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The article An Assessment of Five (PANSS, SAPS, SANS, NSA-16, CGI-SCH) commonly used Symptoms Rating Scales in Schizophrenia and Comparison to Newer Scales (CAINS, BNSS) by Suneeta Kumari and Mansoor Malik was published in the Journal of Addiction Research and Therapy on 11th May 2017. The authors are psychiatrists who work at Howard University Hospitals Department of Psychiatry and Behavioral Sciences (Kumari & Malik, 2017). The objective of this essay is to analyze and review scales used in the diagnosis of schizophrenia by relating the article to the movie A Beautiful Mind which is based on the real-life story of John Nash, a mathematics professor who was suffering from Schizophrenia (Howard, 2001). The movie A Beautiful Mind stars John Nash, a mathematics genius who suffers from Schizophrenia but can beat all odds and go on to win the Nobel Peace Prize.
At Princeton University, John Nash excels well in mathematics. He proceeds on to graduate school, where he excels and starts to teach. While teaching at Princeton University, he gets married to one of his students, Alicia. Due to his mathematical abilities, the United States Department of Defense hired him to break some codes. While working at the Department of Defense, he starts to develop hallucinations and starts to run away, saying he is being chased by the Soviets. His condition worsens, and while at home, he tells Alicia, his wife, that Charles, their friend, wants to kill their son. He leaves their son in the bathroom, but luckily Alicia saves him and calls emergency medical services. Nash is taken to a psychiatric hospital, where he takes antipsychotic drugs. Initially, he suffers from side effects, but his condition improves, and he resumes teaching and eventually wins the Noble Peace in Economics due to his astonishing work on game theory.
In the movie, Nash suffers from hallucinations. At the Department of Defense, he runs away while writing a report on the Soviet Codes when he starts to hallucinate that the Russians are chasing him. Later at Harvard University, Nash starts to hallucinate that hostile people are watching him while he is giving a lecture and tries to run away. He is sedated and rushed to a psychiatric hospital. In the movie, Nash appears worried and is always hearing voices in his head. While at home, Nash manifests negative symptoms such as avolition when he leaves their son in the bathtub after claiming that his friend Charles wants to kill him. According to Kumari and Malik (2017), the DSM5 for diagnosing Schizophrenia is the Scale for the Assessment of Negative Symptoms (SANS) and the Scale for the Assessment of Positive Symptoms (SAPS), which measure the positive symptoms and negative symptoms such as hallucinations and avolition respectively (Kumari & Malik, 2017). Based on the SANS and SAPS tests, Nash is suffering from Schizophrenia which manifests itself in the form of the positive symptom hallucination and the negative symptom avolition.
The purpose of the article is to show the effectiveness of different diagnostic tests for schizophrenia. According to Kumari and Malik (2017), the objective of their article is to assess the effectiveness of the Scale for the Assessment of Positive Symptoms (SAPS), the Negative Symptom Assessment (NSA-16), the Clinical Global Impression Schizophrenia (CGI-SH), and the Scale for Assessment of Negative Symptoms (SANS) and compare them with newer diagnostic tests, the Brief Negative Symptom Scale (BNSS) and the Clinical Assessment Interview for Negative Symptoms (CAINS) (Kumari & Malik, 2017). This will help to improve the diagnosis of Schizophrenia and increase positive outcomes through early detection, accurate diagnosis, and the right treatment intervention.
The results of the study show that CAINS and BNSS are better diagnostic tools for Schizophrenia compared to SANS, CGI-SH, NSA-16, and SAPS. The results show that CAINS and BNSS are effective in developing and evaluating negative symptoms, which provides a more accurate diagnosis of Schizophrenia than evaluating the positive symptoms. The main reason is that negative symptoms help to show the extent of structural and chemical changes within the brain.
The study is important for understanding John Nashs condition since it would have helped to provide an accurate diagnosis and early detection. In the movie, the psychiatric hospitals tested his positive symptoms since they used SANS and SAPS tests. These two tests are not as effective as CAINS or BNSS because they evaluate positive symptoms. The study by Kumari and Malik (2017) showed that the use of CAINS and BNSS is better since they provide an accurate diagnosis of Schizophrenia by evaluating negative symptoms such as avolition which helps to show the extent of structural and chemical changes within the brain of the patient (Kumari & Malik, 2017). The study is important because it will help to increase the number of positive outcomes among Schizophrenic patients by ensuring accurate diagnosis and administration of the right treatment intervention.
When relating the study conducted by Kumari and Malik (2017) to John Nash and his schizophrenic episodes, it should be noted that the biggest indicator that can be met in both the article and the movie is the presence of grand delusions. The latter interferes with the clients life and ultimately leads them to develop an unhealthily exaggerated sense of knowledge and significance. In A Beautiful Mind, John Nash believed he was superior to his surroundings, claiming that the work of one of his classmates was unoriginal and that he would create something inventive instead (Howard, 2001). With the help of the study carried out by Kumari and Malik (2017), one could also get a better view of the early onset of schizophrenic symptoms in John Nash. In his thirties, the client finally met with the display of schizophrenia face to face.
Numerous parallels can be drawn between the article written by Kumari and Malik (2017) and the fictional character of John Nash. It is valid to state that schizophrenia remains one of the main reasons why people suffer from a significant decrease in their quality of life and even have trouble differentiating real-life events from certain fiction (Howard, 2001). The best way to describe the impact of Kumari and Maliks (2017) study on my view of John Nash is to reference their portrayal of delusions that set constant traps for the affected persons consciousness. A perfect example of this in the movie is when John sees the alleged soviet spies who capture him, but then he finds himself in a psychiatric hospital. The advancing nature of a schizophrenics delusions is going to make it harder for people around them to take adequate care of them.
The study on nursing practice implies that nurses will be able to provide better treatment interventions and accurate diagnoses of schizophrenia by using CAINS and BNSS tests. The study will have positive implications for my future nursing practice since I intend to become a mental health nurse. In graduate school, I will conduct more research on how to improve the current BNSS and CAINS tests to ensure that nurses can provide quality care to their patients. I believe that nurses can increase the number of positive outcomes by coming up with better scales that will assess both negative and positive manifestations of schizophrenia in a simpler and user-friendly manner.
References
Howard, R. (2001). A Beautiful Mind [Film] IMDb: Movies & TV Shows. Web.
Kumari, S., & Malik, M. (2017). An assessment of five (PANSS, SAPS, SANS, NSA-16, CGI-SCH) commonly used symptoms rating scales in schizophrenia and comparison to newer scales (CAINS, BNSS). Journal of Addiction Research & Therapy, 8(324). Web.
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