objective 9 Flashcards
Characterized as disorganized speech, as a flight of ideas
or loosening of associations, thought to reflect
disorganized thinking and occurring as a symptom of
some types of mental illness, as manic disorder or
schizophrenia
thought disorder
is considered the most common and
disabling of the psychotic disorders. Although it is a
psychiatric disorder, it stems from a physiologic
malfunctioning of the brain. This disorder affects all
races and is more prevalent in men than in women. It
is considered a chronic syndrome that typically follows
a deteriorating course over time
schizophrenia
what are the symptoms of schizophrenia?
Delusions, agitation, hostility, aggression, bizarre
dress, emotional withdraw, incoherent speech,
rhythmic gestures
what are the 5 key features are associated with psychotic D/Os?
1.Delusions
2.Hallucinations
3.Disorganized thinking
4.Abnormal motor behaviour
5.Negative symptoms
- Substance abuse disorders
- Nicotine dependence
- Anxiety, depression, and
suicide - Physical health or illness
- Polydipsia
co-morbidity
the client experiences MDD, manic, or
mixed episode along with the negative symptoms of schizophrenia
schizoaffective disorder
the client experiences the features of
schizophrenia for more than 1 month, but less than 6 months
schizophreniform disorder
it involves the sudden onset of positive
symptoms (hallucinations, delusions, catatonic ect) that occur for at
least 1 day, but less than 1 month. The individual returns to normal
level of functioning.
brief psychotic disorder
Psychoses caused by a
medical condition (delirium, neurological or metabolic conditions,
hepatic or renal diseases, and many others) as well as by mental
illness such as PTSD or depression, particularly with co-existing
victimization from sexual violence or bullying.
Psychosis or Catatonia Associated With Another Medical
Condition or Another Mental Disorder
characterized by nonbizarre
delusions (i.e., situations that could occur in real life,
such as being followed, being deceived by a spouse, or
having a disease). The person’s ability to function is not
markedly impaired, nor is behaviour otherwise odd or
psychotic
delusional disorder
Psychosis may be induced by substances
such as drugs of abuse, alcohol, medications, or toxins
substance or medication induced psychotic disorder
what are the phases of schizophrenia?
acute
stabilization
maintenance
onset or exacerbation of symptoms
acute
symptoms diminishing
movement toward previous level of functioning
stabilization
at or near baseline functioning
maintenance
Inability to show appropriate
emotional responses
affective disturbance
an individual is unable to relate to
others or the environment
autistic thinking
opposing emotions, attitudes, or ideas
for the same person, thing or situation
ambivalence
(inability to think logically
looseness of association
what are the general assessment findings?
- Positive symptoms
- Negative symptoms
- Cognitive symptoms
- Affective symptoms
- Alterations in thinking
- Delusions—False, fixed beliefs (See Table
15.1) - Persecution
- Grandiosity
- Ideas of reference
- Jealousy, being controlled
- Concrete thinking—Inability to think abstractly
positive symptoms
- Psychiatric, medical, and neurological
evaluation - Psychopharmacological treatment
- Support, psychoeducation, and guidance
- Supervision and limit setting in the milieu
- Monitoring of fluid intake
acute phase
Most interfere with adjustment and ability to
survive
* Affect ( Flat, Blunted, Inappropriate, Bizarre)
* Other negative symptoms include:
* Poverty of speech or speech content, & thought
blocking
* Anergia (lack of energy)
* Anhedonia (inability to experience pleasure)
* Avolition (reduced motivation)
negative symptoms
- Difficulty with
- Attention & Memory
(forgetful) - Information processing
- Cognitive flexibility
- Executive functions
(completing tasks)
cognitive symptoms
- Assessment for depression is crucial
- May herald impending relapse
- Increases substance abuse
- Increases suicide risk
- Further impairs functioning
affective symptoms
- Medication administration/adherence
- Relationships with trusted care providers
- Community-based therapeutic services
stabilization/maintenance phases
- Remove clients from, or avoid, situations known to cause
agitation. - Decrease stimulants such as caffeine, bright lights, loud
noises. - Avoid displaying anger, discouragement or frustration
when interacting with clients - Avoid criticism and do not argue with the client
- Set limits and follow through with the consequences if
violation occurs - Administer prescribed medications
Interventions
agitation
- Decrease environmental stimuli. If visual hallucinations
occur, ask the client to describe what is seen - Attempt to identify precipitating factors by asking the
client what happened before the onset of the hallucination.
If auditory hallucinations occur, ask the client what is
heard or what the voices are saying. - Monitor television programs to minimize external stimuli.
- Monitor for command hallucinations that cause aggressive
or violent behavior - Administer prescribed medication
hallucinations
- Do not whisper or laugh in the presence of a client
- Do not argue with the client or attempt to disprove
delusional or suspicious thoughts. - Explain all procedures and interventions, including
medication management. - Provide personal space and do not touch the client
without warning. - Maintain eye contact during interactions
- Provide consistency in care and assigned caregivers to
establish trust.
delusions
first gen
typical
second gen
atypical
