Iv Test # 2 Schizophrenia

Front 1

schizophrenia has no connection with multiple personality disorder. T or F

Back 1

T

Front 2

Schizophrenia is caused by a combination of factors
- weak genetic disposition; not that strong 10-12%
- biochemical dysfunction

- Also, psychosocial stress does not cause, but can exacerbate or relapse schizophrenia

Effective treatment requires a comprehensive, multi-disciplinary effort
- there is no single treatment

Back 2

T

Front 3

-Suicide is primary risk - 10% die by suicide
- lengthy & freq hospitalization; could be life long custodial care

Back 3

T

Front 4

____ occurs in 40-50% of pts w schizophrenia

Back 4

Substance abuse
- 75-85% smoke nicotine

Front 5

Schizophrenia is a ___ disorder and disturbs thought processes, perception , and affect

Back 5

global

Front 6

____ is what shows on the pt's face

Back 6

Affect
- Ex: an appearance or mood that shows no emotion (flat affect)

Front 7

Prevalence of schizophrenia is 1-1.5% of ttl population;
- no differences related to race or gender

Back 7

T

Front 8

___% see visions
____% hear voices

Back 8

25%
60%

Front 9

males typically start dev symptoms at ____ yrs of age

Back 9

17-22 yrs; males start younger than women who can start at 25 yrs

Front 10

what are positive prognosis factors for returning to full premorbid functioning?

Back 10

- older at onset
- being female
- abrupt onset of symptoms (psychotic thought) vs gradual
- good interepisode functioning: ie, betw psychotic eepisodes, there is good functioning

Front 11

- schizophrenia is a disease of ___; so be careful approaching pts due to altered ____

Back 11

perception, perception

Front 12

1/3 of schizo's don't respond to ____

Back 12

meds

Front 13

the 4 phases to development of schizophrenia are:
1- Premorbid phase
2- Prodromal phase- 1 mo -1 yr before onset of 1st psychotic behavior
3- Schizophrenia
4- Residual phase

Describe these?

Back 13

1- Premorbid phase: shy, antisocial, doing poorly in school
2- Prodromal phase: more withdrawn, personal hygiene neglected, impaired role function, peculiar behavior; can become fixated on something odd- religious or homosexual
3- Schizophrenia- this is the active phase where psychotic behaviors are prominent: delusions, hallucinations, impairment in work & social; psychotic signs must persist for at least 6 months before dx of schizo is made
4- Residual phase- symptoms similar to prodromal phase , ie flat affect and impairment in role functioning

Front 14

Define:
- Delusion- false fixed belief that can't be swayed by reason
- Hallucinations are most often ____

Back 14

auditory

Front 15

Drugs of abuse: LSD, etc, raise dopamine levels and could exacerbate schizophrenia

Back 15

T

Front 16

Describe downward drift hypothesis?

Back 16

that poverty is an environmental influence that can help cause schizo
- prof feels that schizo ruins families financially and socially, and that's why there is a greater incidence of schiz

Front 17

Name the 6 types of schizophrenia?

Back 17

1- DISORGANIZED SCHIZO: flat affect, loss of social inhibitions; bizarre behav
2- CATATONIC SCHIZO: stupor; pt just sits and may need complete care; has waxy flexibility, ie if you place arms and legs of pt in certain position and then let go, the limbs will remain in that position.
3. UNDIFFERENTIATED: may include symptoms of more than one type of schizophrenia.
4- PARANOID SCHIZO - suspicious of others; most common in men, hypervigilant
5- RESIDUAL SCHIZO - symptoms of the illness have gone away, but some features, such as hallucinations and flat affect, may remain.
6. SCHIZOAFFECTIVE SCHIZO: schizophrenic symptoms assoc w mood disorder

Front 18

Define "Brief Psychotic Disorder?"

Back 18

- sudden onset of psychotic symptoms following a severe psychosocial stressor; symptoms only last 1 mo & then pt returns to normal
- not schizophrenia

Front 19

Delusional Disorder? several disorders
1- Erotomanic
2- Grandiose

Back 19

1- Erotomanic: delusion that another person is in love with pt
2- Grandiose Type: delusion of inflated worth, power, knowledge, identity, or special relationship to a famous person
3- Jealous: believe their partner is unfaithful
4- Persecutory: everyone is after them
5. Somatic- the pt has some physical defect or general medical condition

Front 20

Induced Psychotic Disorder?

Back 20

hallucinations and delusions due to substance abuse.. think "roid rage" from using steroids.

Front 21

Positive symptoms of Schizophrenia

Back 21

- these are the psychotic symptoms, those outside of reality..
- hallucinations
- delusions

Front 22

Negative symptoms of Schizophrenia

Back 22

these are normal behaviors that schizophrenics lack and that limit function
- apathy & anergia (lack of energy)
- lack of motivation
- anhedonia- (social withdrawal) an inability to experience pleasure from normally pleasurable life events such as eating, exercise, and social or sexual interaction.
- blunted affect - lack of emotional reactivity on the part of an individual.
- alogia- lack of additional, unprompted talking

Front 23

1- Autism
2- Mutism
3- word salad

Back 23

1- developmental disorder that appears in the first 3 years
of life, and affects the brain's normal development of social and
communication skills.
2- pt is fully capable of speech and understanding language, but can fail to speak in certain social situations when it is expected of them
3- confused usage of words with no apparent meaning or relationship attached to them ( aka schizophasia)
4- waxy flexibility - symptom of catatonic schizophrenia where if you were to move the arm of someone with waxy flexibility, they would keep their arm where one moved it until it was moved again, as if it were made from wax.
5- neologisms - describe the use of words that only have meaning to the person who uses them, independent of their common meaning.
6- loose association - psychotically disorganized speech, words are not linked together based on the normal rules of language, but are strung together based on sounds, rhyme, puns, or free associations.
7. Clang association- Thought disorder wherein words are chosen or repeated based on similar sounds, instead of semantic meaning. "The train rain brained me. He ate the skate, inflated yesterdays gate toward the cheese grater."

Front 24

what are priority nursing dx for schizophrenia?

Back 24

#1 priority - Safety
#2 priority- alteration in thought process

Front 25

What are diff treatment methods for schizophrenia?

Back 25

Group therapy - not very effective for in-pts in hosp
Social Skills Training- role playing with therapist to practice what normal people would do in diff situations
Assertive Community Treatment (ACT) - long term chronic pt management in community where objective is to keep pt out of hospital

Front 26

Prognosis of schizo pts is closely related to how well a pt follows drug treatment plan
- without meds, ___ % will relapse over 12 months
- Drugs taken continuously can reduce relapse to 30%

Back 26

70-80%

Front 27

What is the Paradigm of Thirds in schizophrenia?

Back 27

1/3 achieve lasting improvement
1/3 achieve some improvement with intermittent relapses
1/3 experienc severe and permanent incapacity and will always need long term care