Health and healing week 2

What is psychosis?

A loss of contact with reality, making it difficult to distinguish what is real from what is not.

What three symptom groups are associated with psychosis?

Positive, negative, and cognitive symptoms.

What is a delusion?

A fixed, false belief that cannot be corrected by reasoning.

What is a hallucination?

A false perception involving one or more senses.

What is disorganized behaviour?

Unusual behaviour, such as talking to oneself or responding to internal stimuli.

What can trigger psychosis?

Mental health disorders, medical conditions, substances, alcohol, and medications.

Does a first episode of psychosis always mean a mental health disorder?

No. A thorough medical assessment and testing are needed.

What may trigger psychosis in a vulnerable person?

A stressful event combined with biological factors.

What is schizophrenia?

A chronic brain disease involving symptoms such as delusions, hallucinations, disorganized speech or behaviour, and negative symptoms.

How long must schizophrenia symptoms significantly disturb functioning?

At least 6 months, with required symptoms present for most of a 1-month period.

What are the main symptoms used to diagnose schizophrenia?

Delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behaviour, and negative symptoms.

What is lack of insight in schizophrenia?

Being unaware of one's symptoms or illness.

What can lack of insight contribute to?

Treatment nonadherence, involuntary admissions, relapses, and poorer outcomes.

What are the four stages of schizophrenia?

Prodromal, acute, residual, and remission.

What is the prodromal phase?

Early changes in thinking, perception, behaviour, motivation, or social functioning before clear psychotic symptoms.

What are common prodromal symptoms?

Withdrawal, low energy, reduced motivation, blunted affect, unusual beliefs, and changes in presentation.

What is the acute phase of schizophrenia?

The phase with prominent psychotic symptoms, such as delusions, hallucinations, and disorganized thought or speech.

What is the residual phase?

A phase with fewer symptoms than the acute phase, but some unusual beliefs, reduced motivation, or social withdrawal may remain.

What is remission in schizophrenia?

A period of symptom improvement in which the person can better care for themselves and function in society.

How long must remission last according to the PowerPoint?

At least 6 months.

What are the three broad phases of schizophrenia's course?

Onset, the years following onset, and the long-term course and outcome.

What is the general suicide risk associated with schizophrenia?

The PowerPoint states about 5% die by suicide and 20–40% attempt suicide at least once.

What is the typical age of onset for males with schizophrenia?

18–25 years.

What is the typical age of onset for females with schizophrenia?

25–35 years, with later onset associated with better outcomes.

What is associated with an earlier onset of schizophrenia?

A worse prognosis.

What causes schizophrenia?

There is no single theory; genetic and environmental factors and brain changes may contribute.

What does the neurobiological theory focus on?

Functional changes and neurotransmitters in the brain, including dopamine.

What does the genetic predisposition theory suggest?

Family history increases the likelihood of developing schizophrenia.

What does the PowerPoint state about immediate family members?

They are 10 times more likely than the general population to develop schizophrenia.

What is the stated risk when both parents have schizophrenia?

The PowerPoint states their children have a 40% chance of developing the disorder.

What brain structure changes are associated with schizophrenia in the PowerPoint?

Enlarged lateral ventricles, reduced brain-region volumes, increased cerebrospinal fluid, and decreased frontal-lobe blood flow and glucose metabolism.

What are positive symptoms of schizophrenia?

Additional or distorted experiences, such as delusions, hallucinations, disturbed thought, bizarre behaviour, and catatonia.

What are negative symptoms of schizophrenia?

Loss or reduction of normal functioning, such as motivation, emotional expression, speech, and social engagement.

What are cognitive symptoms of schizophrenia?

Difficulties with attention, memory, learning, reasoning, planning, and problem-solving.

What is depersonalization?

Feeling as though you are outside your own body.

What is derealization?

Experiencing your surroundings as unreal or distorted.

What is boundary impairment?

Difficulty sensing where one's own body or personal boundaries end and another person's begin.

What is flight of ideas?

Rapid shifts between thoughts.

What is thought blocking?

A sudden interruption in the flow of thought or speech.

What is thought insertion?

Believing that thoughts have been placed into one's mind by someone else.

What is thought deletion?

Believing that one's thoughts have been removed.

What is concrete thinking?

Literal thinking with difficulty understanding abstract ideas or proverbs.

What is circumstantiality?

Giving excessive details but eventually returning to the main point.

What is tangentiality?

Giving irrelevant details and never returning to the main point.

What is catatonia?

A motor disturbance involving greatly reduced movement or periods of hyperactivity and agitation.

What is motor retardation?

Slowing of thought, movement, speech, and affect.

What is motor agitation?

Purposeless movements, such as pacing or tapping.

What is echopraxia?

Involuntary imitation or repetition of another person's actions.

What is echolalia?

Involuntary repetition of another person's words or sounds.

What is magical thinking?

Believing one's thoughts or actions can influence or change events in the world.

What is paranoia?

Suspicion or belief that others are watching, following, or controlling a person.

What should nurses assess when a patient reports hallucinations?

The type, content, timing, impact, distress, coping ability, and whether hallucinations are commanding.

What are command hallucinations?

Voices that tell a person to do something, including harming themselves or others.

What should a nurse assess if command hallucinations are present?

What the voices say, whether the person feels in control, and whether they believe the voices are real.

What are the five common types of hallucinations listed in the PowerPoint?

Auditory, visual, tactile, olfactory, and gustatory.

What is an auditory hallucination?

Hearing sounds or voices that are not present.

What is a visual hallucination?

Seeing something that is not present.

What is a tactile hallucination?

Feeling something that is not actually touching the body, such as bugs crawling on the skin.

What is an olfactory hallucination?

Smelling something that is not present.

What is a gustatory hallucination?

Experiencing a taste that is not actually present.

What is a presence hallucination?

Feeling that someone is in the room or standing behind you.

What is a proprioceptive hallucination?

Feeling as though the body is moving or floating.

What is a persecutory delusion?

Believing that one is in danger, being followed, monitored, or conspired against.

What is a grandiose delusion?

Believing one has special powers, talents, abilities, or identity.

What is a delusion of reference?

Believing an unrelated event or message is specifically about oneself.

What is a somatic delusion?

Believing that one's body is diseased or has changed.

What is a nihilistic delusion?

Believing that oneself, a body part, or the world does not exist or has been destroyed.

What is affect?

The outward expression of a person's emotions.

What is flat affect?

Little or no facial expression or emotional range.

What is blunted affect?

A significant reduction in the intensity of emotional expression.

What is inappropriate affect?

An emotional expression that does not fit the situation, such as smiling when told someone has died.

What is alogia?

Reduced speech or use of fewer words.

What is anergia?

Lack of energy.

What is anhedonia?

Inability to feel pleasure.

What is avolition?

Severe lack of motivation or ability to initiate goal-directed activities.

What is poverty of content?

Speech that may be adequate in quantity but is vague, repetitive, or lacking meaningful content.

What cognitive difficulties can occur in schizophrenia?

Impaired reasoning, working memory, attention, learning, verbal fluency, and problem-solving.

What affective symptoms may occur in schizophrenia?

Depression, anxiety, and suicidal thoughts or behaviour.

What is schizoaffective disorder?

Schizophrenia combined with a mood disorder, such as depression or mania.

What should nurses assess when evaluating negative symptoms?

Apathy, reduced speech, poor social functioning, anhedonia, and social withdrawal.

What else should be included in a schizophrenia assessment?

Medication use and adherence, support systems, cognitive difficulties, safety, and personal strengths.

What are potential nursing diagnoses for schizophrenia?

Risk for violence, impaired verbal communication, social isolation, impaired social interaction, and chronic low self-esteem.

What other nursing diagnoses may apply to schizophrenia?

Self-care deficit, ineffective coping, risk for loneliness, and deficient knowledge or medication nonadherence.

What treatments may be used for schizophrenia?

Individual and group psychotherapy, behaviour therapy, social skills training, family therapy, ACTT, recovery-based care, and medication.

What is the purpose of antipsychotic medication?

To treat psychotic symptoms associated with schizophrenia.

How may antipsychotic medications be administered?

Scheduled, PRN, or STAT, and by routes such as oral, sublingual, or intramuscular, depending on clinical needs.

Why is medication adherence important?

Delaying treatment can increase the risk of suicide or other dangerous behaviours.

What should a nurse do if a patient appears to be responding to unseen stimuli?

Assess further, ensure safety, report concerns to staff, validate feelings, and present reality without forcing the issue.

What should a nurse do if a patient reports voices telling them to harm others?

Call for extra help, assess what the voices say and the patient's sense of control, notify staff, and consider appropriate safety measures.

What is the recovery model focused on?

Hope, a productive life, recovery, independence, relapse prevention, and quality of life.

What are priorities during the acute phase of schizophrenia?

Patient safety and medical stabilization.

What are priorities during the stabilization phase?

Address negative symptoms and support social, vocational, and self-care functioning.

What are priorities during the maintenance or recovery phase?

Promote hope, maintain progress, prevent relapse, and support independence and quality of life.