MAKEUP SCENARIO:

This is a case of Danny, a 21 year-old sophomore college student who has recently had a breakup from
his girlfriend of two years. About a month after the break up, his mother narrated that he has been locking
himself up in his room lately and has become neglectful of his hygiene which is a very unusual behavior of his
metrosexual son. She has heard bizarre mumblings and monologues in his room from time to time in the wee
hours of the night.
Aside from the odd behaviors his son is manifesting, his mother further states that for the past two
weeks before his consultation, he lacked energy and pleasure from the things he used to enjoy like playing his
guitar; he also overslept, had poor appetite, experienced difficulty concentrating and even spoke about
committing suicide since he is hearing voices to kill himself..
When he was seen and examined by a psychiatrist, the doctor diagnosed Danny as having
Schizoaffective Disorder since he has become “severely ill and has a mixture of psychotic and mood
symptoms” (Videbeck, n.d.) basing from the information gathered from his mother and his general appearance.
He has difficulty performing simple instructions and is unable to focus or to pay attention to details.
Although there had been difficulty determining what type of psychosis Danny has, the psychiatrist
ruled out Bipolar Disorder since he had also experienced the psychotic symptoms on their own without the
mood symptoms. Basing from Lippincott Advisor for Education, he has mostly met the criteria for the
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) among the symptoms as
follows:
 A constant period of disorder during which there is a major mood that occurs along with
DSM-5 criteria of Schizophrenia;
 Two or more weeks of delusions or phantasms that occur in the absence of depressive or
manic disposition;
 The disruption is not caused by use of a substance abuse or any underlying medical condition
(2019).
In his case, Bipolar has been ruled out since he has not been experiencing any manic episodes but only
depressive periods. Furthermore, the psychiatrist diagnosed Danny as having a brief psychotic disorder in
which according to the book Psychiatric-Mental Health Nursing by Videback, he has been experiencing the
sudden onset of at least one symptom, like delusions, hallucinations, or disorganized speech or behavior, for at
least a month (n.d.).

TREATMENT PLAN:
Along with pharmacologic treatment, individual, group and family therapies can be a great help in
overcoming the illness and produce positive long term effects to schizoaffective patients. Treatment plan
applicable to Danny are as follows:
1. Gather relevant data about Danny’s previous history and his present illness. RATIONALE: Learning
these data will serve as your baseline data to assess the extent of his disorder and can be a good tool to
formulate a care plan suited for him.
2. Establish trust by communicating with Danny therapeutically. RATIONALE: This is to establish trust
which can be very frustrating to do with a schizoaffective patient. After gaining Danny’s trust, rest
assured that his fears may be allayed thus establish therapeutic relationship with him (Videback, n.d.).
3. Since he has been verbalizing suicidal thoughts, the nurse should take necessary safety precautions by
documenting what he just said and be vigilant if there is also a threat to kill others. RATIONALE:
 Early assessment and intervention to persons like Danny may save lives since patients like him often
obey hallucinatory commands to kill self or others.
4. Encourage Danny and his family to submit to psychotherapy which includes Individual, Family or
Group Therapy (“Schizoaffective Disorder”, 2019). RATIONALE: This can aid in normalizing
thought patterns and reduce the recurrence of symptoms. Building a trusting relationship in therapy can
help Danny better understand his condition and learn to manage his symptoms.
5. As per doctor’s order, in Danny’s case, reinforce the need for pharmacologic intervention such as the
use of:
 Anti-psychotics like chlorpromazine (Thorazine) and haloperidol (Haldol), among others.
These drugs are formerly known as manor tranquilizers and are prescribed to “treat disorders
that involve thought processes” (Karch, n.d.).
 Anti-depressants like fluoxetine (Prozac) , the newest anti-depressant drug indicated for the
treatment of depression, obsessive compulsive disorders,, panic attacks, bulimia, posttraumatic
stress disorders, social phobias, and other social anxiety disorders. A very helpful website ,
the Mind.org from UK, states that anti-psychotics should be used watchfully there is a risk that
they may cause some patients to have manic episodes, or to switch between mania and
depression (“Treatment and support”, 2019).

REFERENCES:

Karch, A. Lippincott CoursePoint for Karch: Focus on Nursing Pharmacology. [CoursePoint].

Retrieved from https://coursepoint.vitalsource.com/#/books/9781496358462/

Schizoaffective Disorder. (2019, April 5). Retrieved from https://advisor-

edu.lww.com/lna/document.do?bid=4&did=761543&searchTerm=schizoaffective
disorder&hits=disorder,schizoaffective,disorders

Treatment and support. (2019, May). Retrieved from https://www.mind.org.uk/information-

support/types-of-mental-health-problems/schizoaffective-disorder/treatment-and-support/#.XPU-S4gza00

Videbeck, S. L. Lippincott CoursePoint for Videbeck: Psychiatric-Mental Health Nursing.

[CoursePoint]. Retrieved from https://coursepoint.vitalsource.com/#/books/9781496360014/