Psychotic disorders

Mental Health Exam 3

What is a key characteristic of schizophrenia?

Altered cognition, perception, and reality testing.

At what age range do 75% of individuals typically develop schizophrenia?

Between 15 to 25 years of age.

What phase of schizophrenia is characterized by mild changes before acute symptoms appear?

Prodromal phase.

What are positive symptoms of schizophrenia?

Hallucinations, delusions, alterations in speech, bizarre behavior.

What are negative symptoms of schizophrenia?

Affect, alogia, anergia, anhedonia, avolition.

What is the estimated life loss for individuals with schizophrenia in the U.S.?

28.5 years.

What are common prodromal signs of schizophrenia in children?

Poor academic performance, social withdrawal, unusual motor development.

What type of onset do adolescent prodromal signs typically show?

gradual process lasting a few months to few years; social withdrawal, irritability, depression, anatagonistic, conduct problems, academic decline, suspicious/low lvl of distorted thinking

What is the relationship between gender and schizophrenia diagnosis?

More frequently diagnosed among males.

Name common comorbidities associated with schizophrenia.

Substance use disorders (nicotine), anxiety, depression, suicide, polydipsia (fatal water intoxication from meds causing dry mouth), physical illness

What can excessive polydipsia lead to in individuals with schizophrenia?

Fatal water intoxication.

What biological factors are implicated as possible causes of schizophrenia?

Genetics, neurochemical imbalances, and brain structure abnormalities.

What environmental factors can increase the risk of developing schizophrenia?

Substance abuse, pregnancy (folate deficiency and infection) and birth complications, social determinants like poverty, social isolation, urbanicity

What is the relationship between early treatment and prognosis in schizophrenia?

Early treatment leads to a better prognosis.

What characterizes the acute phase of schizophrenia?

Exacerbation of symptoms.

What is the first thing to do when assessing someone suspected of having schizophrenia?

Conduct a mental status exam.

What are the 4 phases of schizophrenia?

prodromal, acute, stabilization, maintenance/residual

What term describes made-up words that have meaning only to the patient?

Neologisms.

What type of delusions might an individual with schizophrenia exhibit?

Persecutory delusions.

What is the difference between affect and alogia in negative symptoms?

Affect refers to emotional expression, while alogia refers to reduced speech output.

What should be included in client education regarding schizophrenia?

Medication teaching and management of symptoms.

How should a psychiatrist respond to a patient describing a hallucination?

Acknowledge the hallucination and reassure the patient of their safety.

What is the potential outcome of untreated psychosis in schizophrenia?

Longer periods lead to poorer prognosis.

What cognitive findings are common in schizophrenia?

Disordered thinking, inability to make decisions, poor prob solving, difficulty concentrating, short term memory iss, impaired abstract thinking

What is 'clang associations' in speech alterations?

A pattern of speech in which words are chosen for their sound rather than their meaning.

What are typical alterations in perception experienced by individuals with schizophrenia?

Auditory and visual hallucinations, command (voice instruction to perform action), olfactory, gustatory, tactile (body sensations)

What condition can arise from impaired impulse control in schizophrenia?

Catatonia.

What are the primary goals in nursing care for someone with schizophrenia?

Establish trust and ensure safety, address hallucinations and delusions, and promote self-care.

Which phase is characterized by establishing a new baseline after acute symptoms?

Maintenance or residual phase.

What does the term 'avolition' refer to in schizophrenia?

Lack of motivation to initiate and sustain purposeful activities.

What is an important consideration regarding cultural factors in schizophrenia?

Delusions may be culturally accepted in some contexts.

What can auditory hallucinations often prompt in an individual with schizophrenia?

Command hallucinations.

How might schizophrenia affect a person's social behavior?

It leads to impaired social functioning.

What is a common experience for adults in the prodromal phase of schizophrenia?

At least one psychotic symptom, such as hallucinations or delusions.

What must be assessed to ensure comprehensive care of a client with schizophrenia?

Suicidal and homicidal ideation.

What can be a sign of cognitive impairment in schizophrenia?

Difficulty concentrating.

What are alterations in thought that may be experienced by a schizophrenia patient?

Ideas of reference, grandeur, thought broadcasting, thought withdrawal, magical thinking

What behavioral changes might be expected in someone with schizophrenia?

Agitation, automatic obedience, stupor, motor retardation, gesturing/posturing, boundary impairment, impaired impulse control, catatonia, negativism, waxy flexibility, echopraxia.

What should family involvement focus on in a care plan for schizophrenia?

Understanding and supporting the patient’s needs.

What assessment is crucial for evaluating functional ability in clients with schizophrenia?

Mental status assessment.

What happens during the stabilization phase of schizophrenia?

symptoms diminish, movement to previous level of functioning

How does the prodromal phase of BPD differ from schizophrenia?

there is full remission with BPD

How does childhood-onset schizophrenia compare to adult-onset in terms of prognosis?

carries worse prognosis than adult

How long do children and adolescents typically show atypical or prodromal signs before receiving a diagnosis of schizophrenia?

They can exhibit atypical or prodromal signs for years before diagnosis

What are adult prodromal signs?

have at least 1 psychotic symptom like hallucinations, delusions, or disorganized speech; also inability to function in family, socially, or in occupation; neglects basic hygiene and nutrition; tough time regulating body temp

What contributes to the higher premature mortality rate among individuals with schizophrenia?

comorbidities like heart disease, liver disease, and diabetes possibly from under-detection or tx.

What factors determine a better schizophrenia prognosis?

late/sudden onset, good pre-illness functioning, med effectiveness, med adherence, female, minimal cognitive impairment

What factors determine a worse schizophrenia prognosis?

early age/gradual onset, poor pre-illness functioning, fam hx, longer periods of untreated psychosis, male, significant cognitive impairment

What is schizophrenia?

pt has psychotic thinking or behavior for at least 6mos

What is schizotypal personality d/o?

pt has impairments of personality functioning like self and interpersonal, but not as severe as schizophrenia

What is delusional d/o?

pt experiences delusional thinking for at least 1 month. Self or interpersonal functioning isn’t markedly impaired

What is brief psychotic d/o?

pt has psychotic manifestations that last 1 day to 1 month in duration

What is schizophreniform d/o?

manifestations similar to schizophrenia duration 1-6mos and social/occupational dysfunc may not be apparent

What is schizoaffective d/o?

disorder meets criteria for schizophrenia and depressive or BPD

What is substance/medication-induced psychotic d/o?

experiences psychosis d/t substance intoxication or w/drawal or after exposure to or w/drawal from a med

What is psychotic or catatonic d/o?

psychotic features, bizarre behavior or significant change in motor activity but doesn’t meet criteria for diagnosis w/another psychotic d/o; medical ex: brain tumor-infection, stroke, hormone d/o, migraines, alzheimer’s, lupus, lime disease

What are positive signs of schizophrenia?

manifestation of things that aren’t normally present

What are negative signs of schizophrenia?

absence of things that are normally present

What is alogia?

significant reduction in speech output or contentoften associated with schizophrenia or other psychotic disorders.

What is anhedonia?

lack of pleasure or joyin activities usually enjoyed, often seen in schizophrenia and depression.

What are schizophrenic cognitive findings?

probs w/thinking make it difficult to live independently like inability to make decisions, disordered thinking, poor prob solving, difficulty concentrating, short term memory iss, impaired abstract thinking

What are schizophrenic affective findings?

manifestations involving emotions like hopelessness, suicidal ideation, or unstable/rapidly changing mood

What is avolition?

lack of motivation in activities and hygiene

What is anergia?

lack of energy

What are alterations in thought or delusions?

false fixed beliefs that can’t be corrected by reason and are usually bizarre

What are ideas of reference?

misconstrue trivial events and attach personal significance to them

What are thoughts of persecution?

feeling singled out for harm by others

What are thoughts of grandeur?

belief that one is all powerful, important, like God or belief of association with famous people

What are somatic delusion?

belief that one’s body is changing in an unusual way like growing a third arm

What are thoughts of jealousy?

belief that their partner is sexually involved with someone else when there’s no proof

What is magical thinking?

belief that one’s thoughts or actions can control a situation like wearing a certain hat will them invisible

What is associative looseness?

unconscious ability to concentrate on a sgl thought that can progress to flight of ideas where speech moves rapidly from one thought to another that’s incoherent

What are neologisms?

made up words that have meaning only to pts

What is echolalia?

pt repeats words spoken to them

What are clang associations?

meaningless rhyming or words

What is depersonalization?

feeling detached from self and affects ability to recognize thoughts, feelings, and body as own

What is derealization?

feeling detached from environment and affects ability to see your surroundings accurately; things may not seem real or might look distorted in shape/sz

What are illusions?

misperceptions or misinterpretations of a real experience that happen when something real in environment is misinterpreted.

What is echopraxia?

purposeful imitation of movements made by others

What is waxy flexibility?

maintaining a specific position for an extended period of time