Paranoid Schizophrenia: Treatment and Support Options

Q: Paranoid Schizophrenia: Treatment and Support Options

Hello, Xiaoming： Regarding your question, I would like to address it in two parts： symptoms and diagnosis. <br>Most patients with schizophrenia indeed experience auditory hallucinations, which may disappear after treatment or manifest as delusions or disorganized thinking. <br>Co

Paranoid schizophrenia?

Hello Dr.
Chen,
My younger brother has been experiencing significant stress since his military service, leading to a diagnosis of schizophrenia.
He currently holds a moderate disability certificate.
In the mornings, he takes one tablet of Sulpride and one tablet of Sertraline, but he continues to express feelings of sadness and has difficulty concentrating on tasks.
He has been unable to find work.
He reports no auditory hallucinations, but our family feels he is very irritable and is suffering greatly.

Is this issue related to his medication or the diagnosis? Given that he holds a disability certificate, is it possible for him to stay at Yuli Hospital for a while? It seems that this might be beneficial for him.

I kindly ask for your guidance on this matter.
Thank you very much!

Xiaoming, 20~29 year old female. Ask Date: 2008/03/13

Dr. Chen Yixing reply Psychiatry

Hello, Xiaoming: Regarding your question, I would like to address it in two parts: symptoms and diagnosis.
Most patients with schizophrenia indeed experience auditory hallucinations, which may disappear after treatment or manifest as delusions or disorganized thinking.
Concerning the part you described as "feeling very sad," I cannot determine whether this is due to depressive emotional distress or emotional distress caused by psychiatric symptoms.
The reason for "difficulty concentrating" also needs further confirmation, as many mental illnesses can lead to concentration issues, which is not a specific manifestation of schizophrenia.
However, establishing a diagnosis should ideally be done through an in-person consultation.
As for the medications you mentioned, the dosages are not high, so I am concerned that it may be a case of insufficient medication dosage.
Nonetheless, I believe that only a specialist who has conducted a personal examination can make the best judgment.
Regarding admission to our hospital, you can refer to our hospital's website for details.
We have two sections: the "Acute and Chronic Care Ward" under general health insurance treatment and the "Long-term Care Ward." The admission criteria for the health insurance ward are similar to those of other psychiatric departments in hospitals, and it is a closed ward.
The long-term care ward, also known as the community area, requires prior application for caregiving status from the city or county government, and approval is needed before admission.
For information on the application process, you can contact our social work office at 03-8886141, extensions 1158 or 1159.
The basic requirement is to have a disability handbook.
If your brother is willing to receive treatment at our hospital, I think the first step is to confirm the desired treatment approach and duration, as the treatment environment and procedures in health insurance beds are not significantly different from those in other hospitals.
Of course, if it is not too far, you can visit our hospital first before making a decision.
Patients from the northern region can consult Dr.
Lan Tso-Hong at National Taiwan University Hospital for evaluation and arrangement (Friday mornings).
I hope this answers your questions.

Reply Date: 2008/03/13

More Info

Understanding paranoid schizophrenia and its treatment options is crucial for both patients and their families. Paranoid schizophrenia is a subtype of schizophrenia characterized by the presence of delusions and hallucinations, often with a strong focus on paranoia. Patients may experience intense feelings of being persecuted or conspired against, which can lead to significant distress and impairment in daily functioning.

In your brother's case, it seems he is currently on medication, specifically sulpiride (舒立寧) and fluoxetine (克憂果). These medications are commonly used to manage symptoms of schizophrenia and depression. Sulpiride is an atypical antipsychotic that can help alleviate psychotic symptoms, while fluoxetine is a selective serotonin reuptake inhibitor (SSRI) that is often prescribed for depression and anxiety. However, it is important to note that while these medications can be effective, they may not work the same way for everyone, and side effects can vary.

Your brother's feelings of difficulty concentrating and ongoing distress, despite the absence of hallucinations, could be attributed to several factors. It is possible that the current medication regimen is not fully addressing his symptoms, or he may be experiencing side effects that are impacting his mood and cognitive function. Additionally, the stress and pressure he faced during military service could have exacerbated his condition, leading to increased anxiety and irritability.

Regarding the possibility of hospitalization at Yuli Hospital, this can be a beneficial option for individuals struggling with severe symptoms or those who require a more structured environment for stabilization. Inpatient treatment can provide intensive support, medication management, and therapeutic interventions that may help your brother regain stability and improve his overall well-being. It is essential to discuss this option with his healthcare provider, who can assess his current condition and determine the appropriateness of hospitalization.

Support from family members is also crucial in the management of paranoid schizophrenia. Encouraging your brother to engage in therapy, whether individual or group, can provide him with coping strategies and a safe space to express his feelings. Cognitive-behavioral therapy (CBT) has been shown to be effective in helping patients manage symptoms and improve their quality of life.

In summary, the treatment of paranoid schizophrenia often requires a multifaceted approach that includes medication, therapy, and support from loved ones. If your brother continues to experience distress, it may be worthwhile to revisit his treatment plan with his healthcare provider. Open communication about his symptoms, medication side effects, and any concerns he has can lead to adjustments that better meet his needs. Remember, recovery is a journey, and with the right support and treatment, individuals with paranoid schizophrenia can lead fulfilling lives.

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