Schizophrenia Flashcards
a group of disorders characterized by disturbance in thoughts, feelings, perception and behavior
Schizophrenia
Severe impairment of mental and social functioning with grossly impaired reality testing, sensory perception and with deterioration and regression of psychosocial functioning.
Schizophrenia
Schizophrenia symptoms
Delusions, Hallucinations
Ambivalence, Echopraxia
Flight of Ideas, Perseveration
Associative Looseness, Ideas of Reference
Bizarre Behavior
Positive symptoms of Schizophrenia
Schizophrenia Symptoms
Affective flattening and blunting, Alogia
Avolition, Anhedonia
Apathy, Catatonia, Blunted Affect
Avolition or Lack of Volition
Asociality
Flat Affect
Inattention, Disorganized Thinking
Word Salad, Neologism
Clang Association, Verbigeration
Stilted Language, Disorganized behavior
Regression
Negative Symptoms of Schizophrenia
Bleuler’s Four A’s of Schizophrenia
- Associative Looseness
- Autistic behavior
- Affect
- Ambivalence
5th A: Auditory Hallucinations
Person’s thoughts are excessively involved, and focused outward
Autistic Behavior
Also known as derailment, refers
to a thought-process disorder characterized by an absence
or lack of connection between thoughts or ideas. The individual will frequently jump from one idea to an unrelated one.
Associative Looseness
Blunted affect, severe reduction in emotional expressiveness
Affect
Presence of two equally strong feelings coexisting and neutralizing each other
Ambivalence
Etiological Theories
Genetic pattern within the family system
(50% chance for the other identical twin, and 15% for
fraternal twins).
Genetic Factors
Etiological Theories
People
with schizophrenia have relatively less brain tissue and cerebrospinal fluid, enlarged ventricles in the brain and
cortical atrophy.
PET studies suggest that glucose metabolism and oxygen are diminished in the frontal
cortical structures of the brain.
Neuroanatomic and Neurochemical Factors
Etiological Theories
Genetic Factors
Neuroanatomic and Neurochemical Factors
Immunovirologic Factors
Etiological Theories
Exposure to a virus of the
body’s immune response to a virus could alter the brain physiology. Recent researchers have been focusing on
infections in pregnant women as a possible origin for schizophrenia.
Immunovirologic Factors
Poor care giving that leads to psychic alteration (Freud and Blueler)
Loss of ego boundaries
Psychodynamic Theory
Double blind communication pattern within a poor family relationship
Psychodynamic Theory
Types of Schizophrenia
Paranoid Schizophrenia
Hebephrenic Schizophrenia
Disorganized Schizophrenia
Catatonic Schizophrenia
Undifferentiated Schizophrenia
Residual Schizophrenia
Onset: Schizophrenia
- Abrupt or insidious
- Age of onset appears to be an important factor on how well the client fares
- Those who develop the illness earlier show worse outcomes than those who develop it later
Schizophrenia
Behavioral Pattern: Suspicious
Defense Mechanism: Projection
Paranoid Schizophrenia
Characteristics: Extreme suspiciousness, ideas of reference, delusion of persecution, auditory hallucination, and unpredictable violence.
Paranoid Schizophrenia
4Ps of Paranoid Schizophrenia
Projection
Proxemics
Passive Friendliness
Persecutory Delusion
Considerations:
● Consistency to build trust.
● Food: packed or sealed food.
● Social isolation
● Develop trust.
● Be reliable and consistent.
● Safety for other and client
○ Approach non-threatening manner.
○ Never whisper.
○ Never hold complicated objects.
○ Provide solitary.
○ Provide safe and relatively simple activities.
Paranoid Schizophrenia
Characterized
Inappropriate behavior
Silly crying
Laughing
Regression
Transient hallucinations
Hebephrenic Schizophrenia
Onset: Early, usually below 18 years old and is insidious
Behavioral Pattern: Withdrawn
Defense Mechanism: Regression
Disorganized Schizophrenia
Characteristics
Inappropriate behavior
Silly smiles and laughter
Somatic delusions
Impaired ADL
Disorganized Schizophrenia
With stereotyped position (catatonia), waxy flexibility, mutism, bizarre mannerisms.
Characteristics:
● Stupor – Slowed movement.
● Posturing – Weird bizarre positions.
● Rigidity - Cementation/stone-like position.
● Negativism – resistance towards flexion and extension
● Excitability - Hyperactivity.
Catatonic Schizophrenia
Onset: Any age group and usually acute and precipitated by an emotionally disturbing experience.
Behavioral Pattern: Withdrawn
Defense Mechanism: Repression
Catatonic Schizophrenia
2 Types of Catatonic Schizophrenia
Sudden onset of mutism, bizarre mannerisms, waxy flexibility, automatism
Catatonic Stupor
2 Types of Catatonic Schizophrenia
Dangerous periods of agitation, impulsive and explosive behavior.
Catatonic Excitement
Symptoms of more than one type of schizophrenia
Affect is flat.
● Delusion and hallucination.
● Disorganized speech.
● Disorganized catatonic behavior.
● Social withdrawal.
● Does not meet the criteria for paranoid; disorganized or catatonic.
Undifferentiated Schizophrenia
The patient no longer exhibits overt symptoms, no more delusion but still has negative symptoms or odd benefits or unusual perceptions.
Residual Schizophrenia
People with _____________ often neglect basic hygiene and need help with everyday living activities.
Absence of prominent delusion, hallucinations, disorganized speech and grossly disorganized or catatonic
behavior
Residual Schizophrenia
Treatment
- Psychopharmacology
- Maintenance Therapy
Psychopharmacology: Traditional Medications (1950s)
Haloperidol
Chlorpromazine
Thiothixene
Psychopharmacology: New Medications (1990s)
Clozapine
Risperdal
Zyprexa
Treatment Modalities
Psychosocial Interventions and Psychotherapy
- Counselling and Psychotherapy
- Social Skills Education
The client exhibits the symptoms of schizophrenia but for less than 6 months. Social or occupational functioning may
or may not be impaired.
Schizophreniform Disorder
The client exhibits the symptoms of psychosis and at the same time all the features of a mood disorder either
depression or mania.
Schizoaffective Disorder
The client has one or more bizarre delusions, the focus of delusion is believable
Delusional Disorder
Presence of 1 or more false beliefs that persist for at least 1 month
Central Feature
Subtypes of Delusional Disorder
- Erotomanic
- Grandiose
- Jealous
- Persecutory
- Somatic
Patient believes that another person is in love with him
Erotomanic
Patient believes that he has great talent or has made an important discovery
Grandiose
Patient believes that his spouse or lover is unfaithful
Jealous
Patient believes that he is being plotted against, spied, or maligned or harassed
Persecutory
Patient believes that he has a physical deformity, odor, or parasite
Somatic
Current Trends in Schizophrenia Research
Brain imaging and mapping.
Autoimmunity immune systems and dysregulation model.
Ethical and legal considerations in high-risk studies of
schizophrenia.
Pharmacogenetics and tailored drug treatment.
The role of nurses and interdisciplinary team.
