Schizophrenia Flashcards
Postive symptoms of schizophrenia?
Positive Symptoms:
–Excess or distortion of normal functions
–Think of it as more than would be normal
Delusions
–Grandiosity
–Nihilistic beliefs
–Persecutory
–Somatic beliefs
Hallucinations
–Auditory, visual, tactile
Negative symptoms of Schizophrenia?
Negative Symptoms
- Lessening or loss of normal functions
- Think of it as less than normal
Emotions
flattened, absent, blunted
alogia
avolition
anhedonia
poverty of thought
thought blocking
characteristics of psychosis
- Primarily positive symptoms
- Delusions,
- Hallucinations – voices heard, visual hallucinations (drug induced perhaps), tactile (drug induced)
- Disorganized thought, behaviour, speech
- Is not delirium
- a condition which represents loosing touch with reality
- inability to recognize reality
- client will exhibit bizarre behaviors
- inability to deal with life’s demands
- mood changes
- perceptual disturbances
- disordered thinking
- impoverished interpersonal relationships
- social isolation
- withdrawl from the “real” world
- Neglect of personal appearance
Diagnostic groups of schizophrenia?
–Delusional disorder
–Brief psychotic episode
–Drug induced psychosis
–Schizoaffective disorder
–schizophreniform
what is the difference b/w schizophrenia and psychosis
Schizophreniaà specific criteria
–Mixture of positive and negative symptoms
–Persistent symptoms x 1 month but continuous signs of disturbance x 6 months
Psychosis
–varying clinical pictures
–Possibly not so long term in terms of symptom presentation
–General term that may encompass various illnesses
Characteristics of delusions
- Ideas of Reference
- Misconstruing trivial events/remarks and giving them personal significance
- Persecution
- Believing one is being singled out for harm by others
- Grandeur
- Believing one is a powerful, important personage
- Somatic
- False belief that the body is changing
- Jealousy
- False belief that one’s significant other is unfaithful
Types of hallucinations
Auditory
Hearing voices that do not exist. Voices are projections of own inner thoughts.
Visual
Seeing a person or object that does not exist in the environment
Tactile
Feeling strange sensations when no external stimulus exists
Olfactory
Smelling odors not actually present in the environment
Gustatory
Tasting sensations that have no stimulus
Characteristics of schizophrenia
- Positive symptoms
- Disorganization of speech and behaviour
- Negative symptoms
- Problems of emotion
- Impaired decision making
Negative symptoms: ADLs
- Interfere with ability to attend to ADLs including interaction with supports or within community/society
- Do you ask “how are you feeling?” à emtional expressing markedly diminished
- Ambivalence
- Avolition may be profound à hygiene issues, eating, dressing
- Anhedonia à novelty has limited effect, withdrawal from world
neurocognitive impairment of schizophrenia
- Memory (short & long term)
- Attention
- Verbal fluency
- Planning & engagement with others absent
- Decision making impaired
- Frontal lobe changes evident
how does schizophrenia present in children?
–Developmental abnormalities
–Delayed speech & motor skills
–Problematic social adjustment
–Poor social competence / development
communication difficulties in schizophrenia?
- Blocking
- Clang associations
- Echolalia
- Neologisms
- perseveration
- Word salad
- Non-verbal communication: incongruency, posturing, unusual movements or grimacing
Teaching for schizophrenia
- Signs and symptoms, etiological theories
- Develop a relapse plan – what will you do if…
- Attention to self-care deficits
- Comply with treatment
- Avoid ETOH and street drugs
- Keep in touch with supports and follow up appointments
- Maintain healthy diet, exercise, leisure, connections with supports as much as possible
extrapyramidal side effects with medications
•Extrapyramidal (EPSE) side effects
–Pseudoparkinsonianism
–Acute dystonic reaction – oculogyric crisis
–Akathisia – reversible – walk/talk
–Tardive dyskinesia – irreversible
•Continued assessment required
•Check for cogwheeling
•Involuntary movement assessments
–Face/oral, extremities, trunk, globally
nursing care: specific issues with schizophrenia
–Empowerment
–Interpersonal relationships & connections
–Social expectations
–Self image changes
– diminished insight
–Coping with relapse and preventing relapse
–Understanding symptoms of illness
medication teaching: anticholinergic side effects
•Anticholinergic
–Dry mouth
–Urinary hesitancy and retention – S&S UTI
–Blurred vision
–Constipation
–Photosensitivity
–Dry eyes
–Ejaculatory inhibition
working with a hallucinating client
•Determine what sort of hallucination pt having
•Can symptom be managed with current coping?
•Select options for dealing with stimuli:
–Distraction from area/activity to reality…listen to me… let’s go find your shoes now
–Resisting
–Calming
–Treatment
•Provide option as much as possible
•What worked in past?
•Be ready to replace coping as needed – ie. Possibly moving client to quiet room
4 parts to managing psychosis with CBT
1.Normalization—the explanation of psychosis and how anyone can experience similar symptoms in extreme situations
2.Universality—the understanding that many people have experiences similar to the patient’s
- *3.Collaborative therapeutic alliance**—the patient is regarded not as a passive recipient but as an active collaborator in treatment
- *4. **Focus on life goals.—makes treatment meaningful to the patient
what is schizophreniform disorder?
similar features to schizophrenia but only lasts for 6 months, may not turn into schizoprenia
what is a brief psychotic disorder?
sudden onset of psychosis or grossly disorganzied or catatonic behaviour lasting less than one month
what is schizoaffective disorder?
major depressive disorder, manic, or mixed mood episode presenting concurrently with symptoms of schizophrenia. not due to any substance use or medical condition
what is delusional disorder?
non bizzare delusions (things that can happen in real life), doesnt usually affect daily living, can result from brain disease
four main symptom groups of schizophrenia
