“Captain of the Ship” Project – Schizophrenia Spectrum and Other Psychotic Disorders
Week 9: Schizophrenia Spectrum and Other Psychotic Disorders
I am being followed. They are even in my home. I am crouched in the corner of my apartment, but they know I am here and are just waiting to get me. I have a secret and they are trying to get it. The secret is hidden in my brain and they are going to open my skull to get it out. I have to block them from getting into my brain. Hiding in the closet, behind all the clothes, they will not see me….
Jamie, age 26
There are many disorders that result in the development of “positive” symptoms, such as hallucinations and delusions, but not all of these conditions represent schizophrenia. When treating schizophrenia spectrum and other psychotic disorders, emphasis should be placed not only on treating the positive symptoms but the negative and residual symptoms as well.
This week, you will explore a wide variety of disorders along the schizophrenia spectrum as you become “captain of the ship” once again. You also will analyze issues involved with state practice agreements.
Learning Resources
Required Readings
American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.
- Standard 15 “Resource Utilization” (pages 82-83)
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
- Chapter 7, “Schizophrenia Spectrum and other Psychotic Disorders” (pp. 300–346)
Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.
- Chapter 8, “Early-Stage Schizophrenia”
- Chapter 9, “Toward a Dimensional Understanding of Psychosis and Its Treatment”
- Chapter 10, “Psychosocial Treatments for Chronic Psychosis”
- Chapter 11, “Pharmacological Treatment of Psychosis”
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
- “Schizophrenia Spectrum and other Psychotic Disorders”
Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.
Note: All Stahl resources can be accessed through the Walden Library using the link below. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear.
To access information on specific medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.
| Psychosis | Schizoaffective disorder | ||
|---|---|---|---|
| alprazolam (adjunct) amisulpride aripiprazole asenapine blonanserin carbamazepine (adjunct) chlorpromazine clonazepam (adjunct) clozapine cyamemazine flupenthixol fluphenazine haloperidol iloperidone lamotrigine (adjunct) lorazepam (adjunct) loxapine lurasidone |
mesoridazine molindone olanzapine paliperidone perospirone perphenazine pimozide pipothiazine quetiapine risperidone sertindole sulpiride thioridazine thiothixene trifluoperazine valproate (divalproex) (adjunct) ziprasidone zotepine zuclopenthixol |
amisulpride aripiprazole asenapine carbamazepine (adjunct) chlorpromazine clozapine cyamemazine flupenthixol haloperidol iloperidone lamotrigine (adjunct) l-methylfolate (adjunct) loxapine lurasidone mesoridazine molindone olanzapine paliperidone |
perospirone perphenazine pipothiazine quetiapine risperidone sertindole sulpiride thioridazine thiothixene trifluoperazine valproate (divalproex) (adjunct) ziprasidone zotepine zuclopenthixol |
| Schizophrenia | Cataplexy syndrome | Catatonia | Extrapyramidal side effects | |
|---|---|---|---|---|
| amisulpride aripiprazole asenapine carbamazepine (adjunct) chlorpromazine clozapine cyamemazine flupenthixol haloperidol iloperidone lamotrigine (adjunct) l-methylfolate (adjunct) loxapine lurasidone mesoridazine molindone olanzapine paliperidone perospirone |
perphenazine pipothiazine quetiapine risperidone sertindole sulpiride thioridazine thiothixene trifluoperazine valproate (divalproex) (adjunct) ziprasidone zotepine zuclopenthixol Seasonal affective disorder bupropion Sedation-induction hydroxyzine midazolam |
clomipramine imipramine sodium oxybate |
alprazolam chlordiazepoxide clonazepam clorazepate diazepam estazolam flunitrazepam flurazepam loflazepate lorazepam midazolam oxazepam quazepam temazepam triazolam |
benztropine diphenhydramine trihexyphenidyl |
Ferreira, C. D., de Souza, M. G. D., Fernández-Calvo, B., Machado-de-Sousa, J. P., Cecilio Hallak, J. E., & Torro-Alves, N. (2016). Neurocognitive functions in schizophrenia: A systematic review of the effects of typical and atypical antipsychotic drugs. Psychology & Neuroscience, 9(1), 12–31. doi:10.1037/pne0000045
Granholm, E., Holden, J., Link, P. C., & McQuaid, J. R. (2014). Randomized clinical trial of cognitive behavioral social skills training for schizophrenia: Improvement in functioning and experiential negative symptoms. Journal of Consulting and Clinical Psychology, 82(6), 1173–1185. doi:10.1037/a0037098
Required Media
Murphy, L. (2011, July 21). Types of schizophrenia – A day in the life (scary) [Video file]. Retrieved from https://www.youtube.com/watch?v=LWYwckFrksg
Assignment 1: “Captain of the Ship” Project – Schizophrenia Spectrum and Other Psychotic Disorders
In earlier weeks, you were introduced to the concept of the “captain of the ship.” In this Assignment, you become the “captain of the ship” once again as you provide treatment recommendations and identify medical management, community support resources, and follow-up plans for a client with a schizophrenia spectrum/other psychotic disorder.
Learning Objectives
Students will:
- Recommend psychopharmacologic treatments based on therapeutic endpoints for clients with schizophrenia spectrum and other psychotic disorders
- Recommend psychotherapy based on therapeutic endpoints for clients with schizophrenia spectrum and other psychotic disorders
- Identify medical management needs for clients with schizophrenia spectrum and other psychotic disorders
- Identify community support resources for clients with schizophrenia spectrum and other psychotic disorders
- Recommend follow-up plans for clients with schizophrenia spectrum and other psychotic disorders
To prepare for this Assignment:
- Select an adult or older adult client with a schizophrenia spectrum and other psychotic disorder you have seen in your practicum.
In 3–4 pages, write a treatment plan for your client in which you do the following:
- Describe the HPI and clinical impression for the client.
- Recommend psychopharmacologic treatments and describe specific and therapeutic endpoints for your psychopharmacologic agent. (This should relate to HPI and clinical impression.)
- Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices.
- Identify medical management needs, including primary care needs, specific to this client.
- Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client.
- Recommend a plan for follow-up intensity and frequency and collaboration with other providers.
By Day 7
Submit your Assignment.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
- Please save your Assignment using the naming convention “WK9Assgn1+last name+first initial.(extension)” as the name.
- Click the Week 9 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
- Click the Week 9 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.
- Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK9Assgn1+last name+first initial.(extension)” and click Open.
- If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
- Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:
Week 9 Assignment 1 Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 9 Assignment 1 draft and review the originality report.
Submit Your Assignment by Day 7
To submit your Assignment:
Week 9 Assignment 1
Assignment 2: Week 9 Practicum Journal: State Practice Agreements
In many states, nurse practitioners are completely autonomous professionals. In other states, however, NPs have a wide range of “restrictive” practice ranging from requirements for a “supervising” physician to requirements for a “collaborative” agreement with a physician.
In this Practicum Journal Assignment, you will examine the requirements of your own state in order to prepare yourself for the realities of practice upon graduation.
Learning Objectives
Students will:
- Analyze state PMHNP practice agreements
- Analyze physician collaboration issues
- Analyze barriers to PMHNP independent practice
- Create plans for addressing state PMHNP practice issues
**Assigned in Week 9 and submitted in Week 10
To Prepare for this Practicum Journal:
- Review practice agreements in your state.
- Identify at least two physician collaboration issues in your state.
For this Practicum Journal:
- Briefly describe the practice agreements for PMHNPs in your state.
- Explain the two physician collaboration issues that you identified.
- Explain what you think are the barriers to PMHNPs practicing independently in your state.
- Outline a plan for how you might address PMHNP practice issues in your state.
By Day 7 of Week 10
Submit your Practicum Journal.
Making Connections
This week, you explored a wide variety of disorders along the schizophrenia spectrum as you became “captain of the ship” once again. You also analyzed issues involved with state practice agreements.
Next week, you will analyze the diagnostic criteria and treatment options of insomnia, hypersomnolence, narcolepsy, sleep apnea, non-rapid eye movement, nightmare disorder, sleep behavior disorder, and other DSM-5 sleep and parasomnic disorders.
To go to the next week:
Week 10
