chapter 15: schizophrenia spectrum and other psychotic disorders

Question 1

schizophrenia

Answer 1

• illness identified by Eugene Bleuler
• schizophrenia means “split mind” (NOT MPD)
• there is a “split” between a pt’s thoughts and feelings; between person’s reality and society’s reality
• psychotic thought disorder where hallucinations and delusions dominate patient’s thinking
• very serious, debilitat8ing, lifelong psychiatric disorder
• seems to strike people between ages 16-35 most frequently; first psychotic break rarely after 40
• viewed on a gradient of psychopathology from least to most severe (spectrum disorder)

Question 2

other types of psychotic disorders

Answer 2

• delusional
• schizoaffective
• schizophreniform
• psychotic depression or mania
• substance or medication induced psychotic disorder
• postpartum psychosis

Question 3

“insidious” onset

Answer 3

• school grades lower
• quietness
• withdrawal
• “just a stage”
• change in personality
• change in way person relates to others

Question 4

common symptoms

Answer 4

• delusions
• hallucinations
• illusions
• echolalia
• echopraxia
• catatonia

Question 5

delusions

Answer 5

fixed, false belefs that cannot be changed w/ logic

Question 6

hallucinations

Answer 6

false sensory perceptions
- can affect all five senses

Question 7

illusions

Answer 7

mistaken perceptions of reality

Question 8

echolalia

Answer 8

repetition of words

Question 9

echopraxia

Answer 9

repeating actions of others

Question 10

catatonia

Answer 10

impaired motor activity including stupor

Question 11

positive symptoms

Answer 11

• those that are found among people w/ schizophrenia but not present among those who do not have the disorder
• examples include delusions, thought disorders, hallucinations

Question 12

negative symptoms

Answer 12

• those found among people who do not have the disorder but are missing or lacking among individuals w/ schizophrenia and reflect a lessening or loss of normal functions
• examples include lack of desire to form social relationships, inappropriate social behavios (pacing, rocking)

Question 13

causes

Answer 13

• now it is known to be a brain disorder
• theories inculde disruption of neurotransmitters and/or neuron functioning, cortical abnormalities
• genetic predisposition
• family dysfunction is no longer believed to be primary cause

Question 14

medical treatment

Answer 14

• medications
• psychotherapy
• electroconvulsive therapy
• supportive milieu
• ongoing support and education to learn to live w/ the disease and comply w/ medication regimen

Question 15

types of medications

Answer 15

antipsychotics
anticholinergics (to counteract extrapyramidal symptoms)

Question 16

antipsychotics

Answer 16

• these medications ae the main focus of treatment
• patient may need to be on these for the rest of their life
• side effects management of these meds is key part of treatment
• EPS are common w/ many of these drugs

Question 17

Nursing interventions

Answer 17

• NEVER reinforce hallucinations, delusioins, or illusions
• one of the few times when it is acceptable to change the subject in communications
• NEVER whisper or laugh when the patient is not aware of the whole conversation
• keep patient out of competitive or embarrassing situations
• develop trust
• maintain calm, structured milieu
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