Major Mental Disorders Flashcards
A Psychotic Disorder characterized by Delusions, Hallucinations, and Disturbances in Thought, Perception, and Behavior
Schizophrenia
Schizophrenia is a major mental disorder (Psychotic Disorder) characterized by 2 distinct symptoms
- Delusions
- Hallucinations
Schizophrenia is usually diagnosed in late ______ or early ______
Dxd in Late Adolescence
or Early Adulthood
The younger the person will be diagnosed with Schizophrenia, the greater the prognosis is
Two Categories of Symptom of Schizophrenia
Positive Symptoms
Negative Symptoms
Devastatingly, Schizophrenia is characterized by Deterioration of what?
Deterioration of a Person and/or their Personality
Most common sensory Hallucinations are? (There is most common and 2nd most common)
1st - Auditory
2nd - Visual
Schizophrenia is rare in _____
Rare in Childhood
A category of Schizophrenic Symptoms that are caused by TOO LITTLE DOPAMINE in Mesocortical Tract
Negative Symptoms of Schizophrenia
Give 3 Schizophrenic Symptoms that are categorized as Negative Symptoms (1-3; there are 12 in total)
- Alogia
- Anergia
- Asocial Behavior
Give 4 Schizophrenic Symptoms that are categorized as Negative Symptoms (4-7; there are 12 in total)
- Attention Deficits
- Avolition
- Blunted Effect
- Communication Difficulties
Major Neurotransmitter in Schizophrenia
Dopamine
Major Neurotransmitter in Depression
Serotonin
Inhibitors that target both Dopamine and Serotonin
CLOZAPINE (Clozaril)
A category of Schizophrenic Symptoms that are caused by EXCESSIVE DOPAMINE in Mesolimbic Tract
Positive Symptoms of Schizophrenia
Give 4 Schizophrenic Symptoms that are categorized as Positive Symptoms (1-4; there are 12 total)
- Abnormal Thoughts
- Agitation
- Bizarre Behavior
- Delusions
Give 4 Schizophrenic Symptoms that are categorized as Positive Symptoms (5-8; there are 12 total)
- Excitement
- Feelings of Persecution
- Grandiosity
- Hallucinations
Give 4 Schizophrenic Symptoms that are categorized as Positive Symptoms (9-12; there are 12 total)
- Hostility
- Illusions
- Insomnia
- Suspiciousness
Three Overlapping Phases of Schizophrenia (OVERLAPPING - phases may switch from phase to phase
- Acute Phase
- Stabilizing Phase
- Stable Phase
NOTE: ** Most patient ALTERNATE between Acute and Stable Phases commonly**
Give 5 Schizophrenic Symptoms that are categorized as Negative Symptoms (8-12; there are 12 in total)
- Difficulty with Abstractions
- Passive Social Withdrawal
- Poor grooming & Hygiene
- Poor Rapport
- Poverty of Speech
Acute Phase of Schizophrenia requires what two Interventions?
Admission & Administering of Prescribed Medications
Maximum stay in the Hospital is how many days ( For Acute Cases )
2 weeks (14 days)
Chronic cases of mental disorders are transferred/referred to a more higher _____
Facility;
e.g. Putotan
Soft Symptoms/Signs of Schizophrenia (3 identified)
- Flat affect
- Lack of Volition
- Social Withdrawal or Discomfort
DSM-IV TR Diagnostic Criteria
Positive or Hard Symptoms
> Fragmented or poorly related thoughts and ideas
Associative Looseness
DSM-IV TR Diagnostic Criteria
Positive or Hard Symptoms
> Fixed false beliefs that has no basis in reality
Delusions
In dealing with Delusions, the nurse must NOT _____ with the client
Avoid Arguing;
To prevent losing client’s trust
DSM-IV TR Diagnostic Criteria
Positive or Hard Symptoms
> Imitation in the speech and way of communicating of another person whom the client is observing
Echolalia
DSM-IV TR Diagnostic Criteria
Positive or Hard Symptoms
> Imitation in the movements and gestures of another person whom the client is observing
Echopraxia
DSM-IV TR Diagnostic Criteria
Positive or Hard Symptoms
> Continuous flow of verbalization in which the person jumps rapidly from one topic to another
Flight of Ideas
DSM-IV TR Diagnostic Criteria
Positive or Hard Symptoms
> Persistent adherence to a single idea or topic l, verbal repetition of a sentence, word, or phrase resisting attempts to change the topic
Perseveration
DSM-IV TR Diagnostic Criteria
Negative or Soft Symptoms Symptoms
> Tendency to speak very little or to convey little substance of meaning (poverty of content in speech)
Alogia
DSM-IV TR Diagnostic Criteria
Negative or Soft Symptoms Symptoms
> Feeling no joy or pleasure from life or any activities or relationship
Anhedonia
DSM-IV TR Diagnostic Criteria
Negative or Soft Symptoms Symptoms
> Feeling of indifference toward people, activities and events
Apathy
DSM-IV TR Diagnostic Criteria
Negative or Soft Symptoms Symptoms
> Restricted range or emotional feeling, tone or mood
Blunted Effect
DSM-IV TR Diagnostic Criteria
Positive or Hard Symptoms Symptoms
> Holding seemingly contradictory beliefs or feelings about the same person, event or situation
Ambivalence
DSM-IV TR Diagnostic Criteria
Negative or Soft Symptoms Symptoms
> Psychologically induced immobility occasionally marked by periods of agitation or excitement, the client seems motionless as if in a trance
Catatonia
DSM-IV TR Diagnostic Criteria
Negative or Soft Symptoms Symptoms
> absence of any facial expressions that would indicate emotions or mood
Flat Affect
DSM-IV TR Diagnostic Criteria
Negative or Soft Symptoms Symptoms
> Absence of will, ambition, or drive to take action or accomplish tasks
Lack of Volition
______ can control the positive symptom but frequently the _____ Symptoms persist after _____ Positive Symptoms have abated
Medications;
Negative;
Positive
These present a major barrier to recovery and improved functioning in the client’s daily life
Persistence of Negative Symptoms
Symptoms of Schizophrenia does not _____ but can be _____
Does not Disappear but can be Minimized/Managed/Reduces
Types of Schizophrenia (DSM-IV-TR)
According to Client’s Predominant Symptoms
> Characterized by persecutory (feeling victimized or spied on) or Grandiose Delusions, Hallucinations, and Occasionally excessive religiosity (Delusional Religious Focus) or hostile and aggressive behavior
Paranoid Type of Schizophrenia
If patient is Paranoid, there is risk for ______
Aggression/Being Hostile
Types of Schizophrenia (DSM-IV-TR)
According to Client’s Predominant Symptoms
> Characterized by grossly inappropriate or flat affect, incoherence, loose associations, and extremely disorganized behavior
Disorganized Type of Schizophrenia
Types of Schizophrenia (DSM-IV-TR)
According to Client’s Predominant Symptoms
> Characterized by marked psychomotor disturbance, either motionless or excessive motor activity
Catatonic Type of Schizophrenia
Command Hallucinations are/can be dangerous in what Mental Disorder?
Psychotic Depression
The most common type of Hallucination; involve hearing sounds most often voices talking to or about the client
Auditory Hallucination
If severe Hallucination; exhibiting command hallucinations (verbalizations) what treatment is indicated
ECT
A type of Hallucination involving voices that are demanding the client to take action often to harm self or others and are considered dangerous
Command Hallucinations
A type of Hallucination that involve seeing images that do not exist at all such as lights, or dead person; or distortions such as seeing a frightening monster instead of the nurse.
Visual Hallucinations
Three Guiding Points in Managing Hallucinations
- Reorient
- Redirect
- Presenting Reality
A Type of Hallucinations that involve sensation such as electricity running through the body or bugs or crawling on the skin
Tactile Hallucinations
A type of Hallucinations that involve the clients reporting that they feel bodily function that are usually undetectable
e.g.
Sensation of urine forming or impulses being transmitted through the brain
Cenesthetic Hallucinations
A type of Hallucinations that occur when the client is motionless but reports the sensation of bodily movement
Kinesthetic Hallucinations
Three Key Characteristics of Schizophrenia
- Disordered Thinking
- Delusions
- Hallucinations
The younger of the age of the patient diagnosed with Schizophrenia, the poorer the ______
Poor Prognosis
If Gradual onset of Schizophrenia, there is ____ Prognosis;
______ Immediate & Long-term Course than those of an _____ and _____ Onset
Poor Prognosis;
Poorer Immediate & Long-term Course than those of an Acute and Sudden Onset
What is the interval of Relapses preferred for an effective management of Schizophrenia
Longer intervals between Relapses
IMMEDIATE COURSE
In years immediately after the onset of Psychotic Symptoms, Two (2) Clinical Patterns Emerge:
- The client experiences Psychosis never fully recovers, although symptoms may shift in severity over time
- The client experiences Episodes of Psychotic Symptoms that Alternate with Episodes of Relatively Complete Recovery from the Psychosis
The intensity of Psychosis tends to diminish with age. Many clients with longer duration of impairment regain some degree of social and occupational functioning;
Over time, the disease becomes less disruptive to the person’s life and easier to manage but rarely can the client overcome the effects if many years of dysfunction.
Long-term Course
Other disorders that are related to BUT Distinguished from Schizophrenia in terms of Presenting Symptoms and the Duration or Magnitude of Improvement
Related Disorders of Schizophrenia
Related Disorders of Schizophrenia
DSM - IV - TR Categories
> The client exhibits the symptoms of Schizophrenia but for less than 6 Months necessary to meet the Diagnostic Criteria of Schizophrenia; Social or Occupational Functioning may or may not be impaired
Schizophreniform Disorder
Related Disorders of Schizophrenia
DSM - IV - TR Categories
> The clients exhibits the symptoms of Psychosis and at the same time all the features of a mood disorder, either Depression or Mania
Schizoaffective Disorder
Related Disorders of Schizophrenia
DSM - IV - TR Categories
> The client has one or more non-bizarre delusions that is the focus of the delusion is believable; Psychosocial functioning is not markedly impaired and behavior is not obviously odd or bizarre
Delusional Disorder
NOTE: These patients don’t necessarily need Admission; they can still socialize, but once they talk characterizing delusions, they might need to be assessed;
* r/t Grandiosity *
Delusions can be treated mainly with what intervention
Medications Prescribed
Related Disorders of Schizophrenia
DSM - IV - TR Categories
> The client experiences the sudden onset of at least one Psychotic Symptoms, such as Delusions, Hallucinations, or Disorganized Speech or Behavior which last from 1 Day to 1 Month;
The episode may or may not have an identifiable stressor or may follow childbirth (Post-partum Psychosis)
Brief Psychotic Disorder
NOTE: may have prescribed medications for both Psychosis and Depression
A type of sensory hallucination that Involves scent or odors; they may be a specific scent such as urine or feces, or a more general scent such as rotten or rancid odor
Olfactory Hallucinations
A type of Hallucination involves a taste lingering in the mouth or the sense that foods taste like something else. The taste may be metallic or bitter or may be represented as a specific taste
Gustatory Hallucination
Term that Refers to Waxy Flexibility
Catalepsy
Catatonic Type of Schizophrenia that can be indicated by Motor Immobility that can be manifested by ____ or _____
- Catalepsy
- Stupor
Catatonic Type of Schizophrenia that can be indicated by ______ Motor Activity that is apparently _____ and is not influenced by _____ Stimuli
Excessive Motor Activity that is apparently Purposeless and is not influenced by External Stimuli
A Disorder wherein two people share similar Delusion
Shared Psychotic Disorder
The person with this diagnosis develops these delusions in the context of a close relationship with someone who has psychotic delusions
Shared Psychotic Disorder
Are Personality Disorders and not Psychotic Disorders (should not be confused with schizophrenia even though the names sound similar)
**Personality Disorders*
Schizotypal Personality & Schizoid Personality
Identified psychological and social causes of Schizophrenia according to therapists
Dysfunctional Parenting and Family Dynamics
Refers to Pathophysiology of Psychological Conditions in Psychiatric Nursing
Psychodynamics
Treatment involving the deep brain for treating Depression
Deep Brain Stimulation (DBS)
A biologic factor that focuses in immediate families to examine whether schizophrenia is genetically transmitted or inherited; Few have focused on distant relatives
Genetic Factors
Refers to the structure and function of the Brain
Neurochemical Factors
Refers to the Body’s Response to exposure to a virus
Immunovirology
Give the tree identified genetic factors under Biological Theories
- Neuroanatomic
- Neurochemical Factors
- Immunovirology
Clozapine (an Atypical Antipsychotic Drug) precaution regarding WBC Count
Agranulocytosis