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EXAM 4 MENTAL HEALTH
Schizophrenia
| Question | Answer |
|---|---|
| Manifestations | Bizarre thoughts, perceptions, emotions, movements, and behavior |
| Clinical Course | Usually Diagnosed in late adolescence or early adulthood, More common in men. Shorter life expectancy. High Incidence of Substance abuse, homelessness, and suicide. Onset can be abrupt or insidious. Diagnosis occurs when positive symptoms of delusions, hallucinations, and disordered thinking (psychosis) appear. The younger the person is when symptoms appear, the often worse the symptoms are. |
| Schizoaffective Disorder | diagnosed when the client is severely ill and has a mixture of psychotic and mood symptoms. The signs and symptoms include those of both schizophrenia and a mood disorder such as depression or bipolar disorder. The symptoms may occur simultaneously or may alternate between psychotic and mood disorder symptoms. |
| Schizophrenia Positive/Hard Symptoms | Delusions, hallucinations, and grossly disorganized thinking, speech, and behavior. Ambivalence, Associative Looseness, Delusions, Echopraxia, Flight of Ideas, Hallucinations, Ideas of Reference, Perseveration, Bizarre Behavior |
| Schizophrenia Negative/Soft Symptoms | Flat affect, lack of volition, and social withdrawal or discomfort. Alogia, Anhedonia, Apathy, Blunted Effect, Catatonia, Flat Effect, Avolition or Lack of Volition, Inattention |
| Ambivalence | Holding seemingly contradictory beliefs or feelings about the same person, event, or situation |
| Associative Looseness | Fragmented or poorly related thoughts and ideas |
| Delusions | Fixed False Beliefs that have no basis in reality |
| Echopraxia | Imitation of the movements and gestures of another person whom the client is observing |
| Flight of Ideas | Continuous flow of verbalization in which the person jumps rapidly from one topic to another |
| Hallucinations | False sensory perceptions or perceptual experiences that do not exist in reality |
| Ideas of Reference | False impressions that external events have special meaning for the person |
| Perseveration | Persistent adherence to a single idea or topic. Verbal repetition of a sentence, word, or phrase. Resisting attempting to change the topic |
| Bizarre Behavior | Outlandish appearance or clothing. Repetitive or stereotyped, seemingly purposeless movements. Unusual social or sexual behavior |
| Alogia | Tendency to speak little or to convey little substance of meaning (poverty of content) |
| Anhedonia | Feeling no joy or pleasure from life or any activities, or relationships |
| Apathy | Feelings of indifference toward people, activities, and events |
| Asociality | Social withdrawal, few or no relationships, lack of closeness |
| Blunted Effect | Restricted range of emotional feeling, tone, or mood |
| Catatonia | Psychologically induced immobility occasionally marked by periods of agitation or excitement. The client seems motionless, as if in a trance |
| Flat Affect | Absence of any facial expression that would indicate emotions or mood |
| Avolition or Lack of Volition | Absence of will, ambition, or drive to take action or accomplish tasks |
| Inattention | Inability to concentrate or focus on a topic or activity, regardless of its importance |
| Delusional Disorder | The client has one or more nonbizarre delusions—that is, the focus of the delusion is believable. The delusion may be persecutory, erotomanic, grandiose, jealous, or somatic in content. Psychosocial functioning is not markedly impaired, and behavior is not obviously odd or bizarre. |
| Brief Psychotic Disorder | experiences the sudden onset of at least one psychotic symptom, such as delusions, hallucinations, or disorganized speech or behavior, which lasts from 1 day to 1 month. The episode may or may not have an identifiable stressor or may follow childbirth. |
| Shared Psychotic Disorder (Folie a Deux) | Two people share a similar delusion. The person with this diagnosis develops this delusion in the context of a close relationship with someone who has psychotic delusions, most commonly siblings, parent and child, or husband and wife. |
| Schizotypal Personality Disorder | involves odd, eccentric behaviors, including transient psychotic symptoms. Approximately 20% of persons with this personality disorder will eventually be diagnosed with schizophrenia. |
| Schizophreniform Disorder | an acute, reactive psychosis for less than the 6 months necessary to meet the diagnostic criteria for schizophrenia. If symptoms persist over 6 months, the diagnosis is changed to schizophrenia. Social or occupational functioning may or may not be impaired. |
| Social Training in Schizophrenia | involves breaking complex social behavior into simpler steps, practicing through role-playing, and applying the concepts in the community or real-world setting |
| Cognitive Adaption Training in Schizophrenia | using environmental supports is designed to improve adaptive functioning in the home setting. Individually tailored environmental supports such as signs, calendars, hygiene supplies, and pill containers cue the client to perform associated tasks. |
| Cognitive Enhancement Therapy (CET) | Combines computer-based cognitive training with group sessions that allow clients to practice and develop social skills. It is designed to remediate or improve the client's social and neurocognitive deficits such as attention, memory, and information processing. Has also been effective in decreasing substance misuse in schizophrenia |
| Family Education in Schizophrenia | Family education and therapy are known to diminish the negative effects and reduce the relapse rate in schizophrenia. Families often have a difficult time coping with the complex and ramifications of the illness, which creates stress in the family. Family members can also benefit from supportive environments |
| Word Salad | Jumbles words and phrases that are disconnected or incoherent and make no sense to the listener. |
| Echolalia | Repetition or imitation of what someone else says. |
| Clang associations | Ideas that are related to one another based on sound or rhyming rather than meaning |
| Latency of response | Hesitation before responding. May last 30-45 seconds and usually indicates the client's difficulty with cognition or thought process |
| Neologisms | Words invented by the client |
| Verbigeration | The stereotyped repetition of words or phrases that may or may not have meaning to the listener. |
| Stilted Language | Use of words or phrases that are flowery, excessive, and pompous. |
| Persecutory/Paranoid Delusions | Involve the client's belief that others are planning to harm them or are spying, following, ridiculing, or belittling the client. |
| Grandiose Delusions | The client's claim to association with famous people or celebrities or the client's belief that they are famous or capable of great feats |
| Religious Delusions | Often center around the second coming of Christ or another significant religious figure or prophet. Appear suddenly as part of the client's psychosis and are not part of their religious faith |
| Somatic Delusions | Generally vague and unrealistic beliefs about the client's health or bodily functions. Factual information or diagnostic testing does not change their beliefs |
| Sexual Delusions | Involve the client's belief that their sexual behavior is known to others. That the client is a rapist, prostitute, or pedophile, or is pregnant, or that their excessive masturbation led to insanity |
| Nihilistic Delusions | The client's belief that their organs are not functioning or are rotting away, or that some body part of feature is horribly disfigured or misshapen |
| Referential Delusions | Ideas of reference involve the client's belief that television broadcasts, music, or newspaper articles have special meaning for them |
| Auditory Hallucinations | Most common type, involve the patient hearing sounds, voices, talking about or to the client |
| Visual Hallucinations | Seeing images that do not exist at all. Such as lights, a dead person, or monsters. Second most common |
| Olfactory Hallucinations | Involves smells or odors |
| Tactile Hallucinations | Refers to sensations such as electricity running through the body. Or bugs crawling on the skin. Rare in schizophrenia |
| Gustatory Hallucinations | Involve a taste lingering in the mouth, or the sense that food tastes like something else |
| Cenesthetic Hallucinations | Involve the client's report that he or she feels bodily functions that are usually undetectable. Such as the sensation of urine forming or impulses being transmitted through the brain |
| Kinesthetic Hallucinations | Occur when the client is motionless but reports the sensation of bodily movement. Occasionally the bodily movement is something unusual such as floating |
| Nursing Interventions for Schizophrenia | Be sincere and honest.. Be consistent in setting expectations, rules. Never convey you accept the delusions as reality, directly interject doubt regarding delusions as soon as the client seems ready to accept this, but do not argue. PATIENT IS AT RISK FOR OTHER-DIRECTED VIOLENCE, AND RISK FOR SUICIDE. FOCUS ON SAFETY OF CLIENT AND OTHERS |
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