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Treatment: Identification of Schizophrenic Patients

Rashmi Nemade, Ph.D. & Mark Dombeck, Ph.D., edited by Kathryn Patricelli, MA

2020 - prescriptionimage by John Lewis (lic)


Identification of schizophrenic patients

Schizophrenia is a disease that affects how people think and how they experience the world around them. It affects their judgment and ability to tell what is real. Very few people with schizophrenia recognize what is happening to them and voluntarily show up at a doctor's office asking for help. At the same time, few families are prepared for the idea that their loved ones are hallucinating, experiencing delusions or losing touch with reality. Family members tend to minimize the seriousness of their loved one's odd behavior. They may choose to believe that it is caused by stress or other temporary conditions. Between of these tendencies on the part of the person and the family, the symptoms tend to get fairly severe before anyone recognizes how serious the problem is.

People are often identified as possibly having schizophrenia when they are picked up in a psychotic state by police and brought to a hospital. They will be evaluated at the hospital. This evaluation to determine the cause of symptoms may include:

  • history and mental status exams - the doctor will be looking for hallucinations, headaches, recent head injury, and drug use, prescription or otherwise. This helps to see whether the symptoms are substance/medication-induced.
  • physical and neurological (brain) exams - these exams will be looking for medical causes of the symptoms.
  • basic lab tests - may include blood count, blood chemical screens and urinalysis. The goal here is to rule out body imbalances that could be causing the symptoms.
  • psychological tests - these can be helpful in the early cases or cases where it isn't quite clear what is going on.
  • lumbar puncture - in this procedure, fluid is drawn from the lower back and used to check for brain diseases or infections that could be causing the symptoms.
  • EEG - since some medications used to treat schizophrenia can affect the heart, an EEG will be done to check the current heart condition.
  • MRI/CT Scans - these may be used to check for brain lesions that could be causing the symptoms.

People rarely get to stay in a hospital for a long time due to insurance limitations. As soon as possible, people are examined, diagnosed, and put on medications that will reduce their symptoms. They may even be released from the hospital before symptoms have been greatly reduced when they do not appear to be a danger to themselves or others.

Outpatient or partial hospital treatment is generally coordinated prior to leaving the hospital. These treatment options pick up where hospital care ends. Also, at this time (or sooner) family members may receive education about schizophrenia, the absolute need for ongoing treatment if best outcomes are going to happen, and their role in helping that treatment becomes and remains successful.

When funding allows for it, a case manager may be assigned to assist with coordination of patient care and family support. If a patient is not taking medications or the medications are not reducing the symptoms, the person may become (or remain) acutely ill again. This may require a return trip to the hospital if the person's insurance or situation allows for it.