Ch 15 Schizophrenia Flashcards
What is the biggest problem in treating schizophrenia?
Relapse
Clients won’t stay on meds due to side effects
4 risk factors for schizophrenia
genetic predisposition
biochemical influence
phsyiological factors
psychological factors
Biochemical risk factor for schizophrenia
there is an excessive amount of dopamine
Physiological risk factors for schizophrenia
Viral infections (usually in utero) anatomical abnormalities
Psycho-social risk factors for schizophrenia
poverty/stress can intensify or speed up onset of schizophrenia
Positive symptoms of schizophrenia
anything that adds to their behavior hallucinations delusions alteration is speech bizarre behavior
Negative sx of schizophrenia
flat affect alogia (sparse speech) anhedonia (inability to have fun) avolition (no motivation) anergia (no energy)
Cognitive sx of schizophrenia
disordered thinking inability to make decisions poor problem solving ability difficulty concentrating memory deficits (hippocampus is affected)
Sx treated by traditional/typical antipsychotics
positive sx only
Sx treated by atypical antipsychotics
positive and negative sx
also treat cognitive sx and help a person’s thinking become more ordered
Reason to switch from typical to atypical med
EPS
First line of treatment for NMS
dantrium
Age of onset of schizophrenia
earlier in men (around 20) than women (around 30)
possibly due to women’s hormones
4 phases of schizophrenia
premorbid
prodromal
active
residual
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Social maladjustment Antagonistic thoughts and behavior Shy and withdrawn Poor peer relationships Doing poorly in school Antisocial behavior
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
