Schizophrenia Spectrum Disorders

Question 1

Delusional Disorder

Answer 1

Fixed false beliefs that have lasted a month or longer include grandiose, persecutory, somatic and referential themes
Not severe enough to impair functioning

Question 2

Brief Psychotic disorder

Answer 2

Lasts longer than a day but not longer than a month
Delusions, Hallucinations, disorganized speech and disorganized or catatonic behavior
expectation of returning to normal functioning

Question 3

Schizophreniform

Answer 3

Schizophrenia symptoms that last less than 6 months

Question 4

Schizoaffective Disorder

Answer 4

Major depressive or manic episode concurrent with symptoms that meet the criteria for schizophrenia
Need to rule out substance abuse or medical conditions

Question 5

DSM-5 Criteria for Schizophrenia

Answer 5

Two or more of the following symptoms for 6 months or more.
Delusions
Hallucinations
Disorganized speech
Grossly disorganized or catatonic behavior
Negative symptoms (diminished emotional expression or withdrawn)
Need to rule out substance abuse or medical conditions

Question 6

Comorbidity’s of schizophrenia

Answer 6

Anxiety, depression and suicide
Substance abuse disorder
Nicotine addiction
Polydipsia
Physical Illness

Question 7

Phases of Schizophrenia

Answer 7

Prodromal - Onset; mild symptoms
Acute- exacerbation of symptoms
Stabilization- symptoms diminish, movement towards previous level of functioning
Maintenance or residual- New baseline is establish

Question 8

Positive Symptoms

Answer 8

Hallucinations, delusions, disorganized speech, bizarre behavior, Concrete thinking

Question 9

Negative Symptoms

Answer 9

Blunted affect
poverty of though (alogia)
Loss of motivation (avolition)
Inability to experience pleasure or joy (anhedonia)

Question 10

What are some cognitive symptoms?

Answer 10

Inattention, easily distracted
impaired memory
Poor problem-solving skills
poor decision making
illogical thinking
impaired judgement

Question 11

Define the different types of alterations in speech:
Associative looseness
Clang association
Neologism
Echolalia

Answer 11

Associative looseness- word salad, meaningless jumble of words
Clang association -words that rhythm
Neologism- meaning for the patient only
Echolalia- pathological repetition of another words “parroting”

Question 12

Define the following different types of thought distortion:
Thought blocking
Thought insertion
Thought Deletion
Magical Thinking
Paranoia

Answer 12

Thought blocking -Interruption or stopping of thought.
Thought insertion- Belief someone has inserted thoughts into their brain
Thought Deletion -A belief that thoughts have been taken or are missing
Magical Thinking -belief that thoughts or actions effect other’s consequences
Paranoia-irrational fear

Question 13

illusion vs delusion

Answer 13

Illusion- Misinterpretation of real experience
Delusion- fixed false belief

Question 14

Define the following alterations in behavior:
Boundary impairment
Gesturing/ posturing
Echopraxia
Stereotypes behaviors
Catatonia

Answer 14

Catatonia- lack of movement
Stereotypes behaviors- repetitive behaviors with no logical purpose
Echopraxia- mimicking another’s movement
Gesturing/ posturing- unusual or illogical expressions
Boundary impairment

Question 15

What is a serious affect of schizophrenia?

Answer 15

Major depressive disorder

Question 16

What are first generation antipsychotics and what receptor do they target?

Answer 16

Dopamine antagonist (D2 receptor) Haloperidol (Haldol) and chlorpromazine (thorazine)

Reduces positive symptoms

Question 17

What are the second generation antipsychotics and what receptor do they target?

Answer 17

Serotonin (5-HT2a receptor) and dopamine (D2 receptor), olanzipine, pamoate, paliperidone, palmitate, clozapine, risperdone

Reduces positive and negative symptoms

Question 18

What are side effects of first generation antipsychotics?

Answer 18

EPS, Anticholinergic, Tardive dyskinesia, endocrine disturbances

Question 19

Dangerous responses to antipsychotics

Answer 19

Anticholinergic toxicity - reduced or absent peristalsis, urinary retention, mydriasis, hyperpyrexia, tachycardia, seizure or repetitive motor movements

Nursing response: Hold all medications, consult with prescriber, implement cooling measure, catheterize if needed and if needed hospitalize

Neuroleptic malignant syndrome- severe muscle rigidity, reduced or absent speech/ movement, hyperpyrexia, autonomic dysfunction: tachycardia, diaphoresis, incontinence. delirium, stupor, coma

Nursing response: Stop medication, transfer to ICU

Question 20

Why is clozaril not a first choice for second generation antipsychotic?

Answer 20

Can cause agranulocytosis and neutropenia. Blood work CBC/CMP needed weekly. Report if patient presents with fever or sore throat, notify physician and hold drug

Question 21

Types of delusions