Lecture 4- Schizophrenia Flashcards
What is Schizophrenia?
A disabling psychological disorder that causes disturbances in thought processes, perception, and affect.
When do symptoms of Schizophrenia become apparent?
Late adolescence or early adulthood
What are the four phases of Schizophrenia?
Premorbid, Prodromal, Schizophrenia, and Residual
Premorbid Phase
Before clear evidence of illness begins, can go unnoticed
Prodromal Phase
Symptoms clearly manifest as signs of developing schizophrenia.
Symptoms of deterioration show along with social withdrawal and cognitive impairment
Brief (A few weeks or months, up to 5 years)
Schizophrenia Phase
Chronic illness characterized by acute episodes in which the symptoms are more pronounced. Notable psychotic symptoms
Residual Phase
Periods of remission and exacerbation following the active phase where symptoms are absent or no longer prominent
Positive symptoms may improve but negative symptoms may remain
Using substances with their meds can cause exacerbations.
Co-morbidity in Schizophrenia
Substance abuse
Nicotene dependence
Depressive symptoms
High percentage of anxiety disorders
Polydypsia
Co-morbidity 1
Substance abuse
In 40-50% of patients
A lot of them self-medicate
May be their way to socialize, out of boredum, or because they’re not connected to a community for support
Comorbidity 2
Nicotene dependence
In 80-90% of patients
Smoking is said to decrease hallucinations (esp. auditory)
Comorbidity 3
Depressive symptoms
Very common
10% of patients who try to commit suicide succeed
Comorbidity 4
Polydypsia
Increased thirst related to: Delutional thoughts
Changes in secretion of ADH
Abnormalities in the hypothalmic region
Patients who have this can throw off their electrolytes and cause cardiac issues!!
Schizophrenia symptoms can be caused by
Genetics
Excessive dopamine
Stress
Substances (bath salts, marijuana laced with formaldehyde)
Someone in a manic state
Symptoms of Schizophrenia
Affect
Associative looseness
Autism
Ambivalence
Symptom
Affect
Flat affect
Blunted affect
Inappropriate affect
Visual manifestations associated with feelings or emotional tone
Our affect is not always congruent with our emotions in this disorder
Flat affect
Not a lot of expression
Blunted affect
Where you see some expressions but its less than what you would expect
Inappropriate affect
Talk about something sad and laugh
Symptom
Associative looseness
Half-hazard confused thinking that comes out as a logical speech
No connection
Symptom
Autism
They are not bound to reality with a private perceptual world (hallucinations, delusions, neologisms)
Symptom
Ambivalence
Difficulty making decisions
Difficulty with opposing emotions or attitudes with things
Difficulty realizing someone has different emotions and merging two things together to get overall picture
DSM-V diagnostic criteria
2 or more of the following and each are present for a significant of time for 1 month:
1. Delusions, hallucinations, disorganized speech, grossly disorganized of catatonic behavior, negative symptoms
2. Social/occupational dysfunction
3. Duration: Lasting for atleast 6 months
Delusion
Fixed false beliefs that are irrational and that the individual maintains are true despite evidence to the contrary
Illusion
A misinterpertation of real external stimuli
Patients will see shafows on wall and say its a monster
Positive Symptoms
Hallucinations
Delusions
Bizarre Behavior
Paranoia
Grandiosity
Pressured Speech
Distractible speech
Incoherence
Clanging
Hallucinations
Sensory perceptions without external stimuni
Positive symptoms
Delusions
Fixed false beliefs
Types of delusions
Perseutory
Referential
Grandiose
Somatic
Erotomanic
Persecutory Delusion
Belief that one is going to be harmed by others
Referential Delusion
Belief that cues in the enviornment are specifically referring to them
Grandiose Delusion
Belief that they have exceptional greatness
Somatic Delusion
Beliefs that center on ones body functioning
Erotomanic Delusion
Belif that someone of higher status or celebrity is in love with them
Auditory Hallucination
False perception of sound
Most common
Visual Hallucination
False visual perceptions
Tactile Hallucination
False perceptions of touch
Crawling on skin
Gustatory Hallucination
False perception of taste
Unpleasent
Olfactory Hallucination
False perceptions of smell
Positive symptom
Disorganized thinking
Manifested in speech
Loose association
Tangentiality
Circumstentiality
Incoherence
Neologisms
Clang associations
Echolalia
Disorganized Thinking
Loose association
Unaware topics are connected
Disorganized Thinking
Tangentiality
Veering away from topic, difficulty focusing
Disorganized Thinking
Circumstantiality
Delays point in communication due to details
Incoherence
Unclear
Includes word salad
Disorganized Thinking
Neologisms
Newly invented words that are meaningless
Disorganized Thinking
Clang associations
Words that rhyme
Disorganized Thinking
Echolalia
Repeating words or phrases
Positive Symptom
Catatonia
Ranging from rigid or bizzare posture and decreased responsivity to complete lack of verbal or behavioral response to the enviornment
Catatonic excitement
Excessive and purposeless motor activity
Catatonic Stupor
May look like they’re out of touch with reality but they may be aware of whats going on
You need to orient to reality
They can become aggressive
Catatonic behaviors priority
Physiological health
They can sit in a chair so long without drinking or using the bathroom
Catatonic behavior
Waxy flexability
a condition in which the client with schizophrenia allows body parts to be placed in bizarre or uncomfortable positions
Catatonic behavior
Echopraxia
imitates movements made by others
Catatonic behavior
Echolalia
repeating words or phrases spoken by another
Hallucinations interventions
Assess for presence
Direct concrete communication
Decrease enviornmental stimuli
Reality based communication
Respond to feeling tone
Hallucination intervention
Assess for presence
Make sure to confirm observatons
Safety is primary goal
Offer a quiet place to go to they dont have
Hallucintion intervention
Reality based communication
Show the patient reality based distractions if they are having hallucinations
Look outside, its a nice sunny day.
Look at a book or watch TV
Depends
Hallucination intervention
Respond to feeling tone i.e if client is fearful
Focus on one topic at a time
Involve them in a small simple activity e.g. walking, engaging in a card game
