Running head: SCHIZOPHRENIA 1
SOWK 6090 Week 7 Assignment
Racquel Walsh
Walden University
Individuals diagnosed with schizophrenia tend to undergo a number of assessment
measures in order to have their symptoms evaluated. One of the assessment tools that can
used when assessing and evalua/ng schizophrenia is the Clinician Rated Dimensions of
Psychosis Symptom Severity (CRDPSS). “CRDPSS can be used to rate the eight dimensions which
are Hallucina/ons, Delusions, Disorganized speech, Abnormal psychomotor behavior, Nega/ve
Symptoms, Impaired Cogni/on, Depression, and Mania that can be present in psycho/c
disorders” (Liemburg, Nienhuis & Veling 2020). The items on the assessment are scored based
o< of the presence as well as the severity. It can be noted that both posi/ve and nega/ve
symptoms can be evaluated using this tool. This approach supports a dimensional analysis of
the clinical presenta/ons of schizophrenia. Applying to the case of Sak and McGough, this tool
can signi>cantly help as one of the con>rmatory diagnos/c tools to check for schizophrenia. The
complexity and heterogeneity of symptoms of schizophrenia can be be@er assessed using the
di<erent domains in this tool. Another assessment instrument that can be used to assess for
the diagnosis of schizophernia is the World Health Organiza/on Disability Assessment Schedule
(WHODAS). This tool provides a generic assessment measure for health and disability that can
be applied not only in mental disorders but in a wide array of diseases (World Health
Organiza/on, n.d.). Similar to the CRDPSS, the WHODAS also check several domains however
they are more focused on daily func/oning such as cogni/on, mobility, self-care, interac/ng
with people, ability to ful>ll work and school responsibili/es, and par/cipa/on in community
ac/vi/es. These domains are par/cularly helpful in the diagnosis of schizophrenia because it
provides an assessment of the individual's level of func/oning. Catherine, Aurelie, Eric, Pierre,
Raphaelle, Marine, Pascal, Christophe, and Laurent (2017) inves/gate the func/oning levels of
pa/ents with schizophrenia and found out the relevant rela/onship between schizophrenia and
low-level func/oning. This study suggests the need to use the WHODAS to determine the
nega/ve e<ect of schizophrenia on their daily lives.
The case of Sak and McGough presents the most common clinical manifesta/ons of
schizophrenia. According to the Na/onal Ins/tute of Mental Health (n.d.), schizophrenia refers
to a serious mental illness where an individual has distor/ons of reality. It can signi>cantly
a<ect all aspects of their life including their family as it can be disabling when leC untreated. In
the case of Sak, the diagnosis was made during her college days while for Sak it was during her
teen years. The onset for both individuals is typical for most cases however studies said that
earlier diagnosis usually occurs in males. Both Sak and McGough experienced changes in
thinking and social func/oning. McGough reported that she also a@empted suicide during the
early phase of the disorder even before the diagnosis was made. She would also experience
hallucina/ons that a<ected her school work. For Sak, the psycho/c episodes developed acutely
as she manifested odd behaviors, delusions, and disorganized speech. Understanding the onset
of schizophrenia is important in determining the prognosis or outcomes of treatment.
According to Vernal, Boldsen, Lauritsen, Correll, and Nielsen (2020), early-onset schizophrenia
is associated with more hospital days compared with adult-onset. However, the study also
revealed that it does not support poorer long-term outcomes. The longer hospitaliza/on days
during the >rst few months of diagnosis can be because of several factors including the
acceptance of diagnosis, unfamiliarity of the treatment, and s/gma. Such as in the case of
McGough wherein her mother refused to believe her condi/on that may have caused the
delayed treatment thus worsening of symptoms.
The treatment of schizophrenia is focused on managing the severity of symptoms and
allowing the pa/ent to func/on at their full poten/al. Individualized treatment is important to
consider since di<erent pa/ents would have di<erent needs. Some of the treatment and
therapies included are an/psycho/c medica/ons, psychosocial interven/ons, family educa/on,
and support, coordinated specialty care, and asser/ve community treatment (Na/onal Ins/tute
of Mental Health, n.d.). In most cases, be@er health outcomes are associated when these
treatments are combined. Winkelbeiner, Leucht, Kane, Homan (2019) evaluated the overall
di<erence in individual treatment among pa/ents with schizophrenia. The researchers
concluded that personalized treatment would be more e<ec/ve compared to a standardized
treatment. This is because of the assumed varying e<ects of treatment and individual
condi/ons. Moreover, the pa/ent's acceptance is also another factor to be considered in the
treatment. Sak reported that she >rst refused to take the drug as she believed that it will cause
more harm than good. Nevertheless, the con/nuity of her symptoms prompted her to take the
drugs at a later phase. Aside from long-term treatments, challenges in their daily lives can be
experienced by these pa/ents. The s/gma a@ached to schizophrenia can be very stressful and
debilita/ng. The nega/ve percep/on of the disorder is a<ected by social iden/>ca/on and has
resulted in delayed treatments (Klik, Williams & Reynolds, 2018). This that providing new
insights towards schizophrenia can signi>cantly impact help-seeking behaviors among pa/ents
thereby improving their mental health.
Sociodemographic and environmental characteris/cs have a great impact on the
individual's experience with schizophrenia. Sak's journey of her mental illness is a great
presenta/on of how a person's environment can help these people live produc/vely. However,
this is not the case for most individuals with the same mental disorder. Lacey, Manuel, Schluter,
Porter, Pitama, and Jamieson (2019) stated that among older adults who have access to
community health service support, a signi>cant number of the popula/on tend to experience
social disadvantages because of their diagnosis. It is concerning because of the dispari/es that
occur in certain groups that can result in inappropriate treatment and nega/ve health
outcomes. Racial or ethnic dispari/es and gender di<erences are social issues that are not only
per/nent in the realm of mental disorders but in many health problems. For example, in the
study of Nagendra, Halverson, Pinkham, Harvey, Jarskog, de Mamani, and Penn (2020), Black
Americans are dispropor/onately diagnosed with schizophrenia thus leading to poorer health
outcomes. This shows a comparably strong link between demographic pro>le-related variables
and schizophrenia. This data calls for interven/ons and policies to meet the social needs of
these individuals.
References
Catherine, F., Aurelie,V., Eric,G., Pierre, M., Raphaelle,R., Marine, A., Pascal, A., Christophe, L. &
Laurent, B.(2017). De>ning func/oning levels in pa/ents with schizophrenia: A combina/on of a
novel clustering method and brain SPECT analysis. Psychiatry Research: Neuroimaging 270: 32-
38.
Klik, K., Williams, S., & Reynolds, K. (2018). Toward understanding mental illness s/gma and
help-seeking: A social iden/ty perspec/ve. Social Science & Medicine 222: 35-43.
Lacey, C., Manuel, J., Schluter, P., Porter, R., Pitama S., Jamieson, H. (2019). Sociodemographic,
environmental characteris/cs, and comorbidi/es of older adults with schizophrenia who access
community health service support: A na/onal cross-sec/onal study. Aust N Z J
Psychiatry. 53(6):570-580.
Liemburg, E., Nienhuis, F., & Veling, W. (2020). M95. DSM-5 CLINICIAN-RATED DIMENSIONS OF
PSYCHOSIS SYMPTOM SEVERITY: PSYCHOMETRIC PROPERTIES. Schizophrenia Bulle n, 46(Suppl
1), S170-S171
Nagendra, A., Halverson, T., Pinkham, A., Harvey, P., Jarskog, L., de Mamani,. A. & Penn, D.
(2020). Neighborhood socioeconomic status and racial dispari/es in schizophrenia: An
explora/on of domains of func/oning. Schizophr Res. 224:95-101.
Na/onal Ins/tue on Mental Health. (n.d.). Schizophrenia.
Vernal, D., Boldsen,S., Lauritsen, M., Correll, C., &Nielsen, R. (2020). Long-term outcome of
early-onset compared to adult-onset schizophrenia: A na/onwide Danish register
study. Schizophrenia Research, 220: 123-129.
Winkelbeiner S, Leucht S, Kane JM, Homan P. Evalua/on of Di<erences in Individual Treatment
Response in Schizophrenia Spectrum Disorders: A Meta-analysis. JAMA
Psychiatry. 2019;76(10):1063-1073.
World Health Organiza/on. (n.d.) WHO Disability Assessment Schedule 2.0 (WHODAS 2.0).
