Week 8; Care of Pt's With Chronic Mental Illness Flashcards
SUICIDE ASSESSMENT:
*CURRENT IDEATION
*HISTORY OF ATTEMPTS
*INTENT
*PLAN
*MEANS
DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS
(DSM-5)
*DEFINES AND CLASSIFIES MENTAL DISORDERS IN ORDER TO IMPROVE DIAGNOSES, TREATMENT AND RESEARCH
SCHIZOPHRENIA
*THE WORD SCHIZOPHRENIA IS DERIVED FROM THE
GREEK WORDS SKHIZO (SPLIT) AND PHREN (MIND).
*EARLY 1900’S CALLED “DEMENTIA PRAECOX” –
DISAPPEARED WITH 1ST PUBLICATION OF THE
DIAGNOSTIC AND STATISTICAL MANUAL: MENTAL
DISORDERS (DSM-1) SCHIZOPHRENIA IS NOT A SPLIT PERSONALITY.
SCHIZOPHRENIA IS MOST LIKELY CAUSED BY
A COMBINATION OF FACTORS, INCLUDING
*GENETIC PREDISPOSITION
*BIOCHEMICAL DYSFUNCTION
*PHYSIOLOGICAL FACTORS
*PSYCHOSOCIAL STRESS
COMMUNITY BASED TREATMENT
*PRIMARY PREVENTION –
*USING SCREENING TOOLS, MENTAL HEALTHY FAIRS,
TRAINING, AT RISK POPULATIONS, SCREENING
COMMUNITY BASED TREATMENT
SECONDARY PREVENTION -
IDENTIFICATION AND PROMPT TREATMENT
*OUTPATIENT, DAY TREATMENT, INPATIENT TREATMENT,
CRISIS MANAGEMENT, SUICIDE PREVENTION
COMMUNITY BASED TREATMENT
TERTIARY PREVENTION –
PREVENTING COMPLICATIONS, REHABILITATION, HELPING PERSON REACH MAXIMUM LEVEL OF FUNCTIONING
*THERAPY, GROUP THERAPY, COUNSELING AND SUPPORT
GROUPS
OF ALL MENTAL ILLNESSES, SCHIZOPHRENIA CAUSES MORE
*LENGTHY HOSPITALIZATIONS
*CHAOS IN FAMILY LIFE
*EXORBITANT COSTS TO PEOPLE AND
GOVERNMENTS
*FEARS
*WITH SCHIZOPHRENIA, THERE IS A
SEVERE DETERIORATION OF SOCIAL AND
OCCUPATIONAL FUNCTIONING.
SCHIZOPHRENIA CAUSES DISTURBANCES IN
*THOUGHT PROCESSES
*PERCEPTION
*AFFECT
Phases of schizophrenia
Phase I: premorbid
Phase II: prodromal
Phase III: schizophrenia
Phase IV: residual phase
PHASE I
*PREMORBID PHASE
*SOCIAL MALADJUSTMENT
*ANTAGONISTIC THOUGHTS AND BEHAVIOR
*SHY AND WITHDRAWN
*POOR PEER RELATIONSHIPS
*DOING POORLY IN SCHOOL
*ANTISOCIAL BEHAVIOR
PHASE II
*PRODROMAL PHASE
*LASTS FROM A 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
PHASE III
*SCHIZOPHRENIA
*IN THE ACTIVE PHASE OF THE DISORDER,
PSYCHOTIC SYMPTOMS ARE PROMINENT.
*DELUSIONS
*HALLUCINATIONS
*IMPAIRMENT IN WORK, SOCIAL
RELATIONS, AND SELF-CARE
PHASE IV
*RESIDUAL PHASE
*SYMPTOMS SIMILAR TO THOSE OF
THE PRODROMAL PHASE.
*FLAT AFFECT AND IMPAIRMENT IN
ROLE FUNCTIONING ARE
PROMINENT
Schizophrenia prognosis
*A RETURN TO FULL PREMORBID FUNCTIONING IS
NOT COMMON.
*FACTORS ASSOCIATED WITH A POSITIVE PROGNOSIS
INCLUDE
*GOOD PREMORBID FUNCTIONING
*LATER AGE AT ONSET
*FEMALE GENDER
*ABRUPT ONSET PRECIPITATED BY A STRESSFUL EVENT
*ASSOCIATED MOOD DISTURBANCE
*BRIEF DURATION OF ACTIVE-PHASE SYMPTOMS
FACTORS ASSOCIATED WITH A POSITIVE PROGNOSIS OF SCHIZOPHRENIA INCLUDE
*MINIMAL RESIDUAL SYMPTOMS
*ABSENCE OF STRUCTURAL BRAIN
ABNORMALITIES
*NORMAL NEUROLOGICAL FUNCTIONING
*FAMILY HISTORY OF MOOD DISORDER
*NO FAMILY HISTORY OF SCHIZOPHRENIA
SCHIZOPHRENIA BIOLOGICAL INFLUENCES
*GENETICS; A GROWING BODY OF KNOWLEDGE
INDICATES THAT GENETICS PLAYS
AN IMPORTANT ROLE IN THE
DEVELOPMENT OF SCHIZOPHRENIA
*BIOCHEMICAL INFLUENCES; ONE THEORY SUGGESTS THAT
SCHIZOPHRENIA MAY BE CAUSED BY AN
EXCESS OF DOPAMINE ACTIVITY IN THE
BRAIN. ABNORMALITIES IN OTHER
NEUROTRANSMITTERS HAVE ALSO BEEN
SUGGESTED.
*PHYSIOLOGICAL INFLUENCES; FACTORS THAT HAVE BEEN IMPLICATED
INCLUDE: VIRAL INFECTION, ANATOMICAL ABNORMALITIES, HISTOLOGICAL CHANGES IN BRAIN
SCHIZOPHRENIA PSYCHOLOGICAL INFLUENCES
*THESE THEORIES NO LONGER HOLD
CREDIBILITY. RESEARCHERS NOW FOCUS
THEIR STUDIES OF SCHIZOPHRENIA AS A
BRAIN DISORDER.
*PSYCHOSOCIAL THEORIES PROBABLY
DEVELOPED EARLY ON OUT OF A LACK OF
INFORMATION RELATED TO A BIOLOGICAL
CONNECTION.
SCHIZOPHRENIA ENVIRONMENTAL INFLUENCES
*SOCIOCULTURAL FACTORS: POVERTY
HAS BEEN LINKED WITH THE
DEVELOPMENT OF SCHIZOPHRENIA.
*DOWNWARD DRIFT HYPOTHESIS:
POOR SOCIAL CONDITIONS SEEN AS
CONSEQUENCE OF, RATHER THAN A
CAUSE OF, SCHIZOPHRENIA.
*STRESSFUL LIFE EVENTS MAY BE
ASSOCIATED WITH EXACERBATION OF
SCHIZOPHRENIC SYMPTOMS AND
INCREASED RATES OF RELAPSE.
*STUDIES OF GENETIC VULNERABILITY FOR
SCHIZOPHRENIA HAVE LINKED CERTAIN
GENES TO INCREASED RISK FOR PSYCHOSIS
AND PARTICULARLY FOR ADOLESCENTS WHO
USE CANNABINOIDS.
THEORETICAL INTEGRATION
*SCHIZOPHRENIA IS MOST LIKELY A
BIOLOGICALLY BASED DISEASE, THE ONSET
OF WHICH IS INFLUENCED BY FACTORS IN
THE INTERNAL OR EXTERNAL
ENVIRONMENT.
DELUSIONAL DISORDER
*THE EXISTENCE OF PROMINENT,
NONBIZARRE DELUSIONS
*EROTOMANIC TYPE
*GRANDIOSE TYPE
*JEALOUS TYPE
*PERSECUTORY TYPE
*SOMATIC TYPE
*MIXED TYPE
BRIEF PSYCHOTIC DISORDER
*SUDDEN ONSET OF SYMPTOMS
*MAY OR MAY NOT BE PRECEDED BY A
SEVERE
PSYCHOSOCIAL STRESSOR
*LASTS LESS THAN 1 MONTH
*RETURN TO FULL PREMORBID LEVEL OF
FUNCTIONING
*PSYCHOTIC DISORDER ASSOCIATED WITH
ANOTHER MEDICAL CONDITION
*PROMINENT HALLUCINATIONS AND
DELUSIONS ARE DIRECTLY ATTRIBUTABLE
TO A GENERAL MEDICAL CONDITION.
SUBSTANCE-INDUCED PSYCHOTIC DISORDER
*THE PRESENCE OF PROMINENT
HALLUCINATIONS AND DELUSIONS THAT
ARE JUDGED TO BE DIRECTLY
ATTRIBUTABLE TO SUBSTANCE
INTOXICATION OR WITHDRAWAL
THE CATATONIC FEATURES SPECIFIER
*CATATONIC FEATURES MAY BE ASSOCIATED WITH OTHER
PSYCHOTIC DISORDERS, SUCH AS BRIEF PSYCHOTIC
DISORDER, SCHIZOPHRENIFORM DISORDER,
SCHIZOPHRENIA, SCHIZOAFFECTIVE DISORDER, AND
SUBSTANCE-INDUCED PSYCHOTIC DISORDER.