1: Schizophrenia Flashcards
incidence of schizophrenia
1% worldwide
onset of schizophrenia
typically early in life: 15-25 y/o
- during critical years of school, academic, and vocational development
- Sx can hinder a person’s ability to meet their own goals
which parts of the mental status exam are grossly abnormal in schizophrenia?
- thought process/form
- thought content
psychotic or positive Sx
- hallucinations (disturbed perceptions)
- delusions (disturbed thought content)
- disorganization (disturbed thought formation)
negative Sx
- restricted or inappropriate affect
- avolition (lack of motivation)
- alogia (paucity of speech)
- inability to start and follow through with activities
- lack of pleasure or interest in life
cognitive impairement Sx
- difficulty prioritizing tasks or organizing thoughts
- lack of insight (anosognosia)
- problems with information processing and verbal memory
schizophrenia diagnosis criteria
- two or more of the following for a significant portion of one month:
- delusions (fixed false beliefs)
- hallucinations (usually auditory)
- disorganized speech (tangential, incoherent, derailment)
- grossly disorganized or catatonic behavior (agitation, posturing)
- negative Sx (affective flattening, avolition, alogia) - interpersonal or psychosocial dysfunction present
- continues signs of illness for at least 6 months with at least 1 month of active criterion A sx
- not due to another mental illness
- not due to substances or general medical condition
mental status abnormalities in attitude
- suspicious
- resistive
- negativistic
- guarded
- hostile
mental status abnormalities in appearance
- disheveled
- unkempt
- unshaven
- no makeup
- malodorous
- mismatched and/or dirty clothing
- impaired temp response
- clothes inappropriate for weather
mental status abnormalities in behavior
- awkward
- decreased arm swing while walking
- stereotypical movements
- poor eye contact
- decreased rate of speech
- Parkinsonian gait and/or tremors (often med side effect)
mental status abnormalities in mood and affect
- subjective: depressed, poorly described
- objective: FLAT, irritable, angry, hostile
mental status abnormalities in thought processes **
- loose associations
- disorganized
- tangential
- non-sequential
- decreased spontaneity
- unable to reach conversational goals
- poverty of thought
- thought blocking
- alogia (paucity of speech)
- neologisms
- word salad
- clang associations (putting together words based on alliteration or rhyming rather than meaning)
mental status abnormalities in thought content **
- distortions of reality
- psychotic
- grandiose
- paranoid delusions
- delusions of thought broadcasting
- thought insertion or thought control
- ideas of reference from the TV or radio
- bizarre delusions
- auditory hallucinations (often complex)
mental status abnormalities in insight
-diminished capacity to understand that they are experiencing Sx of an illness and therefore need ongoing Tx
mental status abnormalities in judgment
-often poor as evidenced by lack of relationships, employment, inability to provide for basic needs of food and/or shelter
