Purpose: Analyze and apply critical thinking skills in the psychopathology of mental health patients and provide treatment and health promotion while applying evidence-based research.
Scenario: A 44-year-old white Australian man who was not religious was referred to outpatient psychiatric treatment. He had been playing with an Ouija board for two months when he started to believe that a spirit had entered his body through his rectum and was controlling him. He thought the spirit made him move and speak in a certain way.
He sought help from a local church, where he was told it was a psychiatric problem and that he was not really possessed. Two exorcisms at a local church failed to achieve any improvement.
Questions: Remember to answer these questions from your textbooks and NP guidelines. At all times, explain your answers.
- Discuss the relationship between mental illness and religion.
- Is this classified as psychopathology? Support your response using DSM5 criteria.
Full Answer Section
- Religious Coping Mechanisms: Religion can play a positive role in mental health, providing support, meaning, and purpose. Rituals and prayer can offer coping mechanisms and improve well-being for individuals and communities.
- Misattribution and Delusions: However, in some cases, religious beliefs may contribute to or be misinterpreted as symptoms of mental illness. For example, delusions of religious persecution or possession could be linked to conditions like schizophrenia or schizoaffective disorder.
Therefore, it's crucial to avoid cultural bias and assess each case individually without invalidating or dismissing valid religious beliefs. A collaborative approach involving mental health professionals and religious leaders familiar with mental health issues can be beneficial.
Question 2: Classification as Psychopathology - DSM-5 Criteria
Based on the information provided, it's difficult to definitively diagnose the man's condition without a complete clinical evaluation. However, several clues suggest the possibility of psychopathology:
- Unusual beliefs: The belief in spirit possession through the rectum is not a typical or widely held belief in any major religion.
- Functional impairment: The man's experience is causing him distress and impacting his daily life, suggesting potential functional impairment.
- Unsuccessful religious interventions: The failure of exorcisms to alleviate the symptoms further suggests a need for medical or psychological intervention.
While the DSM-5 does not have a specific diagnosis for "spirit possession", the man's experience could be considered under several diagnoses based on the presented symptoms:
- Delusional Disorder: The fixed, false belief about spirit possession could be classified as a delusion, potentially indicating Delusional Disorder.
- Schizophrenia or Schizoaffective Disorder: If the man experiences additional symptoms like hallucinations, disorganized thinking, or altered behavior, a diagnosis of Schizophrenia or Schizoaffective Disorder might be considered.
- Other Psychotic Disorders: Depending on the specific presentation of symptoms, other diagnoses like Psychotic Disorder Not Otherwise Specified (PDNOS) could also be explored.
It's important to note that these are just possible diagnoses based on limited information. A thorough clinical evaluation by a qualified mental health professional is essential for arriving at an accurate diagnosis and developing an appropriate treatment plan.
Critical Thinking & Evidence-Based Practices:
This case highlights the importance of critical thinking in psychopathology. Healthcare professionals must:
- Consider cultural and religious contexts.
- Avoid relying solely on self-reported symptoms.
- Utilize standardized diagnostic tools like the DSM-5.
- Base treatment recommendations on evidence-based practices.
In this case, further assessment and a possible referral to a psychiatrist specializing in psychosis could be crucial in determining the most effective treatment approach. This might involve medication, psychotherapy, or a combination of both.