Week Five: Schizophrenia

Question 1

What is schizophrenia?

Answer 1

A syndrome or disease process of the brain that causes distorted and bizarre thoughts, perceptions, emotions, movements, and behaviours
most disruptive and disabling of the mental disorders

Question 2

What is the peak incidence of onset for men and women who have schizophrenia?

Answer 2

men: 15-25 years
women: 25-35 years

Question 3

What are the two classifications of symptoms for schizophrenia?

Answer 3

1. positive or hard
2. Negative or soft

Question 4

What is the classification positive or hard of schizophrenia consist of?

Answer 4

hallucinations, flight of ideas, delusions, ideas of reference(false impressions), preservation, bizarre behaviour

Question 5

What is the classification negative or soft of schizophrenia consist of?

Answer 5

alogia (limited speech), apathy (suppression of emotions), sociality, blunt or flat effect, catatonia, avolition (lack of motivation, inattention

Question 6

When does the DSM-5 diagnosis occur with pt with schizophrenia?

Answer 6

when the pt has two+ symptoms for 1 months. These symptoms include:
- delusions, hallucinations, disorganized speech, grossly disorganized or catatonia behaviour, and/ or negative symptoms

Question 7

What is a schizoaffective disorder?

Answer 7

mixture of psychotic and mood disorder
- signs and symptoms of both schizophrenia and a mood disorder

Question 8

What is the immediate course of action after a pt is diagnosed with schizoaffective?

Answer 8

clinical pattern one
- ongoing psychosis
- never a full recovery despite shift in symptom severity

clinical pattern two
- episodes of psychotic symptoms alternating with episodes of complete recovery from psychosis

Question 9

How do you treat someone with schizoaffective?

Answer 9

NO CURE
- antipsychotics play a huge rule in the disease process and individual outcomes
- longer periods of uncontrolled psychosis leads to poorer long term outcomes

Question 10

What is schizophreniform disorder?

Answer 10

symptoms of schizophrenia are experienced for less than 6 months required for a diagnosis of schizophrenia

Question 11

What is catatonia?

Answer 11

marked psychomotor disturbance, excessive or virtually immobile

Question 12

What is a delusion disorder?

Answer 12

one or more non bizarre delusions (focus on the delusion is believable) psychosocial functioning not darkly impaired and behaviour is not bizarre

Question 13

What is brief psychotic disorder?

Answer 13

one psychotic episode with symptoms lasting 1 day to 1 month; may or may not have identifiable stressor (ie childbirth)

Question 14

What is shared psychotic disorder?

Answer 14

similar delusion shared by two people, one of whom has psychotic delusions most commonly siblings or parent and child

Question 15

What is schizotypical personality?

Answer 15

odd eccentric behaviours, transient psychotic behaviour

Question 16

What is the etiology of schizoaffective disorder?

Answer 16

• interpersonal relationships are definitional early in life
• genetic factors
• neuroanatomic and neurochemical factors (detected with MRI. Ventricles are much larger with pt with schizophrenia)
• immunovirology (exposure to a virus changes brain physiology)
• Pregnant women (children who are born with mothers with the flu, virus, or other infections have an increased risk)

Question 17

What are the two neurotransmitters that are related to schizoaffective disorder?

Answer 17

dopamine and serotonin

Question 18

What are some treatments used to treat schizophrenia?

Answer 18

• neuroleptics
• antipsychotics LAIs
• psychosocial treatment

Question 19

What are the two types of neuroleptics medications used for schizophrenia?

Answer 19

does not cure but decrease or manage symptoms
two types:
1. conventional antipsychotics
2. atypical antipsychotics

Question 20

What are the side effects of antipsychotic medication in schizophrenia?

Answer 20

• minor discomfort to permanent movement disorders
• dystonic reactions (akathisia, pseudo Parkinsonism)
• neurological (tardive dyskinesia, seizures)
• non-neurological (agranulocytosis, weight gain)

Question 21

What is psychosocial treatment for schizophrenia? What are the two most important aspects?

Answer 21

includes individual and group therapy, focus groups, social skill training, cognitive adaption training(cues), cognitive enhancement therapy
two most important: family therapy and family education

Question 22

What parts of the brain does schizophrenia affect?

Answer 22

Affects all functions of the brain

Question 23

What are the 7 types of delusions?

Answer 23

1. persecutory/ paranoid
2. grandiose (belief that you are famous or capable of great things)
3. religious
4. somatic: vague/unrealistic belief of their health
5. referential: beliefs that the news etc have a special meaning to them
6. nihilistic: belief that their organs aren’t functioning and rotting or disfigured
7. sexual

Question 24

What is a hallucination?

Answer 24

false sensory perceptions or perceptual experience that do not exist in reality
- visual, auditory, sensual

Question 25

What is part of the assessment for schizophrenia?

Answer 25

history, general appearance, motor behaviour, mood and affect, speech, delusions, hallucinations, deterioration of self concept, are their roles and relationships affected, physiologic and self care considerations

Question 26

What are some elder considerations for someone with schizophrenia?

Answer 26

usually associated with depression or dementia - remainder are mostly unchanged

Question 27

What are some community based care for a pt with schizophrenia?

Answer 27

- housing with family, independently, or residential program - ACT treatment - behavioural home health care - community support programs - case management

Question 28

What are atypical antipsychotics?

Answer 28

2nd generation medication - dopamine and serotonin antagonists - diminish positive symptoms and lessen the negative signs **examples**: clozaril, risperdal, Seroquel, zyprexia

Question 29

What are conventional antipsychotics?

Answer 29

1st generation medication - dopamine antagonist - target positive signs - no affect on negative signs **examples**: haldol, prolixin, Thorazine

Question 30

What is LAI's antipsychotic medication used to treat schizophrenia?

Answer 30

they are injection forms of antipsychotics that are used for maintenance therapy. examples: haldol

Question 31

What are the 8 speech patterns to look out for with patients with schizophrenia?

Answer 31

clanging associations: ideas related by sound or rhyme neologism: new invented words verbigeration: repetition of words or phrases with no meaning behind it echolalia: repetition of what someone else says stiles language: flowery or pompous word salad: jumbled, disconnected or incoherent words preservation latency of response: hesitation before responding

Question 32

What is a delusion?

Answer 32

false, fixed beliefs with no basis in reality