TOPIC 6 - psychotic disorders Flashcards

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1
Q

schizoaffective disorder

A

characterized by an uninterrupted period of illness during which time there is a major depressive, manic, or mixed episode, concurrent with symptoms that meet the criteria for schizophrenia. The symptoms must not be a result of any substance use or abuse or be attributable to a general medical condition

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2
Q

schizophreniform disorder

A

The essential features of schizophreniform disorder are exactly the same as those of schizophrenia except the symptoms may only last a short time, and impaired social or occupational functioning is usually not apparent

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3
Q

brief psychotic disorder

A

Brief psychotic disorder is characterized by a sudden onset of psychotic symptoms (delusions, hallucinations, disorganized speech) or grossly disorganized or catatonic behavior. The episode is usually short-lived and the person returns to his or her premorbid level of functioning. These disorders are usually precipitated by extremely stressful life events.

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4
Q

delusional disorder

A

Delusional disorder involves nonbizarre delusions (situations that occur in real life, such as being followed, infected, loved at a distance, deceived by a spouse, or having a disease) of at least 1 month’s duration. The person’s ability to function is not markedly impaired, nor is the person’s behavior obviously odd or bizarre. Common types of delusions seen in this disorder are of grandeur, persecution, or jealousy; somatic delusions; and mixed delusions

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5
Q

shared psychotic disorder

A

a condition in which an individual who is in a close relationship with another individual who has a psychotic disorder with a delusion eventually comes to share the delusional beliefs either in total or in part. Apart from the shared delusion, the behavior of the person who assumes the other’s delusional behavior is not odd or unusual. Impairment of the person who shares the delusion is usually much less than that of the person who has the psychotic disorder with the delusion

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6
Q

substance induced psychotic disorder

A

Psychosis may be induced by substances (drugs of abuse, alcohol, medications, or toxins) or caused by the physiological consequences of a general medical condition (delirium, neurological conditions, metabolic conditions, hepatic or renal diseases, and many others). Medical conditions and substances of abuse must always be ruled out before a primary diagnosis of schizophrenia or other psychotic disorder can be made

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7
Q

areas of functioning affected with schizophrenia

A

reality perception - hallucination or delusion
cognitive ability - disorganized thinking, impaired memory, problem solving skills
speech - grossly disorganized thoughts and language
affect - may include dysphoria, SI, hopelessness
behavior and social interaction - inability to function in social settings or ADL’s

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8
Q

positive symptoms

A

altered sensory perception - hallucination and delusion
catatonia
speech disturbances
thought disturbances

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9
Q

negative symptoms

A

affect restriction (flat affect)
alogia (poverty of speech or thought block)
avolition (loss of motivation)
apathy (lack of caring)
anergia (little or no energy)
anhedonia (little or no pleasure)
asociality (social isolation)
attention deficit
anosognosia (lack of insight)

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10
Q

mood symptoms

A

depression
anxiety
demoralization
dysphoria
suicidality

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11
Q

cognitive symptoms

A

memory impairment
disruption in social learning
inability to reason
inability to problem solve
inattention

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12
Q

most common type of hallucination

A

auditory
(secondary is visual)

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13
Q

delusions

A

false fixed beliefs
types: persecutory, jealous, grandiose, religious, somatic

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14
Q

ideas of reference

A

misinterpretation of messages or giving private, personal meaning to the communication of others

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15
Q

thought broadcasting

A

belief that ones thoughts can be heard by others

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16
Q

thought insertion

A

belief that others thoughts are being inserted into ones mind

17
Q

thought withdrawl

A

belief that thoughts are being removed from ones mind

18
Q

loosening of associations

A

illogical, haphazard thinking, nonsensical

19
Q

tangenital thinking

A

inclusion of excessive, unnecessary detail when answering a question

20
Q

speech disturbance

A

associative lossening
neologisms
clang association
word salad
echolalia and echopraxia (seen in catonia)

21
Q

altered behavior/catatonia

A

bizarre behavior, extreme motor agitation, stereotyped behaviors, wavy flexibility, stupor, negativism, automatic obedience, impulse control

22
Q

comorbidities

A

substance abuse
anxiety
depression
OCD
panic disorder
obesity

23
Q

neurochemical receptors involved

A

dopamine
serotonin
glutamate

24
Q

types of imaging used diagnostically

A

CT
MRI
fMRI
PET

25
Q

course of schizophrenia

A

prodromal - acute phase 1 - stabilization phase 2 - maintenance phase 3

26
Q

acute phase 1

A

inpatient stabilization with meds and interventions, likely hospitalized

goal is crisis management, establish support and maintenance/ patient safety !

27
Q

stabilization phase 2

A

transition into home, patient and family education/skills training/relapse prevention skills

goal is outpatient continuity, may require group therapy, med compliance and understanding, control and relapse prevention

28
Q

maintenance phase 3

A

goal is to keep clients stable and out of the hospital

29
Q

nursing diagnosis: positive symptoms

A

risk for self directed violence
risk for other directed violence
disturbed sensory perception
disturbed thought processes
impaired verbal communication

30
Q

nursing diagnosis: negative symptoms

A

risk for violence
self care deficit
social isolation
impaired social interaction
risk for loneliness
chronic low self esteem
ineffective coping
constipation

31
Q

interventions for auditory hallucinations

A

ask if the client is hearing voices and what they are saying then document and report
provide reality check
stay calm
assess for increased anxiety

32
Q

interventions for delusional thinking

A

get in touch with emotions, never argue, decrease anxiety, observe for triggers

33
Q

psychosocial therapy

A

include family in:
psychologic strategies, teaching about illness, recognizing effect of stress, psychosocial activities, identifying support system and sources

34
Q

pharmacological therapy

A

antipsychotic meds
many carry significant risk