Schizophrenia

Question 1

Typical Antipsychotics

Answer 1

chlorpromazine (Thorazine)
haloperidol (Haldol)

Question 2

Antipsychotic Depot Injections: Long lasting- 2weeks

Answer 2

haloperidol (Haldol decanoate)
risperidone (Consta)
paliperidone (Invega)

Question 3

Anticholinergic medications

Answer 3

benztropine (Cogentin)
diphenhydramine (Benadryl)
Trihexphenidyl (Artane)

Question 4

Dissolvable Antipsychotics

Answer 4

olanzapine (Zydis)
risperidone (Risperdal M-tab)

Question 5

Atypical Antipsychotics

Answer 5

clozapine (Clozaril)*
olanzapine (Zyprexa)*
quentiapine (Seroquel)*
respiridone (Respiradol)*
Respiradol Consta*
ziprasidone (Geodon)*
aripiprazole (Abilify)*
paliperidone (Invega)*

Question 6

what is schizophrenia

Answer 6

Is defined as a psychosis
characterized by abnormalities
in perception, content of
thought, and thought processes,
and extensive withdrawal of one’s
interest from people and the
outside world.

Question 7

what is psychosis

Answer 7

A state in which the individual
is experiencing hallucinations,
delusions or disorganized
thoughts, speech or behavior.

Question 8

Criteria of schizophrenia is one of….

Answer 8

delusions
hallucinations
disorganized speech

Question 9

signs of schizophrenia must be present for how long

Answer 9

at least 6 months

Question 10

schizophrenia interferes with a person’s ability to

Answer 10

think clearly
manage emotions
make decisions
relate to others

Question 11

schizophrenia is most diagnosed in

Answer 11

males
urban males

Question 12

peak age onset of schizophrenia

Answer 12

15-35

Question 13

etiology of schizophrenia

Answer 13

Genetics
Environmental
Brain Chemistry
Substance Use

Question 14

Earlier you start schizophrenia treatment…..

Answer 14

better the prognosis

Question 15

10 Comorbidities of Schizophrenia

Answer 15

Substance use disorders
Nicotine dependence
Anxiety, depression, and suicide
Diabetes
Cardiovascular Disease
Obesity
Malignant Neoplasm
HIV/AIDS
Osteoporosis
Hep C

Question 16

Positive Symptoms of Schizophrenia

Answer 16

hallucinations
delusions
disorganized behavior
disorganized speech

Question 17

what are hallucinations

Answer 17

Perceptual experiences that occur without actual external sensory stimuli. They can include all five senses:
auditory (hearing) most common; obscene, accusatory or insulting
visual (seeing) usually threatening
tactile (touch)
olfactory (smell)
gustatory (taste)

Question 18

what are command hallucinations

Answer 18

are auditory hallucinations that are in the form of commands. Can range from innocuous to commands to harm self or others

Question 19

Signs of hallucinations

Answer 19

eyes tracking
muttering or talking to self
appearing distracted
suddenly stopping conversation
watching vacant area
WATCH FOR SIGNS OF ANXIETY

Question 20

what do we want to do with someone having hallucinations

Answer 20

ask about the content to determine nature of command
Do not negate hallucination
Focus on reality
Address underlying emotion
Promote and guide reality

Question 21

what do we want to teach schizophrenia patients

Answer 21

Manage stress

Use other sounds to compete with hallucinations

Find out what is and isnt real

Engage in other activities

develop plan

Talk with self

Question 22

what are delusions

Answer 22

erroneous fixed beliefs that cannot be changed by reasonable arguement

Question 23

what are the types of delusions 6

Answer 23

Grandiose: belief that one has exceptional powers,
wealth, skills, influence, destiny

Nihilistic: belief that one is dead, or a disaster is
impending

Persecutory: belief that one is being watched,
plotted against, ridiculed

Somatic: belief about abnormalities in body function or
structure

Religious: believe they have a special relationship with
God or are on a mission for God, or that they are
sinners

Referential: believe that newspaper articles, TV shows
or song lyrics are directed specifically at them

Question 24

How to treat delusions

Answer 24

Establish a therapeutic relationship
Respond to suspicion in a matter-of-fact, empathic, supportive & calm manner

Ask the client to describe his beliefs
“Tell me more about someone
trying to hurt you.”

Never debate the delusional content. Supportively convey doubt where appropriate
“Although it is frightening for you,
it seems as if it would be hard for a
girl that small to hurt you.”

Validate if part of the delusion is real.
“Yes, there was a man at the
nurse’s station, but I did not hear
him talk about you.”

ocus on the feelings or themes of the delusion
“You seem to wish you could be more
powerful.”
“It must feel frightening to believe that
others want to hurt you.”
Use reality-based interventions to help meet the client’s underlying needs. If the client believes he is powerful it may represent a sense of powerlessness. Increase the client’s power by offering options.
Acknowledge that while the belief seems very real to the client, illnesses can make things seem true even though they aren’t.
Do not dwell excessively on the delusion. Instead refocus onto reality-based topics.

Question 25

types of distorted thoughts

Answer 25

Thought Blocking: In the middle of talking about his childhood, the client abruptly pauses, after which he can’t remember what he was saying. Thought broadcasting: “I know you know what I’m thinking. Everybody hears what I’m thinking.” Thought withdrawal: The man continually blames his poor memory on “government agents” who he claims can steal his thoughts. Thought insertion: The client repeatedly complains of having disturbingly violent thoughts, which, she claims, are being sent to her by Satan. Paranoia: An irrational fear, ranging from mild (wary, guarded) to profound (believing irrationally that another person intends to kill you)

Question 26

Types of disorganized speech

Answer 26

Circumstantiality: extremely detailed & lengthy talk about a topic but gets eventually to the point Tangentiality: extremely detailed & lengthy talk about a topic but usually doesn’t get to the point Loose Associations: absence of normal connectedness of thoughts, ideas & topics (“I was home when the drum began beating. I flew too low.”) Flight of Ideas: topic of conversation changes repeatedly & rapidly with only superficial associative connections (A man begins talking about his business, but quickly shifts to discussing the economy, the government, and other countries.) Echolalia: repetition of another’s words, pathological repetition of another’s word Clang Association: repetition of words that are similar in sound but in no other way (“I heard the bell. Well, hell then I fell.”) Stilted Language: overly & artificial formal language Pressured Speech: as if words are being forced out Word Salad: string of words totally unconnected, jumble of words meaningless to a listener (Because it makes a twirl in life, my box is broken help me blue elephant.”) Neologisms: made up words, meaning for the patient only (I got do angry I picked up a dish and threw it at the geshinker.”) Paranoia: suspiciousness that is unrealistic Illogicality: conclusions are reached that do not follow logically

Question 27

types of disorganized behavior

Answer 27

Aggression: behaviors or attitudes that reflect rage Agitation: inability to sit still or attend to others, pacing Catatonic Excitement: hyperactivity characterized by purposeless activity & abnormal movements Echopraxia: involuntary imitation of another's movements & gestures Regressed Behavior: childlike/immature Stereotype: repetitive purposeless movements that are peculiar to the person Hypervigilance: sustained attention to external stimuli Waxy Flexibility: posture held in fixed position

Question 28

Negative symptoms of schizophrenia

Answer 28

Affective Flattening or Blunting: flat or blunted emotion ambivalence: presence of two opposing forces leading to inaction, can't decide, stuck Alogia: brief and lack of content verbeal responses, not able to elaborate (poverty of speech) Avolition: inability to complete projects, assignments, or work Anhedonia: inability to gain pleasure Asociality: decreased desire for, or comfort during social interactions

Question 29

Cognitive Symptoms of Schizophrenia

Answer 29

Concrete Thinking: inability to think abstractly Impaired memory: impacts short-term memory and the ability to learn Impaired information processing: delayed responses, misperceptions or difficulty understanding others Impaired executive functioning: difficulty with reasoning, setting priorities, comparing options, planning…

Question 30

4 phases of schizophrenia

Answer 30

prodromal acute stabilization maintenance or residual

Question 31

symptoms of prodromal phase

Answer 31

mild changes in thinking reality testing and mood speech and thought = odd or eccentric anxiety, obessive thoughts, and compulsive behaviors may be present deterioratoin in concentration, school/work performance and socail functioning = distressing thoughts, suspiciousness, memory impairment and significant disorganization in speech or behavior

Question 32

symptoms of acute phaase

Answer 32

hallucinations, delusions, apathy, social withdrawal, diminished affect, anhedonia, disorganized behavior, impaired judgement, and cognitive regression result in functional impairment

Question 33

stabilzation phase

Answer 33

symptoms are stabilizing and diminishing, and there is movement toward a previous level of functioning.

Question 34

maintenance or residual phase

Answer 34

condition has stabilized, and a new baseline is established. Positive symptoms are usually absent or significantly diminished but negative symptoms continue to be a concern

Question 35

T/F which relapse in schizophrenia usually requires a longer period to recover

Answer 35

True

Question 36

major reason for schizo relapse

Answer 36

medication nonadherence

Question 37

Risk factors of Suicide with schizo

Answer 37

deprerssive symptoms young age at onset abscence of supportive family and friends