Schizophrenia Spectrum

Question 1

possible causes of schizophrenia

Answer 1

Genetic predisposition
Biochemical dysfunction
Physiological factors
Psychosocial stress

Question 2

cure for schizophrenia

Answer 2

there is not one

Question 3

Compared to other mental illnesses, schizophrenia is more likely to increase:

Answer 3

Lengthy hospitalizations
Chaos in family life

Question 4

suicide risk with schizophrenia

Answer 4

About 1 out of 3 attempt suicide
1 out of 10 die from completed suicide

Question 5

Severe mental condition
Disorganization of the personality
Deterioration in social functioning
Loss of contact with, or distortion of, reality
May be evidence of hallucinations and delusional thinking
Can occur with or without organic impairment

Answer 5

psychosis

Question 6

disturbances related to schizophrenia

Answer 6

Thought processes
Perception
Affect
Severe deterioration of social and occupational functioning

Question 7

factors of person in phase 1: premorbid phase of schizophrenia

Answer 7

Social maladjustment
Antagonistic thoughts and behavior
Shy and withdrawn
Poor peer relationships
Doing poorly in school
Antisocial behavior

Question 8

factors of person in phase 2: prodromal phase of schizophrenia

Answer 8

Few weeks to a few years
Deterioration in role functioning and social withdrawal
Substantial functional impairment
Sleep disturbance, anxiety, irritability
Depressed mood, poor concentration, fatigue
Perceptual abnormalities, ideas of reference, and suspiciousness herald onset of psychosis

Question 9

factors of person in phase 3: active psychotic phase of schizophrenia

Answer 9

Schizophrenia is a chronic illness
Acute episodes in which symptoms are more pronounced
Delusions
Hallucinations
Impairment in work, social relations, and self-care

Question 10

symptoms of phase 4: residual phase of schizophrenia

Answer 10

Symptoms are similar to those of the prodromal phase
Flat affect and impairment in role functioning are prominent

Question 11

neurotransmitter implication theories

Answer 11

Excess of dopamine activity in brain
Abnormalities in norepinephrine, serotonin, acetylcholine, and GABA
Abnormalities in prostaglandins and endorphins
Excess of serotonin

Question 12

possibility of a viral infection being predisposed to schizophrenia

Answer 12

effect of autoimmune antibodies

Question 13

structural brain abnormalities for predisposition to schizophrenia

Answer 13

Ventricular enlargement
Reductions in gray matter
Reduced symmetry of lobes of brain
Reduced size of structures in limbic system

Question 14

environmental predisposing factors for schizophrenia

Answer 14

Poverty has been linked with development of schizophrenia
Stressful life events may be associated with exacerbation of symptoms and increased rates of relapse

Question 15

Predisposing Factors: Transaction Model

Answer 15

Theoretical integration and transaction model
Most likely a biologically based disease
Onset is influenced by factors in the internal or external environment

Question 16

the existence of prominent, nonbizarre delusion

Answer 16

delusional disorder

Question 17

subcategories of delusional disorders

Answer 17

Erotomanic type
Grandiose type
Jealous type
Persecutory type
Somatic type
Mixed type

Question 18

brief psychotic disorder

Answer 18

Sudden onset of symptoms
Possibly preceded by a severe psychosocial stressor
Lasts less than 1 month
Evidence of impaired reality testing
Incoherent speech, delusions, hallucinations, bizarre behavior, and disorientation
Catatonic features possible

Question 19

substance induced psychotic disorder

Answer 19

Presence of prominent hallucinations and delusions
Directly attributable to substance intoxication or withdrawal

Question 20

signs associated with Psychotic Disorder Due to Another Medical Condition

Answer 20

Prominent hallucinations and delusions
Directly attributable to a general medical condition
Not occurring during course of delirium

Question 21

examples of Psychotic Disorder Due to Another Medical Condition

Answer 21

CNS infection
Thyroid disorders
Migraine headaches
Renal disease

Question 22

signs and symptoms of schizophreniform disorder

Answer 22

Same symptoms as schizophrenia
Duration of the disorder has been at least 1 month but less than 6 months

Question 23

Symptoms of schizophrenia accompanied by a strong element of symptomatology associated with either mania or depression

Answer 23

schizoaffective disorder

Question 24

assessment of pt with schizophrenia

Answer 24

Positive symptoms - something is added
-Disturbances in thought content
-Disturbances in thought processes manifested in speech
-disturbances in thoughts
-disturbances in thought
-disturbances in perception

negative symptoms
-disturbances in affect
-apathy
-avolition
Lack of interest or skills in interpersonal interaction
Lack of insight
Anergia
Lack of abstract thinking ability
Associated features

Question 25

Shift of ideas from one unrelated topic to another

Answer 25

loose associations

Question 26

Made-up words that have meaning only to the person who invents them

Answer 26

neologisms

Question 27

Literal interpretations of environment

Answer 27

concreteness

Question 28

Choice of words is governed by sound

Answer 28

clang associations

Question 29

Group of words put together in a random fashion

Answer 29

word salad

Question 30

Delay in reaching the point of a communication because of unnecessary and tedious details

Answer 30

circumstantiality

Question 31

Inability to get to the point of communication due to introduction of many new topics

Answer 31

tangentiality

Question 32

Persistent repetition of the same word or idea in response to different questions

Answer 32

perseveration

Question 33

refers to repeating words or phrases spoken by another

Answer 33

echolalia

Question 34

hallucinations may involve any of the 5 senses

Answer 34

Auditory Visual Tactile Gustatory Olfactory

Question 35

positive outcomes for client with schizophrenia

Answer 35

Demonstrates ability to relate satisfactorily with others Recognizes distortions of reality Has not harmed self or others Perceives self realistically Demonstrates ability to perceive environment correctly Maintains anxiety at a manageable level Relinquishes the need for delusions and hallucinations Demonstrates the ability to trust others Uses appropriate verbal communication in interactions Performs self-care activities independently

Question 36

planning and implementation for schizophrenia

Answer 36

Disturbed sensory perception: auditory/visual Disturbed thought processes Risk for violence

Question 37

evaluations for pt with schizophrenia

Answer 37

Has client established trust with at least one staff member? Is anxiety level maintained at a manageable level? Is delusional thinking still prevalent? Is client able to interrupt escalating anxiety with adaptive coping mechanisms? Is client easily agitated? Is client able to interact with others appropriately?

Question 38

2 psychological treatments for schizophrenia

Answer 38

Individual psychotherapy Group therapy Behavior therapy Social skills training Family therapy ACT Recovery model Recovery after an initial schizophrenia episode (RAISE) Psychopharmacological treatment

Question 39

Long-term therapeutic approach; difficult because of client’s impairment in interpersonal functioning

Answer 39

individual psychotherapy

Question 40

Some success if occurring over the long-term course of the illness; less successful in acute, short-term treatment

Answer 40

group therapy

Question 41

Difficult to generalize to community setting after client has been discharged from treatment

Answer 41

behavior therapy

Question 42

Use of role play to teach client appropriate eye contact, interpersonal skills, voice intonation, posture Aimed at improving relationship development

Answer 42

social skills training

Question 43

Aimed at helping family members cope with long-term effects of the illness

Answer 43

family therapy

Question 44

Evidence-based program of case management Team approach Providing comprehensive, community-based psychiatric treatment Providing rehabilitation and support to individuals with serious and persistent mental illness

Answer 44

assertive community treatment (ACT)

Question 45

Concept of healing and transformation enabling a person with mental illness to live a meaningful life in the community Striving to achieve his or her full potential

Answer 45

recovery model

Question 46

Program of case management Team approach Providing comprehensive, community-based psychiatric treatment Providing rehabilitation and support to persons with serious and persistent mental illness Early intervention at first episode of psychosis

Answer 46

Recovery after an initial schizophrenia episode (RAISE)

Question 47

typical antipsychotics

Answer 47

Thorazine (chlorpromazine) Prolixin (fluphenazine) Prolixin Deconoate Haldol (haloperidol) Haldol Deconoate

Question 48

atypical antipsychotics

Answer 48

Clozaril (clozapine) agranulocytosis Geodon (ziprasidone)—prolonged Q-T Risperdal (risperdone) Seroquel (quetiapine)—sedation Abilify (aripiprazole) Zyprexa (olanzapine)—metabolic syndrome Invega (paliperidone)

Question 49

Antipsychotic Adverse Effects

Answer 49

Anticholinergic effects Nausea; gastrointestinal upset Skin rash Sedation Orthostatic hypotension Photosensitivity Hormonal effects Electrocardiogram changes Hypersalivation Weight gain Hyperglycemia/diabetes Reduction in seizure threshold Agranulocytosis Extrapyramidal symptoms Tardive dyskinesia Neuroleptic malignant syndrome Black Box Warning: Increased risk of mortality in elderly clients with dementia!!!!

Question 50

examples of extrapyramidal symptoms associated with antipsychotics

Answer 50

Pseudoparkinsonism Akinesia Akathisia Dystonia Oculogyric crisis

Question 51

agents that may be prescribed to counteract EPS

Answer 51

antiparkinsonian agents

Question 52

mimicking movements

Answer 52

echopraxia