Share This Link

"I'm going to ignore your lack of self-care because it is an aspect of the disorder." Ignoring the client’s hygiene neglect does not support their well-being or promote self-care. While poor self-care is a symptom of schizophrenia, the nurse should encourage hygiene rather than dismiss it.

"Do you really think it is ok not to bathe? What is going on with you?" This confrontational statement may make the client feel judged or defensive, potentially worsening their resistance to self-care. Clients with schizophrenia may have impaired insight and motivation, making supportive guidance more effective.

"This is it! You are getting a bath! There are three of us here to bathe you!" Using forceful or coercive language can cause distress and escalate resistance. Encouraging hygiene should be done through therapeutic communication and gentle prompts rather than threats or intimidation.

Illness anxiety disorder. This condition, previously known as hypochondriasis, involves excessive worry about having a serious illness despite minimal or no symptoms. Unlike factitious disorder, clients do not intentionally cause harm to themselves but rather misinterpret normal bodily sensations as signs of severe disease.

Functional neurological symptom disorder. Formerly called conversion disorder, this condition involves neurological symptoms, such as paralysis or seizures, that cannot be explained by medical findings. The symptoms are involuntary and not intentionally produced, unlike in factitious disorder.

Dissociative amnesia. Dissociative amnesia is characterized by sudden memory loss due to psychological stress or trauma, often affecting personal information or life events. It does not involve self-inflicted injuries or deliberate symptom fabrication, making it unrelated to this scenario.

"I don't eat because I do not like the taste of food." Clients with anorexia nervosa typically avoid food due to intense fears of weight gain and body image concerns rather than a dislike for taste. Their restrictive eating is driven by psychological distress rather than a simple aversion to flavor.

"I restrict myself to 2,000 calories per day." Individuals with anorexia nervosa usually consume significantly fewer calories than recommended daily amounts. A restriction of 2,000 calories per day is within normal dietary guidelines and does not reflect the extreme caloric limitation seen in this disorder.

"I don't bother to track the number of calories I eat in a week." Individuals with anorexia nervosa are typically obsessive about tracking their calorie intake, often meticulously counting every calorie consumed. This level of control is a defining characteristic of the disorder.

Encourage the client to use relaxation techniques. While relaxation techniques can help manage symptoms in somatic symptom disorder, they should not be the first response to a new symptom like chest pain. The nurse must first rule out a medical cause before assuming the pain is psychological.

Reassure the client that pain is an expected part of their disorder. Assuming that the pain is purely psychosomatic without assessing for a potential medical emergency could lead to a delay in necessary treatment. Each new symptom should be evaluated independently.

Explain to the client that the pain is not real. The pain experienced by clients with somatic symptom disorder is real to them, even if a physical cause is not found. Dismissing their symptoms can damage trust and discourage them from reporting future concerns.

Dissociative amnesia. This condition involves memory loss of personal information or past events due to psychological stress or trauma. It does not cause physical symptoms like numbness or an inability to grip the steering wheel.

Depersonalization/derealization disorder. This disorder causes feelings of detachment from oneself (depersonalization) or the environment (derealization). While distressing, it does not typically result in sensory or motor deficits such as hand numbness.

Factitious disorder. Factitious disorder involves deliberately fabricating or inducing symptoms to assume the sick role. In this case, the client is describing involuntary symptoms that appear to have a psychological basis rather than being intentionally produced.

Employment assistance. While employment support is valuable for clients with schizophrenia, housing stability should be prioritized first. A client without a place to live may struggle to maintain a job, making housing support the more immediate concern.

Psychiatrist. A psychiatrist plays a crucial role in managing schizophrenia through medication and therapy. However, the client’s immediate need is housing, which falls outside the psychiatrist’s primary role and is better addressed by a social worker.

Spiritual advisor. While spiritual guidance may provide emotional support, it does not directly address the client’s urgent need for housing. The primary intervention should focus on securing a safe and stable place to live.

Somatic symptom disorder. This disorder involves excessive concern over physical symptoms that are actually present, even if they are mild. In contrast, illness anxiety disorder is characterized by intense fear of having a serious illness despite the absence of significant physical symptoms.

Factitious disorder. Factitious disorder involves deliberately fabricating or inducing symptoms to assume the sick role. In illness anxiety disorder, the client genuinely believes they are ill but does not intentionally create symptoms.

Functional neurological symptom disorder. This condition, previously called conversion disorder, involves neurological symptoms (e.g., paralysis, blindness) that cannot be explained by medical findings. Unlike illness anxiety disorder, these symptoms are involuntary and not focused on a fear of disease.

Schizophrenia. Schizophrenia is a severe psychiatric disorder characterized by delusions, hallucinations, and disorganized thinking. While somatic symptom disorder (SSD) involves excessive focus on physical symptoms, it is not commonly linked to schizophrenia, which primarily affects perception and cognition.

Borderline personality disorder. While borderline personality disorder (BPD) is associated with emotional dysregulation and unstable relationships, it is not the most common comorbidity of SSD. BPD can co-occur with SSD, but depression and anxiety disorders are more frequently seen.

Bipolar disorder. Bipolar disorder involves mood fluctuations between mania and depression, whereas SSD is primarily characterized by excessive health-related concerns. While both conditions can co-exist, depression is more commonly associated with SSD.