Schizophrenia Flashcards
What are the five key features associated with psychotic disorder?
- Delusions: Alterations in thought content (what a person thinks about). Delusions are false fixed beliefs that cannot be corrected by reasoning or evidence to the contrary. “Unusual” beliefs maintained by one’s culture or subculture are not delusions.
- Hallucinations: Perception of a sensory experience for which no external stimulus exists (e.g., hearing a voice when no one is speaking).
- Disorganized thinking: The loosening of associations, manifested as jumbled and illogical speech and impaired reasoning.
- Abnormal motor behaviour: Alterations in behaviour, including bizarre and agitated behaviours (e.g., stilted, rigid demeanour; eccentric dress, grooming, and rituals). Grossly disorganized behaviours may include mutism, stupor, or catatonic excitement.
- Negative symptoms: The absence of something that should be present but is not—for example, the ability to make decisions or to follow through on a plan. Negative symptoms contribute to poor social functioning and social withdrawal.
What other than schizophrenia exist in psychotic disorder?
Schizophreniform Disorder
Brief Psychotic Disorder
Schizoaffective Disorder
Delusional Disorder
Substance- or Medication-Induced Psychotic Disorder
Psychosis or Catatonia Associated With Another Medical Condition or Another Mental Disorder
Define Schizophrenia
It affects thinking, language, emotions, social behaviour, ability to perceive reality accurately.
A chronic syndrome that typically follows a deteriorating course over time.
Not curable; treatments to prevent the illness do not exist either
Describe the onset of schizophrenia
May begin late in adolescence or early in adulthood, usually before age 30
The younger the client is at the onset of schizophrenia, the more discouraging the prognosis.
However, abrupt onset of illness is greater potential for recovery.
What are the 3 phases of Schizophrenia?
- Phase I—Acute: Onset or exacerbation of florid, disruptive symptoms (e.g., hallucinations, delusions, apathy, withdrawal) with resultant loss of functional abilities; increased care or hospitalization may be required.
- Phase II—Stabilization: Symptoms are diminishing, and there is movement toward one’s previous level of functioning (baseline); day hospitalization or care in a residential crisis centre or a supervised group home may be needed.
- Phase III—Maintenance: The person is at or nearing baseline (or premorbid) functioning; symptoms are absent or diminished; level of functioning allows the person to live in the community. Ideally, recovery with few or no residual symptoms has occurred
How do Dr. base their diagnosis with Schizophrenia?
no yet lab to diagnose. Psychiatrist comes to diagnose. The diagnosis is based on symptoms: - What the person says - What the family reports - What health care professionals observe
What are the criterias for Schizophrenia?
- Characteristic symptoms (at least 2 of the following during 1 month): Delusions, Hallucinations, Disorganized speech, Grossly disorganized or catatonic behaviour, Negative symptoms
- Social-occupational dysfunction: work, interpersonal, self-care functioning below the level achieved before onset
- Duration: continuous signs of the disturbance for at least 6 months
All other mental disease have been rules out
All other medical conditions have been ruled out (not caused by substance use, meds, general medical disorder)
What are the 2 possible patterns when a patient is experiencing psychotic symptoms?
- the patient experiences continued psychosis, with some shift in severity of symptoms, but never fully recovers from the psychosis
- The patient experiences episodes of psychotic symptoms followed by relatively complete recovery from the psychosis between episodes
What are the factors that hinder recovery?
- Nonadherence to meds
- Late detection
- Long duration of untreated psychosis
- Fragmented, inadequate care
- Little support
- Excess stress and conflict in the personal environment
- Isolation, loneliness
- Neglect of physical health
- Abuse of street drugs
- Hopelessness and despair
Describe the positive symptoms of Schizophrenia.
*Hallucinations
Magical thinking (categorized as cognitive symptoms)
Speech patterns (categorized as cognitive symptoms): Loose association, Neologisms, Concrete thinking, Clang associations, Word salad, Tangentiality, Circumstantiality.
Delusions
Bizarre Behaviour: Clotting, appearance, social/sexual behaviour, excited/agitated behaviour, hostile/aggressive behaviour, repetitive/stereotyped behaviour
Describe negative symptoms of Schizophrenia.
A lessening or loss of normal functions
Affective Flattening, decrease range of affect
Alogia, decrease mental process fluency and production of words
Avolition, (motivation) decrease initiation of goal directed behaviour
Anhedonia, inability to experience pleasure
Asociality, severe impairment in social relationships
Passivity
Difficulty in abstract thinking
Lack of spontaneity
Poor eye contact
Avolition, Apathy, Anhedonia, Physical anergia
Social withdrawal, impaired grooming/hygiene, few recreational interest or activities, impaired intimacy & closeness, little sexual interest or activity
Describe Cognitive/Disorganized Symptoms
Difficulties in concentration & memory Disorganized thinking/speech Difficulty understanding Difficulty expressing thoughts Attention deficits
How do cognitive problems affect daily routine in Schizophrenia?
- When problems are mild, the person will have difficulties with reading, writing, watching TV
- People with greater degree will be unable to carry out task (cooking, shopping), manage their money, look after themself. This may result in poor hygiene, malnutrition and self-neglect.
- The worst type results in potentially dangerous behaviour, walking into traffic, leaving the stone on, mixing up medications
- Over time, can lead to unemployment, disability, poverty, debts, excess dependency
What are the clinical symptoms of cognitive impairment in Schizophrenia?
some experience positive symptoms, others may have more negative symptoms,
it varies between different individuals
What are the 5 subtypes of scizophrenia?
- Paranoid type
- Catatonic type (rare)
- Disorganized type
- Undifferentiated type
- Residual type
Describe the paranoid type of subtype in a Schizophrenic patient.
one or more delusions (persecutory or grandiose delusions) or frequent auditory hallucinations
Ideas of reference
Behavioural change: anger, hostility, violent, unable to trust, guarded, tense, reserved
Defence mechanism used to maintain self-esteem
may pose a threat to the safety of self or others
Describe the Catatonic type of subtype in a Schizophrenic patient.
Psychomotor disturbance: either extreme motor agitation or extreme psychomotor retardation
bizarre posturing
Patient at risk: extreme withdrawal-> vegetative condition, excessive motor activity-> exhaustion or self-inflicted injury
extreme negativisme & resistance & automatic obedience
Echolalia: Persistently repeating the words of others
Echopraxia: mimicking a movement or gesture of others
May be unresponsive to interventions
May continue to exhibit selective mutism or refuse nursing care, food, meds
Describe the Disorganized type of subtype in a Schizophrenic patient.
Behaviour: odd- giggling or grimacing response to internal stimuli, bizarre mannerisms, uninhibited behaviour
Grossly inappropriate affect
Looseness of association, incoherent speech, lack of attention to personal hygiene and grooming
Extreme social withdrawal
Describe the Undifferentiated type of subtype in a Schizophrenic patient.
Atypical symptoms
Positive and negative symptoms
Prognosis is favourable if onset of symptoms is acute or sudden
May have difficulty communicating with these patient due to the presence of atypical, disorganized clinical symptoms
Describe the Residual type of subtype in a Schizophrenic patient.
As chronic form of the disease
In a stage that follows an acute episode of Schizophrenia
No psychotic symptoms, still evidence of illness: Social isolation, Impairment in personal hygiene, Blunted/inappropriate affect, Apathy
