N560: Module One: Behavior and the Brain Discussion 2
Module 2 Overview
During this module, the DSM-5 will be explored.
After completing this module, you will be able to:
- Articulate the purpose and use of the DSM-5.
- Discuss the etiology and epidemiology of schizophrenia and other psychotic disorders
- Describe clinical manifestations of schizophrenia and other psychotic disorders
- Identify diagnostic and screening tools that can be used to evaluate patients with schizophrenia and other psychotic disorders
- Describe the assessment skills necessary to evaluate a patient with schizophrenia or psychosis
- Discuss cultural variances that can impact treatment of a patient with schizophrenia or psychosis
Reading & Resources
- Text resource: Sadock, B., Sadock, V., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer. (Chapters 5, 6, 7)
- Text resource: American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. (Section 1, and review criteria for schizophrenia and psychosis)
- Text resource: Corey, M. S., Corey, G., & Corey, C. (2017). Groups: Process and Practice (10th ed.). Boston, MA: Cengage Learning (Chapter 3).
- Text resource: Stahl, S. (2017). Prescriber’s guide: Stahl’s essential psychopharmacology (6th ed.). New York: Cambridge University Press. (Read aripiprazole, asenapine, chlorpromazine clozapine, haloperidol, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, ziprasidone, and consider how these have been, or may be used, in the treatment of schizophrenia and psychosis.)
- Web resources: https://www.pbs.org/video/what-dsm-5-means-for-diagnosing-mental-health-patients-1376258365/ and https://www.ted.com/talks/eleanor_longden_the_voices_in_my_head and https://www.psychiatry.org/patients-families/schizophrenia/what-is-schizophrenia
- Zachar, P., Regier, D. A., & Kendler, K. S. (2019). The aspirations for a paradigm shift in DSM-5: An oral history. The Journal of Nervous and Mental Disease, 207(9), 778-784. doi:10.1097/NMD.0000000000001063
- Kumari, S., et al. (2018). An assessment of five (PANSS, SAPS, SANS, NGA-16, CGI-SCH) commonly used symptoms rating scales in schizophrenia and comparison to newer scales (CAINS, BNSS). Journal of Addiction and Research Therapy, 8(3), 324.
PANSS (Positive and Negative Symptoms Scale)
Behavior and the Brain Discussion 2
Kumari, in his article, meant to reveal an assessment of five commonly applied rating scales in Schizophrenia including PANSS, SAPS, SANS, NSA‑16, and CGI‑SCH and comparison to new scales such as CAINS and BNSS (Kumari 2018).
In his findings, he revealed that older scales were established over 30 years back. Since then, individuals’ understanding of adverse symptoms has progressed, and new rating scales currently check the negative symptoms’ validity. According to Kumeri et al. (2017), the older scales questionnaire doesn’t involve the latest research on negative symptoms recognized by the NIMH consensus development conference on BNSS and CAINS’s adverse symptoms (Kumari 2018). This thus remains the greatest difference between the newer and older scales. He furthermore reveals that new negative symptom scales signify the improvement in understanding the pathophysiology of Schizophrenia. Though, still, they disregard to address cognitive and psychosocial aspects that are valuable result measures. Although there’re numerous diverse scales accessible to evaluate negative and positive schizophrenia symptoms, a simpler, available, user-friendly scale integrates multi-dimensional type of Schizophrenia, addresses cognitive and psychosocial component, and aids individuals better understanding psychopathology and severity, Schizophrenia yet has to be established.
All these scales are very useful in defining schizophrenia conditions. PANSS affords an objective measure of the clinical response to pharmacological treatments and is very useful in clinical research, with several individuals claiming it as “ a gold standard measure of the treatment effectiveness (Opler, Yavorsky & Daniel 2017).” SANS and SAPS were established in 1980 to fill the invisible gap in the instruments that would efficiently determine the severity of negative and positive symptoms. NSA-16 assesses negative schizophrenia symptoms and includes factors such as communication, social involvement, emotion or affect, retardation and motivation. CGI-SCH scale is useful in determining negative, positive, depressive, overall severity, and cognitive symptoms of Schizophrenia (Park et al. 2020). CAINS and BNNS are too useful, efficient, and validated tools for determining negative schizophrenia symptoms. These two address five presently recognized negative symptoms areas, distinguishing appetitive parts of anhedonia from the consummatory parts addressing the demand for social relations.
To evaluate a client with Schizophrenia, I would use the CGI-SCH scale. This is because it has been revealed as a valid, consistent tool to assess severity responding to treatment in Schizophrenia (Kumari 2018). The tool has also been identified as simple, quick, and concise, making it suitable for use in observational studies and day-to-day clinical practice in relation to Schizophrenia.