Schizophrenia Flashcards
What are the major goals of schizo therapy?
- prevent harm
- bring thoughts and behaviour under pt’s control
- restore contact with reality
- maximize function recovery
- prevent relapse
- eliminating hallucinations/delusions may not be realistic or possible
What is the #1 goal of schizo treatment?
Secondary goals?
To ensure safety
Secondary goals:
- reduce hostility, agitation, anxiety, tension, aggression
- normalize sleeping and eating pattern
- convey empathy and caring
What is schizophrenia?
- chronic, heterogeneous, spectrum disorder
- often severe and/or disabling
- imbalances in structure, NTs and neural transmission
- this leads to disordered thoughts and behaviour
- very difficult to treat and diagnose
What is the etiology of schizo?
Genes - 45% chance if 2 positive parents - 5-10% with 1 positive parent Biologics - imbalance of dopamine Development - 2nd trimester Psychosocial - stress - socioeconomic
What is the first target of antipsychotic drugs?
Dopamine
- excitatory NT
What are the positive symptoms of schizo?
- hallucinations
- delusions
- illusions
- agitation
- anxiety
- hostility
- restlessness
- bizarre actions/statements
- distractable
- suicidal intent
- paranoia
What are delusions?
- false, often fixed beliefs which persist despite falseness or logic
- ## may be paranoid, bizarre, grandiose
What is a thought disorder?
- disorganized, illogical
- garbled speech
- thought blocking or “removal”
- made up words
What are the negative symptoms of schizo?
- immobile facial expression
- monotonous voice
- lack of pleasure in everyday life
- low ability to initiate and sustain planned activity
- speak rarely (with minimal and simple content)
- anhedonia
- poor insight/judgement
- poor hygiene
- apathetic
- no motivation
- withdrawn
- socially isolated
- concrete (take things very literally)
- impaired concentration
- suicidal
What are the cognitive symptoms of schizo?
Cognitive impairment - related to acute sx - from prolonged NT imbalance Impaired execution of function Sustained attention Impaired working memory
What is the timeframe of effectiveness for true anti-schizophrenia drugs?
- gradual onset (4-8 weeks)
- improvement over months-years
- takes time to regulate the imbalance of NTs
This sedating medication replaced electroshock, insulin coma treatments and physical restraints.
Chlorpromazine
Antihistamine properties cause ___________.
sedation
Anticholinergic nature explains ___________ in schizo pts
dryness
- of eyes, mouth and GI
Why does chlorpromazine work so well is schizo patients?
- it blocks stimulant-induced movement
- DA blockage is a key mechanism
