Schizophrenia Flashcards
What is the definition of schizophrenia?
A severe and chronic mental disorder characterized by disturbances in perceptions, thought, and behaviour
What is the definition of schizoaffective disorder?
A complex and persistent psychiatric disorder with varying degrees of symptoms of both schizophrenia and mood disorders
What are the different stages of schizophrenia?
Acute Illness
Stabilization
Maintenance and recovery
Relapse
Acute Illness stage
Sleep disruption
Pacing
Talking to self
Responding to external/internal stimuli
Social withdrawal
Poverty of speech
Stabilization stage
Initiation and mitigation of side effects of medication
Baseline of target symptoms
Assess for substance use
Maintenance and recover stage
Adherence to medication regime or routine
Family and patient education
Looking at learning new skills so that people can cope better in the future
What are the positive symptoms of schizophrenia?
Delusions (Grandiose, nihilistic, persecutory, somatic)
Hallucinations (auditory, visual, tactile, gustatory, olfactory)
Grandiose Delusions
People who experience these delusions are convinced of their own greatness and importance
Nihilistic Delusions
characterized by the delusional belief of being dead, decomposed or annihilated, having lost one’s own internal organs or even not existing entirely as a human being
Persecutory Delusions
They strongly believe people or groups, like the government, intend to harm them
Somatic Delusions
the individual believes something is wrong with part or all of their body
Negative symptoms
Anhedonia – inability to experience pleasure
Alogia – reduced fluency in productivity of thought and speech
Anergia – abnormal lack of energy
Avolition – lack of motivation
Ambivalence – state of having mixed feelings or contradictory ideas about something or someone (feeling stuck)
Affective disturbances – idea of having a blunted affect (inability to demonstrate affect)
Social withdrawal
Disorganized thinking (evident through speech)
Loosening of associations
Circumstantiality
Tangentiality
Thought blocking
Neologisms
Flight of ideas
Perseveration
Pressured speech
Word salad
Clang associations
Echolalia
Disorganized thinking (delusions)
Delusions of control
Bizarre delusions
Religious delusions
Depersonalization
Magical thinking
Disorganized behaviour
Agression
Agitation
Biologic sources of schizophrenia
Genetic predisposition
Dopaminergic dysfunction
Hypofrontality
Cognitive deficits
Immune dysfunction
Neuroanatomic changes
Social sources of schizophrenia
Decreased financial status
Family and caregiver stress
Homelessness
Stigma and community isolation
Psychological sources of schizophrenia
Difficulties in relating
Affective blunting (decreased emotional expression)
Difficulties with decision making
Self-concept change
Decreased stress response and coping
Loss of family relationship
Spiritual sources of schizophrenia
Spiritual confusion as auditory hallucinations seem from a higher power
Delusions may be religiously oriented
DSM 5
Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one of these must be (1), (2), or (3)
1. delusions
2. hallucinations
3. disorganized thinking
4. disorganized behaviour
5. negative symptoms
- Schizoaffective disorder, depressive disorder and bipolar disorder has been ruled out
- not attributed to drugs
Biological assessments
Current and past health history
Physical functioning
Nutritional assessment
Fluid imbalance assessment
Pharmacologic assessment
Psychological assessments
Assess for positive and negative symptoms (standardized scales)
Mental Status Exam
Behavioural responses
Self-concept
Stress and coping patterns
Risk assessment
Social assessments
Social systems
Quality of life – their perspective on it
Family assessment
Biological diagnoses
Self-care deficit
Disturbed sleep patterns
Imbalanced nutrition
Excess fluid volume
Constipation
Sexual dysfunction
Psychological diagnoses
Disturbed thought processes
Disturbed body image
Low self-esteem
Disturbed personal identity
Risk for violence
Ineffective coping
Knowledge deficit
Social diagnoses
Impaired social interactions
Ineffective role performance
Disabled family coping
Interrupted family processes
Biological interventions
Monitor medications
Minimize side effects
Decrease impact of movement disorders
Address immune function
Address nutritional status
Modify cognitive deficits
Address sleep
Psychological interventions
Address social skills
Address problem-solving skills
Address self-concept
Increase stress management skills
Address symptom management and relapse prevention skills
Address family relationships
Social interventions
Promote economic stability
Decrease family/caregiver stress
Provide family education
Maintain housing
Increase social contact
Spiritual interventions
Guard dignity of patient
Support hope and meaning
Support helpful sacred activities
What are the different types of health care professionals involved in the recovery process?
The most effective treatment approach for individuals with schizophrenia involves a variety of disciplines
Pharmacologic management is the responsibility of physicians, and nurses – all members of the mental health team can implement various psychological interventions
What are side effects of antipsychotic meds?
Akathisia
Akinesia
Pseudo-parkinsonism
Tardive dyskinesia
NMS
Akathisia
motor restlessness, inability to remain still, can also occur as a subjective feeling
Akinesia
absence of movement or difficulty with movement
Pseudo-parkinsonism
shuffling and slow gait; mask-like facial expressions; tremors; pill-rolling; movements of the hands; stooped posture; rigidity
Tardive dyskinesia
involuntary and abnormal movements of the mouth, tongue, face, and jaw; may progress to the limbs, irreversible condition; may occur in months after discontinuation of antipsychotic medication
Neuroleptic Malignant Syndrome
a potentially lethal side effect of antipsychotic medications that requires emergency treatment; manifested symtoms include: hyperthermia, muscle rigidity, tremors, change in mental state, tachycardia, hypertension, diaphoresis, incontinence, creatinine phosphokinase elevation, leukoocytosis, metabolic acidosis
