- Hallucinations and Illusions Delusions - Abnormal thought patterns or perceptions - Bizarre behavior

- Affective flattening - Anhedonia (a reduced level of interest in activities you used to enjoy, and a decline in your ability to feel pleasure) - Attention impairment - Asocial behavior (withdrawn from people) - Anergia (lack of energy) - Autism - Avolition (total lack of motivation that makes it hard to get anything done)

- Attention defects - Disturbances of activities - Auditory hallucination

Schizophrenia Flashcards by Alyanna Alih

A major form of psychotic disorder that
affects a person’s thinking, language,
emotions, social behavior and ability to
perceive reality

Schizophrenia

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T or F

In dx schizophrenia, it needs at least 4 of 5 types of positive and negative symptoms

At least 2 of 5 types of positive and
negative symptoms

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T or F

Schizo has characteristic symptoms and causes ocial or occupational dysfunction
(interpersonal relationships IPR, self-care)

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To dx schizo duration must be

(continuous for at least 6
months)

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Positive symptoms

Hallucinations and Illusions Delusions
Abnormal thought patterns or
perceptions
Bizarre behavior

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Negative symptoms

Affective flattening
Anhedonia (a reduced level of interest in
activities you used to enjoy, and a
decline in your ability to feel pleasure)
Attention impairment
Asocial behavior (withdrawn from
people)
Anergia (lack of energy)
Autism
Avolition (total lack of motivation that
makes it hard to get anything done)

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Delusions

Persecutory
Religious
Grandeur
Ideas of reference

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persistent, troubling, false beliefs that one is about to be harmed or mistreated by others in some way.

Persecutory

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pt thinks he is a messenger of God, or thinks he is God.

Religious

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when you believe that you have more power, wealth, smarts, or other grand traits than is true.

Grandeur

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the false belief that irrelevant occurrences or details in the world relate directly to oneself.

Ideas of reference

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Disturbed thought processes

Looseness of association
Flight of ideas
Ambivalence
Magical thinking
Echolalia/echopraxia
Word salad
Clang association
Neologism
Thought blocking
Concrete association

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Bleuler’s Four A’s of Schizophrenia

Affective Disturbances
Autism
Associative looseness
Ambivalence (good or bad)

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Other A’s

Attention defects
Disturbances of activities
Auditory hallucination

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Maybe seen when a person exhibits clinical
symptoms of illogical thinking, incoherent
speech, delusions, or disorganized behavior after psychological trauma. Less than 6 months

Brief Psychotic Disorder

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Develops in the second person as a result of a
close relationship with a person who has psychosis.

Induced Psychotic Disorder

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delusion of plunder, infidelity, delusions does
not change

Delusional Psychotic Disorder

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Characterized by depression or elation as the
psychotic symptoms of schizophrenia and MDD
Major depressive d/o

Schizoaffective disorder

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When a person exhibits features of schizophrenia for more than one week but less than 6 months.

Schizophreniform

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Schizophrenia subtypes:

Paranoid
Disorganized
Catatonic ECT
Undifferentiated schizophrenia

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most common form of the schizophrenia.

Paranoid

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T or F

Pts with schizophrenia are suspicious and violent.

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Interventions for pt with paranoid schizo that is suspicious

Promote trust
Short interaction but frequent
Food in containers (sealed)
Prepare food in front of them
Let them see the preparation of drugs

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Interventions for pt with paranoid schizo that is violent

Keep door open
Position near the door and with distance of
1 arm length (patient-nurse)
Don’t touch
Maintain eye contact

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absence of systematized delusions; presence of incoherence & inappropriate affect.

Disorganized

Symptoms of disorganized schizo

- Inappropriate, flat affect - Hebephrenic, flight of ideas

Catatonic ECT symptoms

Risk for suicide ➢ Catatonic stupor, rigidity ➢ Waxy flexibility ➢ Catatonic excitement (silent pt suddenly became aggressive w/o any provocation, shouting, running)

it is a posture that an individual can stay for longer hours without experiencing any discomfort

Waxy flexibility

need to categorized, combinations of symptoms, hard to specify, lack of assessment information. (Usually in mentally challenged homeless people)

Undifferentiated schizophrenia

no more positive symptoms but withdrawn

Residual schizophrenia

- Disturbed Thought Process - Disturbed Sensory Process - Risk for self-directed violence - Risk for other directed violence

Intervention of schizo

- Present safety - Present reality

Anti-psychotic drugs

Taractan Loxitane Stelazine Mellaril Thorazine Molindone Seroquel Serlect Trilafon Haloperidol Clozapine Navane

Haldol, Prolixin, decanoate, and modecate are ______-acting psychotic drugs.

long-acting

Side effects of antipsychotic

Decrease v/s Constipation / dry mouth Postural hypotension Photophobia/photosensitivity Drowsiness Agranulocytosis Extrapyramidal symptoms

Extrapyramidal symptoms

Parkinson’s syndrome ➢ Akathisia ➢ Akinesia loss of voluntary muscle control ➢ Dystonia – oculogyric crisis, torticollis, opisthotonos ➢ Tardive dyskinesia ➢ NMS neuroleptic malignant syndrome - lethal

Undesirable effects of anti-psychotic drugs

Sedation/sunlight sensitivity/sleepiness Tardive dyskinesia Anticholinergic/aganulocytosis/akathisia Neuroleptic malignant syndrome Cardiac effects (Orthostatic hypotension) Extrapyramidal Syndrome EPS (dystonia)

Motor retardation or akinesia characterized by mask-like appearance, rigidity, tremors, “pill-rolling”, salivation

Parkinsonism

_________ generally, occurs after 1st week of treatment of schizo or before the second month

Parkinsonism

Administer anticholinergic agent, anti-Parkinson medication

Akineton

Constant state of movement, characterized by restlessness, difficulty sitting still, or strong urges to move about.

Akathisia

___________ generally, occurs two weeks after treatment begins

Akathisia

Irregular, involuntary spastic muscle movement, wryneck or torticollis, facial grimacing, abnormal eye movements, backward rolling of eyes in the sockets

Acute dystonic reactions

May occur anytime from a few minutes to several hours after first dose of antipsychotic drug

Acute dystonic reactions

Treatment for acute dystonic reactions

Administer anticholinergic agent, have respiratory support equipment available.

Most frequent serious side effect resulting from termination of the drug, during reduction in dosage, or after long term high dose therapy. Characterized by involuntary rhythmic, stereotyped movements, tongue protrusion, cheek puffing, involuntary movements of extremities and trunk

Tardive dyskinesia

Occurs in approximately 20-25% of patients taking antipsychotics for over two years

Tardive dyskinesia

No treatment except discontinuation of the antipsychotic agent

Tardive dyskinesia

A potentially fatal syndrome

Neuroleptic malignant syndrome

T or F Neuroleptic malignant syndrome may occur anytime during therapy

Seen during the initiation of therapy, change of therapy. After a dosage increase or when a combination of meds is used

Neuroleptic malignant syndrome

Early sign NMS

rigidity or mental status changes

Symptoms of NMS

catatonia, tachycardia, tachypnea, labile blood pressure, dysphagia, diaphoresis, incontinence, rigidity, myoclonus, tremors, low grade fevers

What to do if NMS is present?

Discontinue antipsychotic agent. Have cardiopulmonary support available; administer skeletal muscle relaxant or central acting dopamine agonist

skeletal muscle relaxant

dantrolene

central acting dopamine agonist

bromocriptine

Anti-parkinsonian drugs

Dopaminergic Drugs Anti-cholinergic drugs

Dopaminergic Drugs

Levodopa carbidopa Amantidine bromocriptine pergolide selegiline

Anticholinergic drugs

BENADRYL, ARTANE, COGENTIN, PARSIDOL, AKINETON, KEMADRIN

Manifestations of schizo

S-social isolation * C-catatonic behavior * H-hallucinations * I-Incoherence * Z-zero/lack of interest and initiative * O-obvious failure in development * P-peculiar behavior * H-hygiene and grooming impaired * R-recurrent illusions * E-exacerbations and remissions * N-no organic factor account S/S * I-inability to return to functioning * A-affect is inappropriate

Other treatments of schizo

Psychotherapy Milieu therapy