Schizophrenia & Other Related Disorders

What is schizophrenia?

A psychotic spectrum disorder characterized by distorted thoughts, perceptions, emotions, movements, and behaviors.

How is schizophrenia commonly conceptualized in modern medicine?

As a brain disease or syndrome affecting cognition, perception, and behavior.

What social issue has historically surrounded schizophrenia?

Significant stigma and fear toward individuals with the disorder.

What is catatonia?

A condition marked by severe psychomotor disturbances such as excessive movement or immobility.

What term describes the immobility seen in catatonia where limbs remain in positions placed by others?

Waxy flexibility.

What behaviors may occur in catatonia?

Mutism, negativism, echolalia, and echopraxia.

What is echolalia?

Repeating another person’s words.

What is echopraxia?

Imitating another person’s movements.

In catatonia, can clients usually process what is happening around them?

Yes, they can often hear and process events even if they appear unresponsive.

What is delusional disorder?

A disorder characterized by one or more non-bizarre delusions.

What is a non-bizarre delusion?

A belief that could occur in real life but is false.

What are common types of delusions seen in delusional disorder?

Persecutory, grandiose, erotomanic, and somatic.

How is psychosocial functioning typically affected in delusional disorder?

It is usually not significantly impaired.

What is brief psychotic disorder?

A sudden onset of psychotic symptoms lasting between 1 day and 1 month.

What may trigger brief psychotic disorder?

Severe stressors such as childbirth or life crises.

What is shared psychotic disorder?

A condition in which two closely related individuals share the same delusion.

What is another name for shared psychotic disorder?

Folie à deux.

In shared psychotic disorder, whose symptoms typically improve when separated?

The more submissive individual.

What type of etiology is associated with schizophrenia?

Multifactorial, involving genetic and environmental factors.

What is the risk of schizophrenia in identical twins if one twin has the disorder?

About 50%.

What is the risk of schizophrenia in fraternal twins if one twin has the disorder?

About 15%.

What is the risk of schizophrenia in children if both parents have the disorder?

About 46%.

What neuroanatomical brain changes are associated with schizophrenia?

Less brain tissue, enlarged ventricles, and cortical atrophy.

What metabolic brain change is often observed in schizophrenia?

Reduced glucose metabolism in frontal cortical areas.

What is the primary neurochemical theory of schizophrenia?

Excess dopamine activity causes psychotic symptoms.

What neurotransmitter besides dopamine may influence schizophrenia symptoms?

Serotonin.

What prenatal viral exposure has been linked to schizophrenia risk?

Maternal influenza infection.

What immune-related substances are associated with schizophrenia risk?

Cytokines.

What birth season has been linked to a higher incidence of schizophrenia?

Winter.

What environmental setting is associated with increased schizophrenia risk?

Urban environments.

What social factors may increase schizophrenia risk?

Poverty and severe stress.

What are positive symptoms of schizophrenia?

Psychotic symptoms added to behavior.

What are examples of positive symptoms?

Hallucinations, delusions, and disorganized speech.

What is a hallucination?

A false sensory perception without external stimulus.

What are auditory hallucinations?

Hearing voices or sounds that are not present.

What is a delusion?

A fixed false belief not based in reality.

What is disorganized speech?

Speech that is difficult to understand due to disordered thinking.

What are loose associations?

Thoughts that shift from one topic to another with little connection.

What are neologisms?

Newly invented words that only have meaning to the client.

What is word salad?

Incoherent, jumbled speech with no logical meaning.

What are negative symptoms of schizophrenia?

Capabilities or normal behaviors that are diminished or absent.

What is anhedonia?

The inability to experience pleasure.

What is alogia?

Poverty of speech or lack of meaningful conversation.

What is avolition?

Lack of motivation or goal-directed behavior.

What is apathy?

Lack of interest or concern.

What social behavior is common with negative symptoms?

Social withdrawal.

What is flat or blunted affect?

Reduced or absent emotional expression.

Do antipsychotic medications cure schizophrenia?

No, they manage symptoms but do not cure the disorder.

What are typical antipsychotics?

First-generation medications that block dopamine receptors.

What are examples of typical antipsychotics?

Chlorpromazine and haloperidol.

What symptoms do typical antipsychotics mainly treat?

Positive symptoms.

How effective are typical antipsychotics for negative symptoms?

They have little to no effect.

What are atypical antipsychotics?

Second-generation medications affecting dopamine and serotonin.

What are examples of atypical antipsychotics?

Clozapine, risperidone, and olanzapine.

What symptoms do atypical antipsychotics help treat?

Both positive and negative symptoms.

What is the focus of acute schizophrenia management?

Immediate safety and symptom control.

What type of hallucinations require urgent attention?

Command hallucinations instructing harm to self or others.

What is the focus of long-term schizophrenia management?

Preventing relapse and supporting daily functioning.

What is the most common reason for relapse?

Medication nonadherence due to side effects.

What are extrapyramidal side effects (EPS)?

Movement disorders caused by antipsychotic medications.

What is acute dystonia?

Painful muscle spasms.

What is akathisia?

Severe restlessness and inability to stay still.

What is pseudoparkinsonism?

Parkinson-like symptoms such as tremors and rigidity.

What medications treat extrapyramidal side effects?

Benztropine or diphenhydramine.

What is tardive dyskinesia?

Irreversible involuntary movements caused by long-term antipsychotic use.

What is neuroleptic malignant syndrome (NMS)?

A life-threatening reaction to antipsychotics.

What are key symptoms of NMS?

High fever, severe muscle rigidity, and altered mental status.

What metabolic risk is associated with atypical antipsychotics?

Metabolic syndrome and weight gain.

What serious blood disorder can occur with clozapine?

Agranulocytosis.

What lab value must be monitored for clozapine therapy?

Absolute neutrophil count (ANC).

Why does schizophrenia require lifelong management?

Because symptoms can recur and the disorder is chronic.

What major shift occurred in schizophrenia treatment history?

Movement away from long-term institutionalization to community care.

Where do many clients with schizophrenia live today?

Independently, with family, or in residential programs.

What is Assertive Community Treatment (ACT)?

A program providing intensive community-based support.

What does ACT aim to reduce?

Hospital admissions.

What services does ACT help coordinate?

Medication management, vocational assistance, and social support.

What is case management for schizophrenia?

Assistance with daily living needs and healthcare navigation.

What areas does case management often help with?

Housing, transportation, finances, and appointments.

What is Cognitive Enhancement Therapy (CET)?

A treatment combining computer-based cognitive training and group sessions.

What skills does CET aim to improve?

Social and adaptive functioning.

What is the goal of schizophrenia care plans?

Balance professional support with client independence.

Why is medication education important for clients with schizophrenia?

To encourage adherence and prevent relapse.

What should clients learn about relapse prevention?

Early warning signs and symptom monitoring.

What can help relieve dry mouth caused by antipsychotics?

Ice chips.

What dietary change can help with medication-induced constipation?

Increasing fiber intake.

How should caregivers respond to a client's delusion?

Do not argue or try to prove the delusion wrong.

What communication technique is recommended with delusions?

Acknowledge feelings but state your own reality.

What is an example of stating your reality with hallucinations?

“I don’t hear those voices.”

What should caregivers avoid when responding to delusions?

Agreeing with or reinforcing the delusion.

What should interactions focus on when clients express delusions?

Real and present activities or topics.

Why must nurses examine their own beliefs about schizophrenia?

Personal biases can affect quality of care.

What misconception does society often have about schizophrenia?

That individuals are dangerous or "crazy."

How should nurses reframe their understanding of schizophrenia?

As an organic brain disease.

What attitude is essential for nurses caring for these clients?

Nonjudgmental empathy.

What qualities improve therapeutic relationships with schizophrenia clients?

Sincerity, empathy, and objectivity.

Why must safety assessments always be prioritized in schizophrenia care?

Because command hallucinations may lead to harm to self or others.