Psychiatric Evaluations

[First Generations and Second Generations Antipsychotics]

Psychiatric evaluations are vital first steps in offering mental health services. They enable behavioral health professionals to assess the client’s condition through interviews, questionnaires, and tests. The insights gained from these evaluations inform the creation of customized treatment plans. These plans act as a framework for therapy sessions and help ensure proper medication management.

Schizophrenia is a spectrum disorder that encompasses several subtypes, including:

• Catatonic
• Disorganized
• Paranoid
• Residual
• Undifferentiated

These distort your perception of reality, altering how you think, feel, and behave. Schizophrenia is a form of psychosis, meaning that what appears real to you may not actually be real. You might experience:

• Hallucinations: Seeing or hearing things that aren’t actually present.
• Delusions: Strongly held but incorrect beliefs, such as thinking you have superhuman abilities, are a famous figure or religious leader, or that others are plotting against you.
• Disorganized speech: Speaking in a difficult way for others to understand, using jumbled words or sentences.
• Unusual behavior: Engaging in odd or repetitive actions, like constantly walking in circles, writing non-stop, or remaining completely still and silent for extended periods.
• Withdrawal and apathy: Lacking emotion, motivation, or interest in everyday activities, appearing detached or lifeless.

Associated Conditions

Schizophrenia is distinguished from other related disorders primarily by the duration of symptoms and the presence or absence of mood disorder signs.

• Schizophreniform Disorder: Symptoms last for at least one month but less than six months. Many individuals with this condition eventually develop schizophrenia, making schizophreniform disorder often an early stage of schizophrenia. However, the symptoms may resolve independently for about one-third of those affected.
• Schizoaffective Disorder: This condition involves a combination of psychotic symptoms alongside mood disturbances, such as major depressive disorder or bipolar disorder. Individuals may experience episodes of depression or fluctuations between extremely high energy or irritability and very low energy. For a diagnosis of schizoaffective disorder, psychotic symptoms must sometimes occur, even when mood symptoms are not present. This is a rare, serious, and lifelong illness.

Schizophrenia Treatment Approach

• Antipsychotics: This includes first-generation antipsychoticsand second-generation antipsychotics.
• Mood Stabilizers: Medications such as Lithium (Lithobid), Divalproex (Depakote), Lamotrigine (Lamictal), and Carbamazepine (Tegretol).
• Antidepressants: Most types of antidepressants may be prescribed.
• Psychosocial Interventions: These include Family Psycho-social Education, Assertive Community Treatment (ACT), and participation in outpatient support groups/programs.
• Substance Abuse Treatment: This is particularly important as many individuals with schizophrenia struggle with substance abuse.
• Skills and Therapy: Social skills training, supported employment, Cognitive Behavioral Therapy (CBT), and weight management are also key components.