Info on Schizophrenia

Question 1

Mental status exam (MSE):

Answer 1

• Appearance, Motor Behavior and Speech - is client restless, unable to be calm, pacing, or catatonic? odd facial expressions of stereotypic behavior? echopraxia?, word salad? echolalia? latency of response?
• Mood & Affect - flat or blunted affect? experiencing anhedonia?
• Attitude - also known as rapport, refers to the patient’s approach to the interview process
• Thought process - quantity, tempo (rate of flow) and form (or logical coherence) of thought.
• Thought content - would describe a patient’s delusions, overvalued ideas, obsessions, phobias and preoccupations. Abnormalities of thought content are established by exploring individuals’ thoughts in an open-ended conversational manner with regard to their intensity, salience, the emotions associated with the thoughts, the extent to which the thoughts are experienced as one’s own and under one’s control, and the degree of belief or conviction associated with the thoughts
• Perceptions (Sensorium) - in this context is any sensory experience, and the three broad types of perceptual disturbance are hallucinations, pseudohallucinations and illusions; what types (if any) hallucinations…these involve bodily sensations and five sense but cannot be perceived by anyone but the experiencer; what types of illusions….these are stimulated by something outside experiencer
• Orientation
• Insight & Judgment - how impaired are these faculties?
• Memory

Question 2

Key Points on Schizophrenia

Answer 2

It’s a brain disorder that affects all aspects of a person’s functioning
Auditory hallucinations, delusions, disorganized thinking, and trouble communicating are evident
A passive, low key approach helps (not high EE)
Be simple, clear, non-critical, supportive

Question 3

Positive Symptoms

Answer 3

Hallucinations
Command hallucinations
Delusions (various types)
Ideas of reference
Loose associations and non-goal directed speech
Thought insertion, withdrawal, broadcasting
Word salad

Question 4

Negative Symptoms

Answer 4

Apathy
Social withdrawal
Flat, blunted, or bland affect
Anhedonia
Lack of volition

Question 5

Other Symptoms

Answer 5

Anxiety
Insomnia
Religious and sexual preoccupation
Circumstantial and tangential speech
Poor grooming, hygiene, appearance
Poor appetite
Poor judgment
Poor insight