A Beautiful Mind Schziophrenia Case Study

A Beautiful Mind Overview A Beautiful Mind is the story of John Nash, a real mathematical genius who began having symptoms of schizophrenia upon entering graduate school at Princeton University in 1948. Peers viewed Nash as odd, eccentric, and lacking in basic social skills. Nash often skipped class, wrote mathematical formulas on windows, and spent many hours pursuing an “original idea” befitting his intellectual abilities. Most interpersonal interactions were with Charles (his roommate) and two or three other fellow students. Once he began teaching, John met a young woman, fell in love, got married, and had a child. The Cold War was at its peak. With his ability, John was able to decode messages intercepted from the “enemy.” Soon after, a government secret agent hired him to look for hidden messages in newspapers and magazines. His entire life became consumed with this “mission". Over time, it became apparent that John’s mission was a delusion. Furthermore, it became clear that the secret agent and his college roommate Charles were hallucinations. Initially, John was treated with insulin shock therapy; later, his treatment was with medications. It is important to note that the movie A Beautiful Mind skips many years (1960s--1980s) of the life of the real John Nash, which were quite tumultuous. He and Alicia divorced, although they eventually remarried. Nash had a relationship with another woman, which produced a son, John David. His son with Alicia, John Charles, was diagnosed with paranoid schizophrenia. After decades of fighting the symptoms of his disease, Nash received the Nobel Prize for his mathematical discoveries. For the purposes of this exercise, you are a nurse working with the Nash family as depicted in the film during the time when his illness was at its worst. Client name: John Nash Psychiatric diagnosis: Schizophrenia *For the criteria supporting this diagnosis, please refer to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, by the American Psychiatric Association, and/or your Wolters Kluwer mental-health nursing textbook. Name of the client you are assessing: John Nash Name of the movie: A Beautiful Mind What is the chief complaint? (In the client’s own words and report of others) Response: John believes he is working for the government, decoding messages using the newspaper and magazines, and trying to help his country. John reports his activities of working for the government, Because he is paranoid and suspicious and believes these events as real, he may be reluctant or unwilling to give any information. However, his wife may report his unusual actions, his participation in imaginary events and avoiding sleep. She would explain his suspicious behavior and imaginary activities are preventing him from actively participating in society. Based on the above information and a close viewing of the movie, what questions would you raise during history taking? What are some possible answers? You might base your questions on the: · History of the client’s illness. · Past psychiatric history, treatment, and treatment outcomes. · Psychosocial history. Response: When did John first have symptoms or problems? How long has this been going on? - During graduate school, John’s first major hallucination was of his roommate, Charles. Later, he had a hallucination of Charles’ niece. Both remained with him over many years, even after he realized they were not real - Following graduation, he did some decoding work for the government, followed by his second major, long-lasting hallucination (believing that he was a secret agent), and the delusional belief that the government had hired him to find and decode secret messages in magazines and newspapers. What previous treatment has John had? Was treatment successful? - John initially received insulin shock therapy, which was not particularly effective. This treatment was replaced with medication. While the medications helped some of his symptoms, it did not reduce the hallucinations and the side effects quickly became intolerable. The psychotic symptoms intensified, and he began cutting out articles and using the shed as a “command post” for his secret operations. He became a danger to himself and others. As the years progress, his hallucinations continue and John begins to understand that are not real. What, if anything, makes the symptoms better? - his intellectual abilities help him recognize that his hallucinations do not change, which helps him realize they are not real. Also, his wife support helps provide a stabilizing influence. er v at i onsdoy ouhav eaboutt hecl i ent ’ s Whatot herobs behav i or ? John has some peculiar mannerisms/gestures such as putting his hand on his head and pointing. Early in the movie, John is very confident in his abilities but later, demonstrates self-self-esteem issues related to his years of social isolation. later, his self-esteem becomes quite low after years of symptoms and social isolation. At one point, John physically cuts his arm trying to remove an “identification number” he thought was implanted there. In your opinion, is the diagnosis discussed above accurate? Response: yes What requirements does the client meet that support this diagnosis, based on the DSM-5? Response: John has symptoms of psychosis, delusions, hallucinations, disorganized thought. He presents with negative signs of schizophrenia including flat affect and lack of goal directed behavior. These signs and symptoms are a disruption in his daily life and are causing major problems in his work, relationships and self-care. What treatment plan would you outline? Response: I would outline treatment with medications to reduce symptoms specifically atypical antipsychotics because of the minimal side effects. I would suggest therapy to ensure he participates in meaningful, productive activity as well as family education. With what expected outcomes? Response: Patient will improve social interactions with family, friends and neighbors. Patient will use appropriate social skills. Patient will identify satisfying relationships with real people, Patient will refrain from acting on delusional thoughts. Patients will express thoughts and feelings in a coherent, logical, goal directed manner.