Assignment 1: Early Onset Schizophrenia
Children and adolescents with schizophrenia have more difficulty functioning in academic or work settings, and significant impairment usually persists into adulthood. They may have speech or language disorders and in some cases borderline intellectual functioning. These individuals are more likely to complete suicide attempts or die from other accidental causes. Schizophrenia is characterized by positive and negative symptoms. Positive symptoms include hallucinations, delusions, and behavior disturbance. Negative symptoms include blunted affect and attention, apathy, and lack of motivation and social interest.
In this Assignment, you compare treatment plans for adults diagnosed with schizophrenia with treatment plans for children and adolescents diagnosed with schizophrenia. You also consider the legal and ethical issues involved in medicating children diagnosed with schizophrenia. Early Onset Schizophrenia Essay Paper
Learning Objectives
Students will:
Compare evidence-based treatment plans for adults versus children and adolescents diagnosed with schizophrenia
Analyze legal and ethical issues surrounding the forceful administration of medication to children diagnosed with schizophrenia
Analyze the role of the PMHNP in addressing issues related to the forceful administration of medication to children diagnosed with schizophrenia
To Prepare for this Assignment:
Review the Learning Resources concerning early-onset schizophrenia.
The Assignment (2 pages):
Compare at least two evidence-based treatment plans for adults diagnosed with schizophrenia with evidence-based treatment plans for children and adolescents diagnosed with schizophrenia.
Explain the legal and ethical issues involved with forcing children diagnosed with schizophrenia to take medication for the disorder and how a PMHNP may address those issues.
Note: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements
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Early Onset Schizophrenia
Introduction
Early-onset schizophrenia affects the pediatric population before attaining 18 years of age. Early-onset schizophrenia is typified by functional and symptomatic impairments that adversely affect the social and cognitive functioning of the affected children and adolescents (Aneja et al., 2018). In this assignment, the treatment plans for children and adolescents will be compared with the treatment plans for adults with schizophrenia diagnoses. The paper will conclude by discussing the legal and ethical issues associated with the forceful treatment in early-onset schizophrenia.
Treatment Plans for Adults versus Children and Adolescents
For people with schizophrenia, antipsychotic medications are the first-line treatment. However, atypical antipsychotics are the first-line treatment choices for people with schizophrenia diagnosis due to their few side effects in comparison to the first-generation antipsychotic medications (Patel et al, 2014). The treatment agents that are approved by the FDA to treat the adult population diagnosed with schizophrenia consist of chlorpromazine, haloperidol, ziprasidone, and olanzapine. On the other hand, for children aged 13-years and over, the medications used in treating schizophrenia are aripiprazole and risperidone.
The reason why medications like olanzapine are not recommended for treatment of the pediatric population with schizophrenia is that this population is more prone to side effects like increased weight gain and metabolic adverse effects (Ferrin et al, 2016). In addition, children and adolescents are at a bigger risk of resisting treatment and experiencing extrapyramidal side effects; thus, the first-line treatment for early-onset schizophrenia is supposed to be atypical antipsychotics.
Forceful Treatment in Early-Onset Schizophrenia
The pediatric population with early-onset schizophrenia is likely to resist treatment and this results in the administration of forceful treatment (Sjöstrand et al., 2015). The forceful treatment is associated with various ethical and legal issues. In most American states, the age that children should consent to treatment is 18-years and over. Autonomy provides the patient with the ability to make their treatment decisions and choose their treatment course. When treating children and adolescents, balancing the children’s wishes and the parents is a challenge.
Forceful treatment violates the right of the patient to accept or refuse treatment; ethically, this means the autonomy of the patient is violated with forceful treatment. Furthermore, the forceful treatment breaches the patient’s legal rights regarding their bodily integrity and decision-making. The forceful treatment also encroaches upon the trust between the patient and the healthcare practitioner or the family member forcefully administering the drugs (Sjöstrand et al., 2015). Due to the side effects associated with medications used in treating schizophrenia, minors should be allowed to participate in their treatment decisions. Early Onset Schizophrenia Essay Paper
Addressing the Issue of Forceful Treatment
The PMHNP can address the forceful treatment in the pediatric population with early-onset schizophrenia by educating children and adolescent clients regarding their conditions and the importance of accepting treatment. This can lower the likelihood of the children/adolescents resisting treatment. Moreover, PMHNP should involve children and adolescents during the development of their treatment plans. Assent should be obtained from the pediatric population before beginning the treatment. The PHMNP need to closely monitor the pediatric population being treated for schizophrenia, for any side effects. this is because side effects significantly contribute to the pediatric population resisting the treatment. The above-mentioned strategies will lower the possibility of forceful treatment (Sjöstrand et al, 2015).
References
Aneja, J., Singhai, K., & Paul, K. (2018). Very early-onset psychosis/schizophrenia: Case studies of spectrum of presentation and management issues. Journal of family medicine and primary care, 7(6), 1566–1570. https://doi.org/10.4103/jfmpc.jfmpc_264_18.
Ferrin M, Gosney H, Marconi A & Rey JM. (2016). Using antipsychotic medication for the treatment of schizophrenia in children and adolescents. In Rey JM (ed), IACAPAP e-Textbook of Child and Adolescent Mental Health. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions.
Patel K, Cherian J, Gohil K & Dylan A. (2014). Schizophrenia: Overview and Treatment Options. P T. 39(9): 638–645
Sjöstrand M, Lars S, Karlsson P, Gert H & Juth N. (2015). Ethical deliberations about involuntary treatment: interviews with Swedish psychiatrists. BMC Med Ethics. 16(37).