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Mental Health > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

DSM criteria for Schizophrnia diagnosis

A 
Two or more during 1-month:
-Delusions*-thinking
-Hallucinations*sensory
-Disorganized speech*
-Disorganized or catatonic behavior
Negative Sx: flat 
affect, avolition, alogia
*must have 1 of the first 3*
ALSO
-Social or Occupational Dysfunction in adults
-Failure to meet expected developmental level of interpersonal, academic, or occupational functioning in children, adolescents, or young adults
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2
Q

What are positive symptoms?

A

things that are there that shouldn’t be.

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3
Q

What are negative symptoms

A

the absence of things that should be there

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4
Q

Social or Occupational Dysfunction

A

Work, interpersonal, or self-care markedly below premorbid functioning

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5
Q

How long must symptoms be present for a Schizophrenia diagnosis?

A

Symptoms for at least 6 months, with active phase (Criterion A) for at least 1 month

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6
Q

Hallucinations include

A

All 5 senses

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7
Q

Positive symptoms for Schizophrenia

A 
Hallucinations,
Altered Perceptions 
---Depersonaliztion
--Derealization
Delusions
Altered or disorganized speech
Bizarre Behavior
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8
Q

Examples of delusions

A 
Persecution
Control
Grandeur
Jealousy
Religious
Somatic
Erotomanic
Reference-everything is about you…every conversation people have must be about you.
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9
Q

What are Neologisms

A

Made up words

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10
Q

What is Echolalia

A

repeat or eco back what is said to them

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11
Q

What is Clanging

A

Rhyming

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12
Q

What is word salad

A

collection of words that don’t go together and don’t make sense.

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13
Q

Examples of Bizarre behavior

A 
Unusual dress or grooming
Echopraxia-
Catatonia
Motor retardation or agitation
Stereotyped motor behaviors
Waxy flexibility.
Rigidity
Poor impulse control
Impairment in following directions
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14
Q

What is Echopraxia

A

Copying movements

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15
Q

What is Waxy Flexibility

A

place body in a position and it stays there…raise arm and leave it there until you put it down.

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16
Q

Negative Symptoms of Schizophrenia

A

Flat or blunted affect
Alogia
Avolition
Anhedonia

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17
Q

What is Alogia

A

Not talking

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18
Q

What is Avolition

A

Lack of motivation or drive

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19
Q

What is Anheonia

A

Inability to experience joy

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20
Q

Affective symptoms & Presentation

A

Dysphoria
Suicidality
Hopelessness

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21
Q

Cognitive symptoms & Presentation

A

Inattention, distractible
Impaired memory
Poor problem-solving, judgment, decision-making
Illogical thought
Concrete thought-very literal, don’t understand metaphors.

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22
Q

Epidemiology

A
  • 1% of population
  • No differences in race, culture, SES
  • More common in men
  • Usually presents in teens / 20s
23
Q

Comorbidities

A 
Substance abuse (50%)
(Nicotine in up to 90%)
Anxiety & Depression
Suicide (50% attempt, 10% succeed)
Physical illnesses
-Schizophrenics die 28 years earlier than average population d/t hypertension, diabetes, heart disease, COPD, trauma
24
Q

If a first degree relative has schizophrenia you are ___ X more likely to get it

A

10

25
Q

What neurotransmitters are involved in Schizophrenia

A

Dopamine & some Serotonin

26
Q

Changes in brain structure

A
  • Enlarged ventricles & sulci
  • Reduced cortical, frontal lobe, hippocampal, and cerebellar volumes
  • Lower blood flow & glucose levels to brain
27
Q

Prenatal factors that can cause schizophrenia

A
  • Maternal stress or viral infection
  • Hypoxia, toxins, or malnutrition
  • Father over age 35
  • Birth during late winter / early spring
28
Q

Environmental & Psychological factors that can cause schizophrenia

A
  • Social adversity or poverty (particularly in urban areas)
  • Cannabis use
  • Psychological trauma
29
Q

Course of Schizophrenia

A

Often person was socially awkward, lonely, depressed, or expressed self poorly before onset of illness

Prodromal change in functioning 1 month to 1 year before acute phase
-Anxiety, phobias, obsessions, etc.

Usually chronic & recurring

30
Q

How many phases in schizophrenia

A

3

31
Q

Phase 1: Acute

A
  • Onset of florid, disruptive, active Sx
  • Loss of functional abilities
  • May require hospitalization
32
Q

Phase 2: Stabilization

A
  • Diminishing Sx
  • Moves toward previous functional level
  • Care in residential / group home program may be required
33
Q

Phase 3: Maintenance

A
  • At or near baseline functioning
  • Acute symptoms minimal or absent
  • Can live & function in community
34
Q

Nursing care for acute stage

A
  • Safety, prevent injury / harm
  • Provide structure
  • Therapy, groups, activities
  • Medication
  • Environmental structuring, limit-setting
  • Communication
35
Q

Proper communication …

A

-Lower anxiety, build trust, reinforce skills
-During hallucinations & delusions:
—Understanding of experience
NOT confirming experience
—Use clear, direct, loud tone, nonthreatening and nonjudgmental
—Be factual, focus on reality

36
Q

Nursing care for Stabilization & Maintenance Stages

A
  • Family / support system education!
  • Disease & treatment comprehension
  • S&S of relapse
  • Medication
  • Ongoing therapy or group support
37
Q

Schizophrenia Pharmacology

A

Antipsychotics 1st & 2nd generation

38
Q

1st generation antipsychotics treat + or - symptoms

A

Positive

39
Q

What neurotransmitter does 1st gen antipsychotics effect

A

Dopamine antagonists

40
Q

1st gen antipsychotics can cause extrapayramidal side effects such as

A

Akathisia, dystonia, psuedoparkinsonism, tardive dyskinesia

41
Q

1st gen antipsychotics can cause neuroleptic malignant syndrome

A

True

42
Q

Examples of 1st gen antipsychotics

A

Thorazine, Haldol

43
Q

2nd gen antipsychotics treat +or - symptoms

A

Both

44
Q

Considerations with 2nd gen antipsychotics

A
  • Fewer side effects overall

- Weight gain / metabolic syndrome

45
Q

First line / preferred 2nd gen antipsychotics

A

Abilify, Zyprexa, Seroquel, Risperdal, Geodon

46
Q

Schizophreniform Disorder

A

> 1month but <6months

47
Q

Brief Psychotic Disorder

A

> 1day but <1month

48
Q

Schizoaffective Disorder

A

Depression, Mania, or both w/ Psychotic S&S

49
Q

Delusional Disorder

A

Capgras Syndrome-belief that all the people in your life have been replaced by imposters

50
Q

Shared Psychotic Disorder

A

spouses or family members that live with and start to believe the psychosis to be real for themselves.

51
Q

What is Alogia

A

Inability to speak

52
Q

What is Avolition

A

Lack of initiative or motivation

53
Q

What is Anhedonia

A

Inability to experience pleasure

Mental Health (5 decks)

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