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Mental Health > Schizophrenia Chapter 15 > Flashcards

Schizophrenia Chapter 15 Flashcards

1
Q

Etiology of Schizophrenia

A

genetic predisposition, biochemical dysfunction, physiological factors, and psychosocial stress.

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2
Q

Agreed upon factors of Schizophrenia

A

Not a homogeneous disease.
There may never be a single treatment that cures the disorder

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3
Q

“Schiz”o”phren”ia

A

Schiz mean split
Phren means mind

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4
Q

Schizophrenia Definition

A

Disturbances in thought processes, perception, and affect invariably result in a severe deterioration of social and occupational functioning.

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5
Q

Psychosis

A

Disorganization of personality
Deterioration in social functioning
Loss of contact with, or distortion of reality
Hallucinations and delusional thinking

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6
Q

Phases of schizophrenia

A

Phase I: Premorbid
Phase II: Prodromal
Phase III: Active/Psychotic Phase (Acute Schizophrenic Episode)
Phase IV: Residual

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7
Q

Premorbid Phase

A

Phase I
Occurs before there is clear evidence of an illness
Personality traits: Shy, Withdrawn, Poor peer relationships

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8
Q

Prodromal Phase

A

Phase II
More clearly manifests as signs of developing illness
Can be a brief period of time- 2 to 5 years on average
Shows significant deterioration in functioning
Depressive or OCD symptoms

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9
Q

Psychotic/Acute Schizophrenic Episode

A

Phase III
Active phase of the disorder
Psychotic symptoms are prominent
Positive and negative symptoms are present

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10
Q

Residual

A

Phase IV
Symptoms of the acute phase are either absent or no longer prominent

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11
Q

Positive Symptoms

A

Symptoms that are added to a persons personality that others do not experience
Delusions
Hallucinations
Disorganized thinking, speech and behaviors
Catatonic/Waxy/Dysarthria

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12
Q

Negative Symptoms

A

Symptoms that are taken away from a person personality that others do have/can experience
Diminished emotional expression or avolition
Flat Affect
Impaired function in ADLs
Social Withdrawal

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13
Q

When does schizophrenia begin to manifest

A

Late adolescence into early adulthood
college age- major life change such as going away to college

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14
Q

Types of schizophrenia

A

Paranoid
Disorganized
Catatonic
Undifferentiated

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15
Q

Paranoid Schizophrenia (SCPT)

A

Paranoia
Food being poisoned
Bad person

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16
Q

Disorganized schizophrenia

A

Not making sense
Cannot organize their thoughts

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17
Q

Catatonic Schizophrenia

A

Statue like
Not talking or responding
Physically not moving

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18
Q

Undifferentiated Schizophrenia (SCUT)

A

Does not fit in to the other schizophrenic categories
May have more than one symptom from each category

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19
Q

Risk of suicide

A

1 in 3 will attempt
1 in 10 will succeed

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20
Q

Types of Hallucinations

A

Auditory (most common)- false perception of sound
Visual- false visual perception. May see people or flashes of light that are not there
Tactile- false sense of touch. Feeling something on or underneath the skin
Gustatory- False sense of taste, typically unpleasant tasting
Olfactory- False sense of smell

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21
Q

Delusional Disorder (most common)

A

Grandiose- exaggerated feeling of importance
Jealous- belief partner is being unfaithful regardless of evidence that states otherwise
Persecutory (most common)- being persecuted, plotted against, cheated, followed, spied on. May involve paranoid delusions. CIA is spying on them.

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22
Q

Paranoid Delusions

A

Extreme suspicion of others and their actions or intentions. Not eating food because it was poisoned.

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23
Q

Delusional Disorder (others)

A

Reference
Influence/Magical thinking
Somatic
Nihilistic
Erotomanic

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24
Q

Delusions of Reference

A

events in the environment are for themselves (song lyrics are speaking to them)

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25
Q

Delusions of Influence

A

Another person or objects control their behavior, magical thinking.

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26
Q

Magical Thinking

A

their thoughts/behaviors control situations/people

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27
Q

Nihilistic

A

false idea about body/function

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28
Q

Erotomanic

A

Someone of higher status is in love with them

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29
Q

Religiosity

A

excessive demonstration of or obsession with religious ideas and behaviors that cause distress and impress ability to function

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30
Q

Concrete thinking

A

literal interpretations of the environment
“it’s raining cats and dogs”

31
Q

Recovery Model

A

Functional Recovery
RAISE (Recovery After Initial Schizophrenic Episode)

32
Q

Functional Recovery

A

Focuses on the individual’s level of functioning in such areas as relationships, work, independent living, and other kinds of life functioning.

33
Q

RAISE (Recovery After Initial Schizophrenic Episode)

A

Early comprehensive treatment to decrease debilitating results of schizophrenia.

Includes community treatment, recovery model approaches, family approaches, and comprehensive care models

34
Q

Individual Psychotherapy

A

Reality based orientation
Honest, simple directness which respects privacy and dignity
Help identify real and perceived dangers

35
Q

Group Therapy

A

More effective in outpatient settings when combined with medications
Can be counterproductive in early treatment
Most useful over the long term course of the illness

36
Q

Psychological Treatments

A

Individual
Group- effective as outpatient
Behavior- lessens bizarre behaviors
Social Skills- manage relationships and communications- use of role playing

37
Q

Social Treatments

A

Family Therapy- long term program
Assertive Community Treatment (ACT)

38
Q

Assertive Community Treatment (ACT)

A

case management that takes a team approach in providing comprehensive treatment, rehab and support to the patient

39
Q

Loose Associations

A

Speech where ideas shift from one unrelated subject to another. When the condition is severe, speech may be incoherent

“We wanted to take the bus, but my lunch was cold. The FBI is watching me. No one needs to pay to get to heaven. We have it all in our pockets”.

40
Q

Neogisms

A

The person invents new words, or neologisms, that are meaningless to others but have symbolic meaning to the individual

“She wanted to give me a ride in her new uniphorum”.

41
Q

Clang Associations

A

Choice of words is governed by sounds. Clang associations often take the form of rhyming.

“It is very cold. I am cold and bold. The gold has been sold.”

42
Q

Word Salad

A

A group of words that are put together randomly, without any logical connection

“Most forward action grows life double plays circle uniform”.

43
Q

Circumstantiality

A

Unnecessary and tedious details which delay the point of communication

44
Q

Tangentiality

A

Veering away from the topic, difficulty maintaining focus and attention

45
Q

Perseveration

A

Persistently repeating the same word or idea in response to different questions

46
Q

Echolalia

A

Repeating words or phrases said by someone else

47
Q

Illusions

A

Misperceptions or misinterpretations of real external stimuli.

48
Q

Echopraxia

A

Imitates movements made by others.

49
Q

Affect

A

Behavior associated with an individuals feeling state or emotional tone

50
Q

Inappropriate Affect

A

Emotional tone is incongruent with circumstances

Laughs when told of the death of a loved one

51
Q

Bland/Flat Affect

A

Emotional tone is very weak

Void of emotion or feeling

52
Q

Apathy

A

Indifference or disinterest

53
Q

Avolition

A

Inability to initiate goal-directed activity

Lack of motivation
Neglect of ADLs

54
Q

Anosognosia

A

Lack of Insight
The most common predictor of non adherence to treatment, high relapse, involuntary treatments, poorer psychosocial functioning, aggression and poorer course of illness
Lack of awareness of having an illness or disease

Pt is brought to ED and tells the nurse they were in the apartment and the police told them they had to go to the ED

55
Q

Anergia

A

Lack of energy to perform ADLs or interact with others

56
Q

Anhedonia

A

Inability to experience pleasure

Increases the risk of suicide

57
Q

Waxy Flexibility

A

a condition in which the client with schizophrenia allows body parts to be placed in bizarre or uncomfortable positions

58
Q

Posturing

A

This symptom is manifested by the voluntary assumption of inappropriate or bizarre postures.

59
Q

Organic Treatments for Schizophrenia

A

Psychopharmacology
Antipsychotics aka neuroleptics; major tranquilizers

60
Q

Antipsychotics Indications

A

Effective for the treatment of acute and chronic symptoms of schizophrenia and other psychotic disorders
Typical and Atypical

61
Q

Antipsychotic Mechanism of Action

A

Blocks dopamine to decrease positive symptoms

62
Q

Antipsychotic Side Effects

A

Interferes with normal movement (EPS)
Acute dystonia
Tardive Dyskinesia
Increased prolactin levels
Cholinergic symptoms
Caution when used in elderly population

63
Q

Extrapyramidal Symptoms (EPS)

A

Responses that originate outside the pyramidal tracts and in the basal ganglion of the brain. tremors, chorea, dystonia, akinesia, akathisia, and others.

64
Q

Dystonia

A

Involuntary muscular movements (spasms) of the face, arms, legs, and neck

65
Q

Tardive Dyskinesia

A

bizarre facial and tongue movements, a stiff neck, and difficulty swallowing

66
Q

Cholinergic symptoms

A

dry mouth, blurred vision, constipation, urinary retention, and tachycardia

67
Q

Antipsychotic Medication Patient Education

A

Use caution while driving
Do not stop abruptly
Use sunblock and wear protective clothing
Rise slowly to avoid orthostatic hypotension
Maintain hydration and eat hard candy for dry mouth
Good oral care
Avoid smoking

68
Q

Neuroleptic Malignant Syndrome

A

A rare but potentially fatal complication of treatment with neuroleptic drugs.
Symptoms include severe muscle rigidity
high fever
tachycardia
fluctuations in blood pressure
diaphoresis
rapid deterioration of mental status to stupor and coma.

69
Q

Atypical Antipsychotic Medication

A

Clozapine

70
Q

Clozapine Special Considerations

A

Risk of agranulocytosis
Baseline WBC level
Used in patients who fail to respond to other antipsychotic medications

71
Q

Theory Burst

A

Normal WBC levels: 5-10
Clozapine potential adverse reaction: agranulocytosis (1-2% of pts)
Protocol for this med: weekly CBC fir 6 months then q 2 weeks for 2 weeks then monthly
Only given a 7 day supply at a time
notify physician S/S of infection- sore throat, fever, malaise

72
Q

Medication for non compliant patients

A

Long acting risperidone (Perseris)

90mg or 120mg once a month

73
Q

First Generation Antipsychotics

A

Haldol 1-100mg

74
Q

Second Generation Antipsychotic Medications

A

Aripiprazole (Abilify): 10-30mg
risperidone- Risperdal: 4-8mg
quetiapine fumarate- Seroquel: 300-400mg
clozapine (Clozaril): 300-900mg
iloperidone (Fanapt): 12-24mg
lurasidone (Latuda): 40-80mg
olanzapine (Zyprexa): 5-20mg
paliperidone (Invega): 6-12mg
ziprasidone (Geodon): 40-160mg

Mental Health (3 decks)

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