Assessment, Health Promotion, And Intervention Strategies For Susan – Case Study

Introduction to Susan’s Case Study

The young and tech savvy generation of present day are leading a life that is ridden with a myriad of different worries, troubles and challenges. The youngsters of the 21^st century have a life full of hardships, expectations and disappointments as well. However, the impact of the different stressful elements of life has been affecting the patience and resilience of the youngsters as well and that is the reason why the majority of the young generation are now straying towards substance and alcohol abuse (Pierre 2010). This assignment will focus on the psychotic disorder faced by a patient due to alcohol and substance abuse and recommend intervention strategies taking the aid of a case study.

The case study represents the case of Susan, the patient under focus in the assignment; a 22-year-old youngster had been assessed by the nursing practitioner for urinary tract infection however, the most conspicuous symptoms exhibited by the patient had been her low mood and depression. On further enquiry, Susan revealed that she had been indulging in substance abuse from a very early age of ten. On a more elaborative note, the patient also revealed that she had recently started drinking daily and has been smoking cannabis as well and as a result she had been suffering auditory hallucination. Elaborating more on her condition, it can be mentioned that she had been going through addiction for a very long time in her life and being addicted to substance and alcohol from such a short age has had a significant impact on the psychological health of the patient. With the recent deterioration of drinking everyday and smoking cannabis frequently, her auditory hallucination is being further complicated by paranoia and delusions as well. According to the recent studies, the most important outcome of cannabis addiction is the onset of schizophrenia. As per the objective data, Susan had been experiencing two key symptomatic characteristics of substance induced psychosis, auditory hallucination and paranoia (Shinn, Heckers and Öngür 2013). Along with that, the added impact of alcohol has further complicated the condition of the patient. Now coming to the urinary tract infection that the patient had been having, the major cause of the disease is her regular excessive alcohol consumption. According to the Kingdon et al. (2010), the fluctuation in the intestinal temperature due to excessive alcohol consumption aids to the growth of opportunistic pathogen in the urinary tract and the reduction in the hormone vasopressin facilitates excessive urge to urinate and increases the possibility of the patient catching a UTI.

Aetiology and signs and symptoms – Substance-induced Psychosis

The major health care priorities that the patient of the case study represents include controlling and minimizing the auditory hallucinations that the patient has been suffering with. Along with that, the healthcare professional will also need to address the paranoia and onset of cannabis-induced schizophrenia in Susan. Additionally, she will need a care plan for the urinary tract infection (Hepworth, Ashcroft and Kingdon 2013). Lastly, the patient will require a thorough health promotional intervention strategy to overcome her addiction to alcohol and substance abuse so that she can revert to a healthier lifestyle. The first and foremost intervention strategy will have to focus on assessment of the severity of her substance-induced psychosis. The healthcare professional will require developing a therapeutic mutually respectful relationship with the patient, so that she can feel comfortable to share the details of her hallucinations for better assessment. It has to be understood that the patients had been undergoing a variety of different health care concerns and hence a comprehensive assessment will be required so that improved treatment and care planning can be performed. This comprehensive assessment will have two segments; the first segment will have the basic demographic details shared by Susan, past medical history, strengths and weaknesses, and most importantly the severity of the co-occurring disorders. In this case, Susan had been dealing with both auditory hallucination and paranoia, hence separate screening for both of the co-occurring disorders. There are various assessment tools that can be used for advanced screening of the patient, such as the personality assessment inventory (PAI), million index of personality styles (MIPS), and personality diagnostic questionnaire (PDQ) (Hasin et al. 2013)..

For the health promotion, Susan will need to be recommended to a psychotherapists so that for attending group therapies and one to one cognitive therapies to overcome her trauma and issues and can easily revert back to mainstream society. The therapy will help her face the issues that are triggering the substance and alcohol abuse and will help her overcome her addiction (Fiorentini et al. 2011).

Conclusion:

On a concluding note, it can be stated that the incidence rate of substance abuse has been increasing rapidly in the past decade, the most frequently reported consequence of the rising substance, and alcohol abuse in the youngsters is the psychotic disorders. The patient in this case study had been addicted to both alcohol and drugs, especially cannabis, which was the contributing factor behind the psychotic disorders she had been suffering through. Her paranoia and auditory hallucinations were affecting her career and her social life and without proper attention or medical care, her conditions could easily escalate to cannabis induced schizophrenia. However, with the care plan and health promotional strategy out together for her, she will be able to gain recovery easily.

References: 

Fiorentini, A., Sara Volonteri, L., Dragogna, F., Rovera, C., Maffini, M., Carlo Mauri, M. and A Altamura, C., 2011. Substance-induced psychoses: a critical review of the literature. Current drug abuse reviews, 4(4), pp.228-240.

Hasin, D.S., O’Brien, C.P., Auriacombe, M., Borges, G., Bucholz, K., Budney, A., Compton, W.M., Crowley, T., Ling, W., Petry, N.M. and Schuckit, M., 2013. DSM-5 criteria for substance use disorders: recommendations and rationale. American Journal of Psychiatry, 170(8), pp.834-851.

Hepworth, C.R., Ashcroft, K. and Kingdon, D., 2013. Auditory hallucinations: a comparison of beliefs about voices in individuals with schizophrenia and borderline personality disorder. Clinical psychology & psychotherapy, 20(3), pp.239-245.

Kingdon, D.G., Ashcroft, K., Bhandari, B., Gleeson, S., Warikoo, N., Symons, M., Taylor, L., Lucas, E., Mahendra, R., Ghosh, S. and Mason, A., 2010. Schizophrenia and borderline personality disorder: similarities and differences in the experience of auditory hallucinations, paranoia, and childhood trauma. The Journal of nervous and mental disease, 198(6), pp.399-403.

Niemi-Pynttäri, J.A., Sund, R., Putkonen, H., Vorma, H., Wahlbeck, K. and Pirkola, S.P., 2013. Substance-induced psychoses converting into schizophrenia: a register-based study of 18,478 Finnish inpatient cases. The Journal of clinical psychiatry, 74(1), pp.e94-9.

Pierre, J.M., 2010. Hallucinations in nonpsychotic disorders: toward a differential diagnosis of “hearing voices”. Harvard review of psychiatry, 18(1), pp.22-35.

Roberts, K.B., 2011. Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics, 128(3), pp.595-610.

Schmiemann, G., Kniehl, E., Gebhardt, K., Matejczyk, M.M. and Hummers-Pradier, E., 2010. The diagnosis of urinary tract infection: a systematic review. Deutsches Ärzteblatt International, 107(21), p.361.

Shinn, A.K., Heckers, S. and Öngür, D., 2013. The special treatment of first rank auditory hallucinations and bizarre delusions in the diagnosis of schizophrenia. Schizophrenia research, 146(1), pp.17-21.

Torrens, M., Gilchrist, G. and Domingo-Salvany, A., 2011. Psychiatric comorbidity in illicit drug users: substance-induced versus independent disorders. Drug & Alcohol Dependence, 113(2), pp.147-156.

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