Ch 15 Schizophrenia Flashcards by Sarah Blevins

What is the biggest problem in treating schizophrenia?

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Clients won’t stay on meds due to side effects

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4 risk factors for schizophrenia

genetic predisposition
biochemical influence
phsyiological factors
psychological factors

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Biochemical risk factor for schizophrenia

there is an excessive amount of dopamine

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Physiological risk factors for schizophrenia

Viral infections (usually in utero)
anatomical abnormalities

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Psycho-social risk factors for schizophrenia

poverty/stress can intensify or speed up onset of schizophrenia

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Positive symptoms of schizophrenia

anything that adds to their behavior
hallucinations
delusions
alteration is speech
bizarre behavior

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Negative sx of schizophrenia

flat affect
alogia (sparse speech)
anhedonia (inability to have fun)
avolition (no motivation)
anergia (no energy)

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Cognitive sx of schizophrenia

disordered thinking
inability to make decisions
poor problem solving ability
difficulty concentrating 
memory deficits (hippocampus is affected)

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Sx treated by traditional/typical antipsychotics

positive sx only

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Sx treated by atypical antipsychotics

positive and negative sx

also treat cognitive sx and help a person’s thinking become more ordered

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Reason to switch from typical to atypical med

EPS

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First line of treatment for NMS

dantrium

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Age of onset of schizophrenia

earlier in men (around 20) than women (around 30)

possibly due to women’s hormones

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4 phases of schizophrenia

premorbid
prodromal
active
residual

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signs seen in premorbid phase of schizophrenia

Social maladjustment
Antagonistic thoughts and behavior
Shy and withdrawn
Poor peer relationships
Doing poorly in school
Antisocial behavior

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Phase II: Prodromal phase

can last weeks to years

Deterioration in functioning

Symptoms seen in the prodromal phase

sleep disturbance, anxiety, irritability
depressed mood, poor concentration fatigue
Abnormalities in perception

Active phase of Schizophrenia

delusions
hallucinations
impaired functioning

Residual phase

sx similar to prodromal phase (depression, anxiety, sleep disturbance, irritability)
also flat affect

Schizophrenia prognosis

a return to premorbid functioning is not common

Factors associated with a good prognosis **

good premorbid function
later age of onset
female
abrupt onset
brief active phase
no structural brain abnormalities
no family hx of schizophrenia
family hx of mood disorder/associated mood disturbance

Downward drift hypothesis

poor social conditions are seen as a consequence of rather than a cause of schizophrenia

Delusional disorder

has the existance of prominent, non-bizarre delusions

Types of delusional disorders

Erotomanic (thinks people are in love with them)
Grandiose (thinks they are god)
Jealous type
Persecutory type
Somatic (they overplay physical sx)

Brief psychotic disorder

sudden onset of sx may be preceded by stress last < 1 month return to normal functioning

The Catatonic Features Specifier

may be associated with other psychotic disorders, such as brief psychotic disorder, schizophreniform disorder, schizophrenia, schizoaffective disorder, and substance-induced psychotic disorder

Catatonic disorder sx

Stupor and muscle rigidity or excessive, purposeless motor activity Waxy flexibility, negativism, echolalia, echopraxia (copying how someone else moves)

Schizophreniform Disorder

Same symptoms as schizophrenia with the exception that the duration of the disorder has been at least 1 month but less than 6 months

Schizoaffective Disorder

Schizophrenic symptoms accompanied by a strong element of symptomatology associated with the mood disorders, either mania or depression They are usually highly suicidal

Category of medications to treat positive sx

traditional/typical antipsychotics

Individual psychotherapy as tx for schizophrenia

long term therapeutic approach | difficult because clients have problems with interpersonal functioning

Group therapy as tx for schizophrenia

some success when used long term

behavior therapy as tx for schizophrenia

not a good option | inability to generalize to the community after discharge

skills therapy training as tx for schizophrenia

aimed at improving relationship development | use of role play to teach appropriate behavior

Social treatments

``` milieu therapy (best combined with psychopharmacology) Family therapy ```

Program of Assertive Community Treatment (PACT)

case management using a team approach for comprehensive, community-based psychiatric treatment, rehabilitation, and support