Schizophrenia

Psychosis changes how a person interprets thoughts, perceptions, and external events. Schizophrenia is diagnosed from a sustained pattern of psychotic symptoms and functional change—not from one unusual statement, one hallucination, or a positive screening score. The RPN’s first task is to determine whether the person is safe and physiologically stable, then to describe the mental-status findings precisely enough to guide treatment. The examination picture usually combines positive symptoms such as delusions and hallucinations with negative symptoms such as reduced motivation or emotional expression, and cognitive changes affecting attention, memory, or executive function. An abrupt, fluctuating change in attention or consciousness requires a search for delirium, intoxication, withdrawal, or another medical cause before attributing the presentation to schizophrenia. Medication monitoring is equally concrete: antipsychotics can reduce psychosis but may produce metabolic, neurological, cardiovascular, and sedation-related harms.