Chapter 15 - Schizophrenia Flashcards
define schizophrenia
Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. It is characterized by a combination of symptoms including hallucinations (seeing or hearing things that aren’t there), delusions (false beliefs not based on reality), disorganized thinking and speech, reduced expression of emotions, and difficulty concentrating. These symptoms often impair daily functioning and can be distressing for the individual experiencing them.
Schizophrenia typically emerges in late adolescence or early adulthood, although it can develop at any age. The exact cause of schizophrenia is not fully understood, but it is believed to involve a combination of genetic, brain chemistry, and environmental factors. Treatment usually involves a combination of antipsychotic medications, psychotherapy, and support services to help manage symptoms and improve quality of life. Early intervention and ongoing support are crucial for managing the condition effectively.
simply put schizophrenia is
devastating brain disease affecting thinking, language, emotions, social behavior, and reality perception
at what age does the usual onset of schizophrenia start
s/s generally appear i late adolescence or early adulthood, although they may occur in middle or late adult life
early onset schizophrenia is when s/s appear before age 18
the lifetime prevalence of schizo is about ____% of the general population
1%
comorbidities schizo
substance abuse
anxiety
depression
cognitive impairments
schizo causes disturbances in
thought processes
perception
affect
phases of schizo:
phase 1 - the premorbid phase
s/s occur before there is clear evidence of illness and may include distinctive personality traits or behaviors.
noted; very shy, withdrawn, no friends, antisocial
phase 2: the prodromal phase
more clearly manifested signs of developing illness of schizo.
onset of frank psychotic symptoms, ranges from 2 to 5 years
the person begins to show signs of significant deterioration in function.
depressive symptoms, social w/d, cognitive impairment, OCD.
phase 3: active psychotic phase
acute episodes in which s/s more pronounced.
psychotic symptoms are prominent
Phase 4: residual phase
schizo is characterized by periods of remission and exacerbation.
symptoms of the acute stage are either absent r no longer prominent.
positive symptoms (dellusions, hallucionations) are often alleviated but negative symptoms may remain
flat affect and role impairment are common
DSM-V criteria for schizo
includes 2 or more of each for a significant portion of time during a 1 month period
- delusions
2.hallucinations - disorganized speech
- catatonic behavior
- negative symptoms
what is the prognosis for schizo
difficult to predict and are highly variable.
a more positive outcome comes from:
good premorbid functioning
later age at onset
female
abrupt onset of symp w/ obvious predicting factor
rapid treatment of symptoms
absence of brain abnormalities
normal neurological functioning
and no family hx of schizo
predisposing factors:
genetic
biochemical
increased risk with parent w/ schizo
biochemical r/t pathogenic role of “chemical imbalance” as an explanation of insanity
the dopamine hypothesis
this theory suggests that schizo may be caused by an excess of dopamine-dependent neuronal activity in the brain
a number of neurotransmitters have been implicated in the etiology of schizophrenia
can you name a few?
acetylcholine,dopamine, serotonin, norepinephrine, glutamate, and GABA
physiological factors:
A number of physical factors of possible etiological significance have been identified. However their specific actions are unclear
viral infection:
data indicates a high incidence of shcizo after prenatal exposure to
influenza
Anatomical abnormalities:
structural brain abnormalities have been observed in individuals with schizo - _________enlargemnt is the most consistent finding; however some reductions in ___________matter are also reported
ventricular enlargement, gray matter
long term studies of patients with schizo have noted brain volume _______, particularly in the temporal and preventricular areas
reduction
name some 2nd generation antipychotics
clozpine, quetiapine, ariprizole, risperidone,
psychological predisposing factors
childhood trauma, particullary multiple ones, are associated with development of schizo
sociocultural predisposing factors
greater numbers of patients with schizo come from a lower socioeconomic class
what is the downward drift hypothesis
suggests that because of the characteristic symptoms of the diorder, person has difficulty maintaining gainful employement and “drift down” to lower socioeco level
what is catatonia
significant motor disturbance that may range from stupor to excessive motor activity and agitation
what is delusional disorder
presence of delusions that have been experienced for at least 1 month.
hallucinations if present at all are not prominent and behavior is not bizarre
a persistent false psychotic belief regarding the self or persons or objects outside the self that is maintained despite indisputable evidence to the contrary
brief psychotic disorder
sudden onset of psychotic symptoms that may or may not have been preceded by a severe psychosocial stressor
lasts at least 1 day but less than 1 month
there is an eventual full return to the pemorbid level of functioning
schizophreniform disorder
identical to schizophrenia with the exception that the duration, including prodromal, active, and residual phases, is at least 1 month but less than 6 months
the diagnosis is changed to schizophrenia if the clinical picture persists beyond 6 months
schizoaffective disorder
manifested by s/s of schizophrenia, along with a strong element of symptomatology associated with mood disorders (depression or mania)
general medical conditions that may vause psychotic symptoms
CNS trauma, meningitis, migraines, renal disease, vitamin deficiency
what is the definition of a positive symptom r/t schizophrenia
Positive Symptoms:
Positive symptoms involve the presence of abnormal experiences or behaviors that are not typically seen in healthy individuals.
These symptoms add something to a person’s mental state or behavior that is not usually present.
Examples include hallucinations (seeing, hearing, or feeling things that are not real), delusions (false beliefs that are not based on reality), disorganized thinking, and abnormal motor behaviors.
Positive symptoms are often more responsive to treatment with antipsychotic medications.
hallucinations, delusions
what is a negative symptom r/t schizophrenia
Negative Symptoms:
Negative symptoms involve the absence or reduction of normal experiences or behaviors that are typically present in healthy individuals.
These symptoms represent a loss or reduction in normal functioning or behavior.
Examples include flat affect (reduced emotional expression), avolition (lack of motivation or interest in activities), alogia (reduced speech output), anhedonia (inability to experience pleasure), and social withdrawal.
Negative symptoms are often more difficult to treat and may persist even with treatment.
flat affect, social withdrawal, lack of motivaiton
Disturbances in thought content:
delusions are fixed false beliefs that are irrational and that the individual maintains is true despite evidence to the contrary
what is persecutory delusions
most common, individual believes they are being persecuted or malevolently treated in some way.
“the fbi has bugged my room!”
these also may be called paranoid delusions
“i wont eat this food its poisoned!”
grandiose delusions
exaggerated feeling of importance, power, knowledge, or identiy
“i am jesus christ!”
delusions of reference
events within the environment are referred by the psychotic person to himself
“someone is trying to get a message to me through teh magazine articles - i have to break the code!”
delusions of control or influence
the individual believes they have control over certain objects or persons have control of them or vice versa
“its raining because im sad”
somatic delusions
false idea of functioning of their body
“the doctor says im not pregnant but i know that i am”
nihilistic delusion
believes that self, others, or the world doesnt exist
eromanic delusions
false belie that someone ususally of a higher status is in love with them
disturbance in thought processes manifested in speech:
loose associations
speech in which ideas shift from one topic to the next with no relation
“Im late for the bus. my cat is orange. im hungry”
neologisms
person invents new words that are meaningless to others but have meaning to the individual
clang associations
choice of words goverened by sound. “ its cold, im bold, that is sold”
circumstantiality
delays in reaching the point of communication because of unneccary pointless details
what is avolition
inability to initiate goal directed activity
anosognosia
the lack of awareness of there being any illness or disorder even when symptoms appear obvious to others
anhedonia
inability to experience pleasure
waxy flexibility
