Which information is the most essential in the initial teaching session for the family of a young adult recently diagnosed with schizophrenia?
A. Symptoms of this disease imbalance in the brain.
B. Genetic history is an important factor related to the development of schizophrenia.
C. Schizophrenia is a serious disease affecting every aspect of a person’s functioning.
D. The distressing symptoms of this disorder can respond to treatment with medications.
Correct Answer: D. The distressing symptoms of this disorder can respond to treatment with medications.
This statement provides accurate information and an element of hope for the family of a schizophrenic client. For the initial treatment of acute psychosis, it is recommended to commence an oral second-generation antipsychotic (SGA) such as aripiprazole, olanzapine, risperidone, quetiapine, asenapine, lurasidone, sertindole, ziprasidone, brexpiprazole, molindone, iloperidone, etc. Sometimes, if clinically needed, alongside a benzodiazepine such as diazepam, clonazepam, or lorazepam to control behavioral disturbances and non-acute anxiety. First-generation antipsychotics (FGA) like trifluoperazine, Fluphenazine, haloperidol, pimozide, sulpiride, flupentixol, chlorpromazine, etc. are not commonly used as the first line but can be used.
Option A: There are also arguments that schizophrenia is a neurodevelopmental disorder based on abnormalities present in the cerebral structure, an absence of gliosis suggesting in utero changes, and the observation that motor and cognitive impairments in patients precede the illness onset.
Option B: Several studies postulate that the development of schizophrenia results from abnormalities in multiple neurotransmitters, such as dopaminergic, serotonergic, and alpha-adrenergic hyperactivity or glutaminergic and GABA hypoactivity. Genetics also play a fundamental role – there is a 46% concordance rate in monozygotic twins and a 40% risk of developing schizophrenia if both parents are affected. The gene neuregulin (NGR1) which is involved in glutamate signaling and brain development has been implicated, alongside dysbindin (DTNBP1) which helps glutamate release, and catecholamine O-methyltransferase (COMT) polymorphism, which regulates dopamine function.
Option C: Although the remaining statements are true, they do not provide the empathic response the family needs after just learning about the diagnosis. These facts can become part of the ongoing teaching. The first schizophrenic episode usually occurs during early adulthood or late adolescence. Individuals often lack insight at this stage; therefore few will present directly to seek help for their psychotic symptoms. Common presentations include a relative noticing social withdrawal, personality changes, or uncharacteristic behavior; deliberate self-harm or suicide attempts; calling the police to report their delusional symptoms, or referral via the criminal justice system.