NURS 6670 Trudy is a 49-year-old woman recently diagnosed with schizophrenia

Trudy is a 49-year-old woman recently diagnosed with schizophrenia

Answer:

Trudy, 49-year-old woman recently diagnosed with schizophrenia. While she has a strong family history of mood disorders and has evidenced some depressive symptoms herself by history, her diagnosis of schizophrenia was a big surprise to herself and her family. She has been married for 25 years and had a successful marriage and family life until the past few months when she became increasingly concerned that her best friend was trying to seduce her husband. Further history suggests that she has paranoid delusions and that the memos at work carried messages that her coworkers were trying to destroy her family. Trudy finally sought care when she tried to attack a coworker. There is no apparent precipitating factor, and her family cannot understand why she is just now demonstrating symptoms of schizophrenia. Now that she is in treatment which elements of her history support a good prognosis?

At the first interview, it is good to find out more about her social and family history. Trudy is 49 years old and she has a strong family history of mood disorders with her mother also having schizophrenia. This is a big clue and history shows that this patient has been married since 25 years and had a good marriage and family life until few months ago. It was then when she became increasingly concerned that her best friend was trying to seduce her husband. Trudy started to believe in paranoid delusions which gradually led to an attack on one of the coworkers.

The history of Trudy, a 49-year-old woman recently diagnosed as having schizophrenia, demonstrates a strong family history of mood disorders, often providing clues to the likely diagnosis that otherwise could be missed if one simply focused on the current symptoms. Trudy has always been healthy most of her life, with one notable exception. At age 12, she reacted to stress in her family life by developing mononucleosis. In the following years she had more than one minor streptococcal infection. While neither of these infections were severe, they could have precipitated depression later in life. After a long courtship and early marriage, Trudy married when she was 21 and had three children within four years. She quit work when her third child was born and remains at home now that her youngest is five years old. Her husband is an engineer whom she met in college and married for his intelligence and social skills.

While Trudy does have a family history of mood disorders, the reality is that it is uncommon for a person to develop psychiatric symptoms in the absence of any naturally occurring stressor. Further, she does not appear to be depressed but rather appears to have had a major depressive episode as a result of her delusions or hallucinations, which were then followed by a brief psychotic state.

A good prognosis is possible based on the following indicators:

Question:

Trudy is a 49-year-old woman recently diagnosed with schizophrenia. While she has a strong family history of mood disorders, and has herself evidenced some depressive symptoms by history, her delusions and diagnosis of schizophrenia were a big surprise to herself and her family. She has been married for 25 years and by all accounts has had a successful marriage and family life until the last few months when she became increasingly concerned that her best friend was trying to seduce her husband. Further history suggests that she has paranoid delusions and that her memos from work carried messages that her coworkers were trying to destroy her family. Trudy was finally referred for care when she tried to attack a coworker. There is no apparent precipitating factor, and her family cannot understand why she is just now demonstrating symptoms of schizophrenia. Now that she is in treatment, which elements of her history support a good prognosis?

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