Schizophrenia Spectrum Disorders Flashcards
Delusional Disorder
Fixed false beliefs that have lasted a month or longer include grandiose, persecutory, somatic and referential themes
Not severe enough to impair functioning
Brief Psychotic disorder
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
Schizophreniform
Schizophrenia symptoms that last less than 6 months
Schizoaffective Disorder
Major depressive or manic episode concurrent with symptoms that meet the criteria for schizophrenia
Need to rule out substance abuse or medical conditions
DSM-5 Criteria for Schizophrenia
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Negative symptoms (diminished emotional expression or withdrawn)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
Comorbidity’s of schizophrenia
Anxiety, depression and suicide
Substance abuse disorder
Nicotine addiction
Polydipsia
Physical Illness
Phases of Schizophrenia
Prodromal - Onset; mild symptoms
Acute- exacerbation of symptoms
Stabilization- symptoms diminish, movement towards previous level of functioning
Maintenance or residual- New baseline is establish
Positive Symptoms
Hallucinations, delusions, disorganized speech, bizarre behavior, Concrete thinking
Negative Symptoms
Blunted affect
poverty of though (alogia)
Loss of motivation (avolition)
Inability to experience pleasure or joy (anhedonia)
What are some cognitive symptoms?
Inattention, easily distracted
impaired memory
Poor problem-solving skills
poor decision making
illogical thinking
impaired judgement
Define the different types of alterations in speech:
Associative looseness
Clang association
Neologism
Echolalia
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”
Define the following different types of thought distortion:
Thought blocking
Thought insertion
Thought Deletion
Magical Thinking
Paranoia
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
illusion vs delusion
Illusion- Misinterpretation of real experience
Delusion- fixed false belief
Define the following alterations in behavior:
Boundary impairment
Gesturing/ posturing
Echopraxia
Stereotypes behaviors
Catatonia
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
What is a serious affect of schizophrenia?
Major depressive disorder
What are first generation antipsychotics and what receptor do they target?
Dopamine antagonist (D2 receptor) Haloperidol (Haldol) and chlorpromazine (thorazine)
Reduces positive symptoms
What are the second generation antipsychotics and what receptor do they target?
Serotonin (5-HT2a receptor) and dopamine (D2 receptor), olanzipine, pamoate, paliperidone, palmitate, clozapine, risperdone
Reduces positive and negative symptoms
What are side effects of first generation antipsychotics?
EPS, Anticholinergic, Tardive dyskinesia, endocrine disturbances
Dangerous responses to antipsychotics
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
Why is clozaril not a first choice for second generation antipsychotic?
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
Types of delusions
