Schizophrenia and Its Functional Limitation

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Functional Limitation of Schizophrenia

Schizophrenia is a complicated illness. Hence, it is difficult to determine whether it is a single condition, or it has other related conditions. The generalization of various factors in schizophrenia may be true in limited cases. Generally, people develop conditions for the disorder between the age of 15 and 25 years. The prominent feature is mainly disorganized thought processes and challenges in processing information.

Functional capacity is the ability to conduct desirable activities in one’s life. Thus, the functional limitation may hinder performance in everyday living. The functional limitation of schizophrenia may be positive or negative. Some cognitive functional limitations include hallucinations and changes in thinking processes. On the other hand, negative limitations include diminishing motivation, social isolation, mood changes, and withdrawal.

Functional limitations lead to declines in engaging in physical and mental activities in daily lives. Physical activities are generally mobility, body strengths, and other body senses like hearing, vision, and communication. Mental activities relate to emotional and cognitive activities. All these conditions can be great sources of trouble for persons with schizophrenia.

A functional limitation associated with vision leads to disruptive life among people with the condition. It also affects those who provide care to people with schizophrenia. Visual impairment among people with schizophrenia normally increases when one approaches the age of 75 years. It will affect other activities like mobility.

Schizophrenia causes mobility challenges to people with it. The limitation advances with the age of the patient. In such cases, people may find it difficult to move on their own. Mobility challenges usually increase with the various stages of life. They find it difficult to conduct mobility actions anywhere. At the age of 65 years, the problem may hinder movement around the house, such as climbing stairs. The situation advances in severity with the age of the patient. Vision impairment also contributes to low-levels in other activities like physical, social contacts, depression, and comorbidity. Overall, schizophrenia patients ought to observe regular medical checkups, exercise activities, and social networks to improve their conditions.

Schizophrenia normally makes people withdraw and isolate them from others. This situation has an impact on social relations with family and friends. Impaired social functions may also result in hostility and suspicion. However, this depends on the type of schizophrenia, e.g., paranoia.

Assessment of social functions among people afflicted with schizophrenia is generally scarce. The major cause of poor assessment is a lack of appropriate tools. Previous studies have noted that many facilities did not conduct an assessment of social functions among people with schizophrenia. Moreover, there was no clear definition of social functions in studies and available literature. As a result, various researchers used different approaches to measure social functions. These included interviews, self-reports, and some rating scales. In most cases, researchers normally measure social conditions in relation to certain disorders among patients.

Schizophrenia also causes cognitive function limitations among patients. Neurocognitive functions result in negative outcomes among people with schizophrenia. Patients may have challenges with attention, information processing speed, recall, and language use. This condition may affect work, social, training, and interpersonal relations and skills among people with the schizophrenia condition.

Studies show that the functional limitations of schizophrenia have severe impacts on patients. However, studies have not developed effective assessment tools for various conditions of schizophrenia (Reichenberg, 2010). Thus, it is necessary to understand the factors that are responsible for functional limitations and appropriate interventions to mitigate limitations.

Summary of treatments and/or resources that can help to address functional limitations of schizophrenia

At first, the impacts of schizophrenia will be restricted with minor alterations in actions only, but not in a disturbing way. However, with time, when overlooked or with no effective interventions, schizophrenia can have harmful consequences on the patient and the lives of other stakeholders.

Improving Patient Functioning

Most people have raised the question about the cure for schizophrenia. Unfortunately, schizophrenia has no known cure (Kane and Correll, 2010). However, about 90 percent of schizophrenia patients may recover to certain degrees, which would allow them to function and have improved quality of life.

The patient must make and keep their regular appointments with their physicians

Patients should meet their physicians at least once in a month. This is necessary for reviewing schizophrenia symptoms and other developing challenges. Patients should also have an arrangement for emergencies with their physicians.

Observe diet and other foods

Patients should avoid substances that can cause a chemical imbalance within the body, serious challenges, and deter any progress of improvement. Patients should use consumer decaf products and use chocolate cautiously.

Managing stress

Self-management is critical for patients. They should also engage in productive activities to avoid negative thoughts and stress.

Engage in healthy activities

Patients should get adequate sleep, rest, regular exercise, take balance diets, and take part in productive activities.

Monitor potential cases of relapse

Patients should know signs of relapse and notify their physicians immediately.

While the current medicine cannot cure schizophrenia, patients should engage in positive activities and behaviors to facilitate their chances of recovery. Family members and friends must also provide their support to the patient.

The disease “partly affects patients’ functions” (Lindenmayer, 2008). Treatment approaches differ from one patient to another (Kane, 2010). However, the acute phase requires managing and improving major domains, which can have significant impacts on the patient’s functional capabilities. These may include managing paranoia, aggressive tendencies, and self-care.

In the stable phase, care providers should concentrate on improving “autonomous social behaviors, encourage the patient to take part in rehabilitative therapy, and improve positive outcomes at the workplace” (Lindenmayer, 2008). The general improvement in these domains can ensure that the patient improves relationships and increases the chances of getting employment.

Assessment of functional limitations among schizophrenia is a difficult undertaking, which many people fail to do, particularly during the stable phase. Several cases of relapse may cause poor chances of regaining previous levels of functional abilities. On the other hand, improved symptom control can facilitate the chances of regaining functional abilities. However, some studies have indicated that impairment in symptoms does not automatically affect the functional capacities of the patient. Indeed, physicians should assess functioning limitations independently. This is necessary for enhancing long-term intervention outcomes for schizophrenia patients.

Physicians have associated certain symptoms of schizophrenia with negative outcomes and specific cognitive limitations, such as social perception, attention, memory, and other functions. Several studies have demonstrated that negative symptoms normally show consistency with social limitations and poor relationships. However, such symptoms may not affect skill acquisition. Patients’ cognitive functioning may have an impact on subsequent functional outcomes. The impact may affect independent living, cognitive abilities, relationships, and sustained employment. It is also important to note that functional limitations of schizophrenia based on outcomes may not be associated with the cognitive conditions of the disease. This implies that improvement in symptoms may not enhance functional abilities.

There are several scales of assessment for patient functional abilities. Jean-Pierre Lindenmayer noted that assessment tools based on the DSM-IV criteria were the most clinically meaningful to clinicians and researchers (Lindenmayer, 2008). Thus, physicians should work with such instruments when assessing the functional abilities of the patient.

Summary of Assessment and Interventions

Assessment

A comprehensive assessment that covers physical, psychiatric, and psychological conditions.
Regular assessment of anxiety, depression, comorbidity, drug and substance abuse, and physical conditions.

General approach

Get informed consent
Provide support to all stakeholders in terms of information required.
Allow the patient to seek the second opinion if necessary.
Manage the patient during transfer to different services.
Early treatment of the first episode.
Refer critical cases to mental.
For the acute episode, use pharmacological intervention, fast tranquilization, psychosocial and psychological interventions.
Monitor post-acute recovery.
Facilitate recovery.

Service-Level Interventions

Provide home treatment care providers.
Offer early intervention services.
Encourage community mental health services.
Create an outreach team.
Provide acute day hospitals.
Use appropriate assessment scale.

Pharmacological Interventions

Use the normal antipsychotic treatment agents.
Use specific antipsychotic treatment agents.
Observe the duration of drug administration.
Monitor the patient.

Psychological Treatments

Apply cognitive-behavioral therapy.
Use family and friends’ intervention to avoid relapse (Pharoah et al., 2010).
Use art therapy.
Provide counseling and supportive services.
Apply cognitive remediation.

Some useful resources for Assessment and Intervention

References

Kane, J. and Correll, C. (2010). Past and present progress in the pharmacologic treatment of schizophrenia. Journal of Clinical Psychiatry, 71(9), 1115-24.

Kane, J. (2010). Pharmacologic treatment of schizophrenia. Dialogues Clinical Neuroscience, 12(3), 345–357.

Lindenmayer, J-P. (2008). Increasing Awareness of Patient Functional Impairment in Schizophrenia and Its Measurement. Primary Psychiatry, 15(1), 89-93.

Pharoah, F., Mari, J., Rathbone, J., and Wong, W. (2010). Family intervention for schizophrenia. Cochrane Database Syst Review, (12), CD000088.

Reichenberg, A. (2010). The assessment of neuropsychological functioning in schizophrenia. Dialogues Clinical Neuroscience, 12(3), 383–392.

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