A client with schizophrenia is prescribed risperidone. Which outcome would indicate the medication is having the desired effect?

Choice A reason: While trauma can coexist with many mental health issues, post-traumatic stress disorder (PTSD) is not the most specifically linked comorbidity for OCD in general clinical screening. PTSD involves a distinct pathology related to trauma exposure, whereas OCD centers on an internal cycle of intrusive thoughts and neutralizing ritualistic behaviors.

Choice B reason: Agoraphobia involves an intense fear of environments where escape might be difficult, often linked to panic disorder. While an OCD patient might avoid certain places due to contamination fears, agoraphobia is a distinct anxiety disorder and is not the primary comorbid condition typically anticipated for an OCD diagnosis.

Choice C reason: Research indicates a high rate of comorbidity between obsessive-compulsive disorder and eating disorders, particularly anorexia nervosa. Both conditions share underlying personality traits such as perfectionism, rigidity, and the use of ritualistic behaviors to manage intense anxiety, making this a common finding when reviewing the medical records of these clients.

Choice D reason: Delusional disorder involves fixed false beliefs without the other symptoms of schizophrenia. Although severe OCD can sometimes involve poor insight bordering on delusional thinking, it is categorized separately. Most OCD patients retain some level of awareness that their obsessions are irrational, which distinguishes the condition from a primary delusional disorder.

Choice A reason: Deinstitutionalization was specifically designed to move away from large, state-run psychiatric hospitals. Therefore, it decreased rather than increased institutional-based care. The goal was to integrate patients back into society and provide treatment in less restrictive environments rather than keeping them confined in long-term, isolated medical facilities.

Choice B reason: While deinstitutionalization aimed to normalize mental illness, it unfortunately did not lead to the eradication of stigma. In many cases, the visibility of untreated mental illness in the community due to inadequate support systems actually exacerbated public misconceptions and social stigma rather than eliminating these complex societal prejudices.

Choice C reason: The primary objective of the deinstitutionalization movement, which gained momentum in the 20th century, was to transition care from large asylums to community-based settings. This involved the creation of community mental health centers, halfway houses, and outpatient clinics to allow individuals to live more independently while receiving necessary psychiatric support.

Choice D reason: Although the development of chlorpromazine and other antipsychotics facilitated deinstitutionalization by making symptoms more manageable, the movement itself was a structural change in delivery methods. It emphasized holistic and social integration rather than focusing purely on pharmacological interventions as the sole method of mental health care delivery.