Prevalence of Inappropriate Behavior With Schizophrenia

Prevalence of Inappropriate Behavior With schizophrenia familiarity is basic human need. This need is present at either developmental stage and as age increases, it become more than dominant. gibe to Freud if person fixated at unmatchable stage or its demand reduce then in later biography it comes in his behavior (Townsend, 2006). harmonise to Muslim Public Affairs Council (1996) sexual practice and sexuality ar enumerate taboo subjects in Pakistan. Our culture also doesnt allow talking rough these issues openly before marriage and consider legal to adjoin sexual desire only after marriage. Religion also doesnt support to discuss these matters openly.It is distinguished to discuss on this topic in mental wellness because if we dont discuss on sexuality, the unhurried may start expressing his thoughts in unacceptable manner which is against our norms of society and it is called as sexual disinhibition.The study uncovered that 26.7% of persistent schizophrenic long-s ufferings had huge neurotic enthusiastic indications, with a high prevalence in the age decorate underneath 35 years. Obsessive habitual side effects were more serious in perseverings with term of sickness more than 5 years. The neurotic impulsive indications were more common around paranoid schizophrenics (Hemrom et al, 2009).A 33 yr. old female admitted in Karwan-e-Hayat with complain of schizophrenia. On appraisement I found her depressed and prepared to give teaching on contend mechanism. While giving teaching to her on coping strategies she suddenly started vocalizing her sexual thoughts, desire and feelings to affirm a sexual intercourse. Even she was set up to contrive an intercourse with his divorced husband and wanted to get married. When she was sexual intercourse this I was quiet, anxious, uncomfortable, and not confident to discuss. Once I thought that I was not able to assess her problem for which she needed servicing.In schizophrenia obsessive compulsive sy mptoms that of being contamination, sexual, and aggressive thoughts is the positive sign. In a research it has been found that 10% of schizophrenic patient had these compulsion symptoms (Hemrom et al, 2009). Sexual obsession is common in schizophrenic patients and relates the DSM-IV criteria of schizophrenia and OC (Bancroft, 2008). Who encounter much(prenominal) a sort of unadulterated fixations (i.e., fixations that are regularly portrayed by the absence of unmistakable impulses) assess unpleasant considerations as unsafe and too signifi sack upt and, hence, fight to control their beliefs (DellOsso et al, 2012). The patient was suffering from schizophrenia so having sexual obsession could be the part of her disease process as Turkcan et al. (2007) reported that 16% of patient had obsessive compulsive symptoms with schizophrenia.According to Freud (1961), psychoanalytic theory describes formation of personality finished five stages of psychosexual development. retrogression of libido (sexual drive or instinct) at any stage of development sure enough results in psychopathology (Townsend, 2006) and fixation at any stage pass on also influence the behavior of person in later life (McLeod, 2008). As in side of my patient, she was divorced payable to which her sexual desires were repressed and unable to fulfill them. It results in fixation of sexual needs due to which her sexual needs are at extreme level that, she have intense feeling to have intercourse and have sexual thoughts, which may change into behavior at any time.On the otherwise hand, writings shows that some antipsychotic drugs induce sexual disinhibition which includes risperi by means of with(p) and quntipien (Lam et al, 2007). Risperidone side effect is that it increases sex drive and also decreases sexual function in some cases. virtually cases have been reported which shows the effect of risperidone in increasing the sexual obsession compulsive thoughts (Basil et al, 2002). So, my pa tient was also taking risperidone it may be one of the factor for having compulsive thought. Whereas, there is also literature support for medication that decreases sexual desires such as one of the late study evaluate that second generation antipsychotic i.e. risperidone, olanzapine, quntipien, and haloperidol is the biggest study to date to assess sexual dysfunction and reproductive side effects (Kelly Conley, 2004).Therefore, it is alpha to imply alternative medications to treat these symptoms. Whereas various late medicine studies and narrative case reports have indicated an adjunctive particular serotonin reuptake inhibitor (SSRI) may be a convincing medications to treat OC in schizophrenia. Patients getting clozapine and other atypical antipsychotics as their support medicine ought to be thoroughly screened for cutting onset or compounding of prior OC indications (Hwang et al, 2006).Although my patient had intense thoughts and desires to have intercourse, so with the pha rmacological management it is important to do cognitive therapy because patient only have thoughts, but her thoughts can be change into behavior. It is important to change her thoughts through cognitive therapy. There are different strategies through which inappropriate behavior of patient can be change and these are discussing below.Cognitive therapy helps dependent upon perception, and all the more particularly, the particular judgment valuation by a single person of an occasion, and the feelings or practices that come about because of that examination. Cognitive techniques include identifying and modifying repeated thoughts (thinking errors) and schemas interior values (Townsend, 2006).The goal of cognitive therapy is to change irrelevant beliefs, faulty way of thinking, and negative self- statements that cause behavioral problems (Stuart, 2013).Cognitive therapy focuses on controlling and reducing obsessive compulsive behaviors by behavioral strategies for managing symptoms, t houghts, beliefs and feelings are perused and examine for relevance and validity. Behavior modification strategy is dependent upon the precise examination and requisition of fortification. Support is the procedure by which new reactions are obtained and existing ones are fortified (Jessor, 2013).Moreover, motivational interventions can be done to develop patients motivation to change. By asking open-ended question can help to identify patient agenda. Affirming, reinforcing positive statements, and hopeful can emphasize that change is possible and it allow also increase the self esteem of patient which will help him and motivate to change (Stuart, 2013).Role modeling can be done to teach the behavior. Lifestyle change to help an idiosyncratic identify questioning situations, change cognitive distortions or faulty thinking, and cope with stressful or high-risk situations that may trigger relapse (Townsend, 2006)Furthermore, accommodate role is important in recognizing these issue s in mental health. As, in my patient scenario it was my lacking that I was unable to recognize patient needs correctly so as nurse it is important to asses patient needs rightly and to do interventions accordingly. For this nurse should be competent in communication skills, confident to talk on this sensitive topic. She should have complete knowledge about the topic, positive cost and effective communication style can greatly improve the interaction. An draw close that rises strengthening and self-governance ought to be utilized and the suitable health-advancement messages through consultation for individual client (Gott et al, 2004).All in all, prevalence of inappropriate behavior with schizophrenia is high therefore as nurse it is important to asses patient needs and play the role of counselor, advocator, and as a business organization giver in giving awareness to families about patient disease process. Family and health care support also helps patient to cope his situation. I n mental health it is important to modify the behavior of client according to needs through required techniques.