Week Five: Schizophrenia Flashcards
What is schizophrenia?
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
What is the peak incidence of onset for men and women who have schizophrenia?
men: 15-25 years
women: 25-35 years
What are the two classifications of symptoms for schizophrenia?
- positive or hard
- Negative or soft
What is the classification positive or hard of schizophrenia consist of?
hallucinations, flight of ideas, delusions, ideas of reference(false impressions), preservation, bizarre behaviour
What is the classification negative or soft of schizophrenia consist of?
alogia (limited speech), apathy (suppression of emotions), sociality, blunt or flat effect, catatonia, avolition (lack of motivation, inattention
When does the DSM-5 diagnosis occur with pt with schizophrenia?
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
What is a schizoaffective disorder?
mixture of psychotic and mood disorder
- signs and symptoms of both schizophrenia and a mood disorder
What is the immediate course of action after a pt is diagnosed with schizoaffective?
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
How do you treat someone with schizoaffective?
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
What is schizophreniform disorder?
symptoms of schizophrenia are experienced for less than 6 months required for a diagnosis of schizophrenia
What is catatonia?
marked psychomotor disturbance, excessive or virtually immobile
What is a delusion disorder?
one or more non bizarre delusions (focus on the delusion is believable) psychosocial functioning not darkly impaired and behaviour is not bizarre
What is brief psychotic disorder?
one psychotic episode with symptoms lasting 1 day to 1 month; may or may not have identifiable stressor (ie childbirth)
What is shared psychotic disorder?
similar delusion shared by two people, one of whom has psychotic delusions most commonly siblings or parent and child
What is schizotypical personality?
odd eccentric behaviours, transient psychotic behaviour
What is the etiology of schizoaffective disorder?
- 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)
What are the two neurotransmitters that are related to schizoaffective disorder?
dopamine and serotonin
What are some treatments used to treat schizophrenia?
- neuroleptics
- antipsychotics LAIs
- psychosocial treatment
What are the two types of neuroleptics medications used for schizophrenia?
does not cure but decrease or manage symptoms
two types:
1. conventional antipsychotics
2. atypical antipsychotics
What are the side effects of antipsychotic medication in schizophrenia?
- minor discomfort to permanent movement disorders
- dystonic reactions (akathisia, pseudo Parkinsonism)
- neurological (tardive dyskinesia, seizures)
- non-neurological (agranulocytosis, weight gain)
What is psychosocial treatment for schizophrenia? What are the two most important aspects?
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
What parts of the brain does schizophrenia affect?
Affects all functions of the brain
What are the 7 types of delusions?
- persecutory/ paranoid
- grandiose (belief that you are famous or capable of great things)
- religious
- somatic: vague/unrealistic belief of their health
- referential: beliefs that the news etc have a special meaning to them
- nihilistic: belief that their organs aren’t functioning and rotting or disfigured
- sexual
What is a hallucination?
false sensory perceptions or perceptual experience that do not exist in reality
- visual, auditory, sensual
What is part of the assessment for schizophrenia?
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
What are some elder considerations for someone with schizophrenia?
usually associated with depression or dementia
- remainder are mostly unchanged
What are some community based care for a pt with schizophrenia?
- housing with family, independently, or residential program
- ACT treatment
- behavioural home health care
- community support programs
- case management
What are atypical antipsychotics?
2nd generation medication
- dopamine and serotonin antagonists
- diminish positive symptoms and lessen the negative signs
examples: clozaril, risperdal, Seroquel, zyprexia
What are conventional antipsychotics?
1st generation medication
- dopamine antagonist
- target positive signs
- no affect on negative signs
examples: haldol, prolixin, Thorazine
What is LAI’s antipsychotic medication used to treat schizophrenia?
they are injection forms of antipsychotics that are used for maintenance therapy.
examples: haldol
What are the 8 speech patterns to look out for with patients with schizophrenia?
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
What is a delusion?
false, fixed beliefs with no basis in reality
