Key Feature 2: In “apparently” stable patients with schizophrenia (ex: those who are not floridly psychotic), provide regular or periodic assessment in a structured fashion ex: positive and negative symptoms, their performance of activities of daily living, and the level of social functioning at each visit:
Phase: Follow-up, History
Key Feature 6: In decompensating patients with schizophrenia, determine:
Phase: History, Hypothesis generation
Key Feature 7: Diagnose and treat serious complications/side effects of antipsychotic medications (ex: neuroleptic malignant syndrome, tardive dyskinesia).
Skill: Clinical Reasoning
Phase: Treatment, Diagnosis
The DSM 5 diagnostic criteria for Schizophrenia are listed below. Note that much like the other psychiatric diagnoses that I have reviewed in previous posts, it is pertinent to remember the diagnostic criteria for diagnosis but also for follow-up assessment of how they are doing with respect to the nature and severity of the disease.
If a patient has already been started on a management plan for diagnosed schizophrenia, it is important, as for any chronic health condition, to evaluate adherence to the previously designed treatment plan. Particularly with psychiatric medications there can be many intolerable side effects, and it is not infrequent to hear that patients are not taking a medication as prescribed because of them. UpToDate provides a table of the adverse effects of antipsychotic medications as follows:
UpToDate further describes the antipsychotic side effects and how to manage them in the article, "Pharmacotherapy for schizophrenia: Side effect management," as follows: