Management of Schizophrenia
Comparison between Adult and Children Treatment Plans for Schizophrenia
Early-onset schizophrenia (EOS) is a severe disorder with long-term repercussions in a patient’s social, psychological, educational, and occupational life. It can lead to poor physical health and a reduction in life expectancy. This condition affects about 1.9 per 100000 of the young people’s population (Tiihonen et al., 2017). Compared with adult-onset schizophrenia (AOS), EOS is more severe because it affects the patient’s psychological and cognitive development. Antipsychotic medications have more adverse effects on children and adolescents as they affect their growth and development. They can cause rapid weight gain, systemic disturbances, and influence young people’s sexual development (Tiihonen et al., 2017). Further, the young patient is likely to have negative symptoms as compared to adults.
In a study conducted on antipsychotic drugs effects on EOS and AOS in 2007, there was little evidence on the therapeutic effect of the drugs on the EOS patients (Stafford et al., 2015). During the meta-analysis, an examination of psychosis symptoms at post-treatment, relapse, and follow up was done. Symptoms of anxiety, depression, weight, and psychosocial functioning were analyzed during the study (Stafford et al., 2015). The study included randomized trials evaluating psychological and pharmacological treatment on children, adolescents, and adults. The antipsychotic drugs used in the study include; risperidone, aripiprazole, olanzapine, amisulpride, haloperidol, and paliperidone (Stafford et al., 2015).
From the findings, there are minimum effects for antipsychotics on symptoms in young patients compared to adults (Stafford et al., 2015). There is rapid weight gain in children and adolescents compared to adults, especially in the first six weeks of treatment. The effects are noted more on those on olanzapine therapy who add 1.3-4-5kg weight (Stafford et al., 2015). On the other hand, adults notably improve while using antipsychotic drugs. There are no beneficial effects for the psychotherapy done on EOS patients, but it is effective in adults as it reduces relapse rates. There has been a high discontinuation rate of antipsychotic drugs in EOS, which shows that the drugs are not tolerated well in this population. Early intervention is more effective in EOS than in AOS patients (Stafford et al., 2015). However, due to the evidenced effects of antipsychotics on children and adolescents with schizophrenia, their treatment should be done cautiously.
Legal and Ethical Issues in Drug Administration of Children with Schizophrenia
Most of the psychopharmacology in pediatrics depends on innovation. The department has got little research; thus, there are limited databases to guide how to use medication on children with mental illnesses (Howe, 2008). Before administering antipsychotic drugs on children, the parents should consent, and the young patient should be informed about the illness and the treatment process.
An understandable force can help the patient get treatment (Latha, 2008), as cited in Case law Norfolk and Norwich Healthcare NHS Trust v W (1996). The health professionals can decide and judge the extent of force needed to treat the patient (Latha, 2008) as cited in case law Re MB, 1997, cited by Welsh & Deahl, 2002. It was decided that the power be accorded to the health professionals in treating patients who lack capacity, such as the uncooperative children diagnosed with EOS. Alternatively, some professionals have opted to use covert medication method to hide the medication in the children’s food or drinks (Latha, 2008). The PMHNP may be of great help in providing psychotherapy services to the ailing child and the family.
Health professionals treating schizophrenic patients may face an ethical dilemma as they are torn between maximizing their efforts to help the patients and adhering to their autonomy. However, psychiatrists should always consider moral weight on good values rather than harm, especially when treating patients with schizophrenia whose decision-making and judgment capacities are already impaired.
