Lecture 4- Schizophrenia

Question 1

What is Schizophrenia?

Answer 1

A disabling psychological disorder that causes disturbances in thought processes, perception, and affect.

Question 2

When do symptoms of Schizophrenia become apparent?

Answer 2

Late adolescence or early adulthood

Question 3

What are the four phases of Schizophrenia?

Answer 3

Premorbid, Prodromal, Schizophrenia, and Residual

Question 4

Premorbid Phase

Answer 4

Before clear evidence of illness begins, can go unnoticed

Question 5

Prodromal Phase

Answer 5

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)

Question 6

Schizophrenia Phase

Answer 6

Chronic illness characterized by acute episodes in which the symptoms are more pronounced. Notable psychotic symptoms

Question 7

Residual Phase

Answer 7

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.

Question 8

Co-morbidity in Schizophrenia

Answer 8

Substance abuse
Nicotene dependence
Depressive symptoms
High percentage of anxiety disorders
Polydypsia

Question 9

Co-morbidity 1

Substance abuse

Answer 9

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

Question 10

Comorbidity 2

Nicotene dependence

Answer 10

In 80-90% of patients
Smoking is said to decrease hallucinations (esp. auditory)

Question 11

Comorbidity 3

Depressive symptoms

Answer 11

Very common
10% of patients who try to commit suicide succeed

Question 12

Comorbidity 4

Polydypsia

Answer 12

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!!

Question 13

Schizophrenia symptoms can be caused by

Answer 13

Genetics
Excessive dopamine
Stress
Substances (bath salts, marijuana laced with formaldehyde)
Someone in a manic state

Question 14

Symptoms of Schizophrenia

Answer 14

Affect
Associative looseness
Autism
Ambivalence

Question 15

Symptom

Affect

Answer 15

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

Question 16

Flat affect

Answer 16

Not a lot of expression

Question 17

Blunted affect

Answer 17

Where you see some expressions but its less than what you would expect

Question 18

Inappropriate affect

Answer 18

Talk about something sad and laugh

Question 19

Symptom

Associative looseness

Answer 19

Half-hazard confused thinking that comes out as a logical speech
No connection

Question 20

Symptom

Autism

Answer 20

They are not bound to reality with a private perceptual world (hallucinations, delusions, neologisms)

Question 21

Symptom

Ambivalence

Answer 21

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

Question 22

DSM-V diagnostic criteria

Answer 22

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

Question 23

Delusion

Answer 23

Fixed false beliefs that are irrational and that the individual maintains are true despite evidence to the contrary

Question 24

Illusion

Answer 24

A misinterpertation of real external stimuli

Patients will see shafows on wall and say its a monster

Question 25

Positive Symptoms

Answer 25

Hallucinations Delusions Bizarre Behavior Paranoia Grandiosity Pressured Speech Distractible speech Incoherence Clanging

Question 26

Hallucinations

Answer 26

Sensory perceptions without external stimuni

Question 27

# Positive symptoms Delusions

Answer 27

Fixed false beliefs

Question 28

Types of delusions

Answer 28

Perseutory Referential Grandiose Somatic Erotomanic

Question 29

Persecutory Delusion

Answer 29

Belief that one is going to be harmed by others

Question 30

Referential Delusion

Answer 30

Belief that cues in the enviornment are specifically referring to them

Question 31

Grandiose Delusion

Answer 31

Belief that they have exceptional greatness

Question 32

Somatic Delusion

Answer 32

Beliefs that center on ones body functioning

Question 33

Erotomanic Delusion

Answer 33

Belif that someone of higher status or celebrity is in love with them

Question 34

Auditory Hallucination

Answer 34

False perception of sound | Most common

Question 35

Visual Hallucination

Answer 35

False visual perceptions

Question 36

Tactile Hallucination

Answer 36

False perceptions of touch | Crawling on skin

Question 37

Gustatory Hallucination

Answer 37

False perception of taste | Unpleasent

Question 38

Olfactory Hallucination

Answer 38

False perceptions of smell

Question 39

# Positive symptom Disorganized thinking | Manifested in speech

Answer 39

Loose association Tangentiality Circumstentiality Incoherence Neologisms Clang associations Echolalia

Question 40

# Disorganized Thinking Loose association

Answer 40

Unaware topics are connected

Question 41

# Disorganized Thinking Tangentiality

Answer 41

Veering away from topic, difficulty focusing

Question 42

# Disorganized Thinking Circumstantiality

Answer 42

Delays point in communication due to details

Question 43

Incoherence

Answer 43

Unclear Includes word salad

Question 44

# Disorganized Thinking Neologisms

Answer 44

Newly invented words that are meaningless

Question 45

# Disorganized Thinking Clang associations

Answer 45

Words that rhyme

Question 46

# Disorganized Thinking Echolalia

Answer 46

Repeating words or phrases

Question 47

# Positive Symptom Catatonia

Answer 47

Ranging from rigid or bizzare posture and decreased responsivity to complete lack of verbal or behavioral response to the enviornment

Question 48

Catatonic excitement

Answer 48

Excessive and purposeless motor activity

Question 49

Catatonic Stupor

Answer 49

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 ## Footnote They can become aggressive

Question 50

Catatonic behaviors priority

Answer 50

Physiological health | They can sit in a chair so long without drinking or using the bathroom

Question 51

# Catatonic behavior Waxy flexability

Answer 51

a condition in which the client with schizophrenia allows body parts to be placed in bizarre or uncomfortable positions

Question 52

# Catatonic behavior Echopraxia

Answer 52

imitates movements made by others

Question 53

# Catatonic behavior Echolalia

Answer 53

repeating words or phrases spoken by another

Question 54

Hallucinations interventions

Answer 54

Assess for presence Direct concrete communication Decrease enviornmental stimuli Reality based communication Respond to feeling tone

Question 55

# Hallucination intervention Assess for presence

Answer 55

Make sure to confirm observatons | Safety is primary goal Offer a quiet place to go to they dont have

Question 56

# Hallucintion intervention Reality based communication

Answer 56

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

Question 57

# Hallucination intervention Respond to feeling tone i.e if client is fearful

Answer 57

Focus on one topic at a time Involve them in a small simple activity e.g. walking, engaging in a card game