions, exhibit difficulty in emoting and talking, and also they withdraw from social situation and relationships.

Under the influence of negative symptoms, a patient could seem like a dead person without any emotion or reflex. Their thought process and behavior are highly compromised and one may notice a lack of interest in doing any activity or exhibit withdrawal from a situation of pleasure. They might also feel difficult to speak and do not emote anything at all (Pouget, 2019). Due to slurred speech, they stop expressing themselves. They also could feel that their voice is not reaching to others and they are not audible despite then shouting or similarly many times they become deaf as in they are not able to hear what others are saying or speaking. A negative symptom is of withdrawal wherein the person does not become friends to anyone and lives a secluded life. They become socially disconnected and do not speak to anyone. There are situations wherein patients are so delusional that they stop taking care of themselves and do not apply medicines to their wounds, do not live a hygienic life.

Such positive and negative situations could also lead to depression in an individual wherein they could have multiple issues that could make their lives miserable and they are not able to live a normal life again. It takes a great deal of patience and strong will to come out of such a situation (Nguyen, 2018).

Essay 4:

Neurotransmitters could be understood as the body's chemical messengers. They play the role of courier agents in the body and are responsible for the transmission of messages between neurons and from neurons to muscles. The electrical signals that have traveled along the axon are converted into a chemical for a short duration and a specific response is achieved by the release of neurotransmitters (Ruderfer, et al, 2018). Generally, neurotransmitters are identified to be amine molecules, amino acids, and subsequently to be neuropeptides. When an individual is experiencing the stages of schizophrenia, then there are many small-molecule neurotransmitters along with the flowing more than 100 identified neuropeptides that experience the chemical messengers. Chemicals following an interaction have been experiencing the countless functions impacting the nervous system and even controlling bodily functions.

Schizophrenia is one of the disorders that would likely occur with the span's dysfunctions which covers the majorly multiple circuits and even can affect the neurotransmitter systems. It can also impact the numerous reports that could affect the numerous biochemical changes within the schizophrenia showing the neurotransmitter dysfunction and also impacting the multiple systems that could lead to dopamine, glutamate, impacting the serotonin, and γ‎-aminobutyric acid (GABA). Through the compelling evidence within an individual, the candidate neurotransmitter system can be represented through the schizophrenia which would be impacted through the pharmacological mechanisms that can affect the psychotomimetic along with the antipsychotic drug action (Smeland, et al, 2020). Through the postmortem that can impact the neurotransmitter that can identify the proteins and enzymes, that can result in vivo imaging data showing the neurotransmitter release along with the receptor binding that could be due to the patients, correlations through the animal models, along with the genetic vulnerabilities can be related to the specific neurotransmitter systems. The neurochemical is the neural network that could be identified during the stages of the schizophrenia getting impact with an appropriate focus over the individual neurotransmitter system (Vancampfort, et al, 2016).

References for Angelo Clinical Scenario

Dickerson, F., Severance, E., & Yolken, R. (2017). The microbiome, immunity, and schizophrenia and bipolar disorder. Brain, Behavior, and Immunity62, 46-52.x`

Erhardt, S., Schwieler, L., Imbeault, S., & Engberg, G. (2017). The Kynurenine Pathway in Schizophrenia and Bipolar disorder. Neuropharmacology112, 297-306.

Gandal, M. J., Zhang, P., Hadjimichael, E., Walker, R. L., Chen, C., Liu, S., ... & Shieh, A. W. (2018). Transcriptome-wide isoform-level dysregulation in ASD, schizophrenia, and bipolar disorder. Science362(6420).

Goldsmith, D. R., Rapaport, M. H., & Miller, B. J. (2016). A meta-analysis of blood cytokine network alterations in psychiatric patients: comparisons between schizophrenia, bipolar disorder and depression. Molecular Psychiatry21(12), 1696-1709.

Parellada, M., Gomez-Vallejo, S., Burdeus, M., & Arango, C. (2017). Developmental differences between schizophrenia and bipolar disorder. Schizophrenia Bulletin43(6), 1176-1189.

Pouget, J. G., Schizophrenia Working Group of the Psychiatric Genomics Consortium, Han, B., Wu, Y., Mignot, E., Ollila, H. M., ... & Martin, J. (2019). Cross-disorder analysis of schizophrenia and 19 immune-mediated diseases identifies shared genetic risk. Human Molecular Genetics28(20), 3498-3513.

Nguyen, T. T., Kosciolek, T., Eyler, L. T., Knight, R., & Jeste, D. V. (2018). Overview and systematic review of studies of microbiome in schizophrenia and bipolar disorder. Journal of Psychiatric Research99, 50-61.

Noel, J. P., Cascio, C. J., Wallace, M. T., & Park, S. (2017). The spatial self in schizophrenia and autism spectrum disorder. Schizophrenia Research179, 8-12.

Ruderfer, D. M., Ripke, S., McQuillin, A., Boocock, J., Stahl, E. A., Pavlides, J. M. W., ... & Domenici, E. (2018). Genomic dissection of bipolar disorder and schizophrenia, including 28 subphenotypes. Cell173(7), 1705-1715.

Smeland, O. B., Bahrami, S., Frei, O., Shadrin, A., O’Connell, K., Savage, J., ... & Ueland, T. (2020). Genome-wide analysis reveals extensive genetic overlap between schizophrenia, bipolar disorder, and intelligence. Molecular Psychiatry25(4), 844-853.

Vancampfort, D., Correll, C. U., Galling, B., Probst, M., De Hert, M., Ward, P. B., ... & Stubbs, B. (2016). Diabetes mellitus in people with schizophrenia, bipolar disorder and major depressive disorder: a systematic review and large scale meta‐analysis. World Psychiatry15(2), 166-174.

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