schizophrenia Flashcards
1
Q
defining schizophrenia
A
- extremely complex mental disorders
- disorder characterized by delusions, hallucinations, disturbances in thinking and communication and withdrawal from social activity
- serious, treatable brain disorder which affects a persons ability to know what is reality and what is not
- neurological illness
- psychosis is one element of the illness
2
Q
epidemiology
A
- halter states:
- – lifetime prevalence of schizophrenia is 1% worldwide
- – no difference related no
- —- race
- —- social status
- —- culture
- critical perspective: some compelling evidence that practitioner bias leads to systemic class/cultural bias against racial and ethnic minorities
- more common in males and among persons growing up in urban areas
- ages of onset; 18-25 is typical of males, with later onset of 25-35 more common in females and associated with better outcomes
3
Q
co-morbidity
A
- substance use disorders
- – nicotine, dependence
- anxiety, depression, and suicide
- physical illness
- polydipsia
4
Q
social realities
A
- family and caregiver stress
- stigma and community isolation
- homelessness
5
Q
psychological realities
A
- difficulties in relating, decision making
- affective blunting
- decrease stress response and coping
- self concept changes
- self stigma
6
Q
tortured artist
A
- creative people have a 90% higher chance of being diagnosed with schizophrenia
7
Q
schizophrenia and the brain
A
- dopamine pathways relevant to schizophrenia symptoms
- – mesolimbic and mesocortical dopaminergic system are thought to play an important role in motivation, cognition; significant to stimuli
- – overactivity of the mesolimbic pathway leads to positive symptoms
- – mesocortical pathway dysfunction leads to negative and cognitive symptoms
8
Q
too much or too little dopamine in different regions of the brain
A
- mesolimbic:
- – high levels of D2 dopamine receptors-impaired grasp of reality, emotional dysregulation
- prefrontal cortex:
- – reduction in dopamine can cause decline in neurocognitive fx, memory, attention and problem solving, social traits
9
Q
role of glutamate
A
- activates NMDA- forms connections between brain cells, significant in brain development, learning and memory
- low NMDA thought to lead to schizophrenia later in life
10
Q
theories of etiology
A
all lead to psychosis:
- early causes; genetic, obstetric complications
- vulnerability: neurocognitive impairments, social anxiety, isolation, odd ideas
- abuse of DA drugs
- social stress
11
Q
etiology: stress and infection
A
- the role of emotional and physical stress (infections) can trigger or worsen the symptoms when illness is already present
- immune dysfunction
- vulnerability stress theory
12
Q
link between marijuana and psychosis
A
- people who use marijuana regularly before the age of 16 are 6x more likely to develop a psychosis
- exposure to THC during brain development is an environmental risk for schizophrenia
- the effects of CBD on schizophrenia symptoms have been mixed. some studies have shown CBD antipsychotic potential while others found no therapeutic link
- reality is by grad 12, 50% of students would have used cannabis
13
Q
phases of schizophrenia
A
nursing care depends on the phase
- prodrome
- acute
- – onset or exacerbation of symptoms
- stabilization
- – symptoms diminishing
- – movement toward previous level of functioning
- maintenance
- – at or near baseline functioning
- health promotion
- – improving health outcomes
14
Q
prodromal phase
A
- may arise a year or so before first episode
- most common symptoms based on retrospective studies
- reduced concentration and attention
- reduced drive and motivation
- depression
- sleep disturbances
- anxiety
- social withdrawal
- suspiciousness
- deterioration in role functioning
- irritability
15
Q
positive symptoms
A
- hallucinations (auditory, command, visual)
- delusions (false, fixed belief)
- racing thoughts
- disorganized speech/behaviour
- disturbed/bizarre behaviour
- depersonalization (feeling of being detached from one’s body or mental processes)
- derealization (a mental state where you feel detached from your surroundings)
16
Q
positive symptoms: altered speech
A
- clang associations
- associative looseness
- word salad
- neologisms (creating new words)
- echolalia (meaningless repetition of words)
17
Q
positive symptoms: other disorders of thought or speech
A
- flight of ideas
- thought insertion
- thought broadcasting
- ideas of reference
