Schizophrenia

What is Schizophrenia?

  • A chronic, severe mental disorder that affects how a person thinks, feels, and behaves

  • Characterized by episodes of psychosis including hallucinations, delusions, and disorganized thinking

  • Onset typically occurs in late adolescence or early adulthood

Phases of Schizophrenia

  • Prodromal Phase: Subtle symptoms before full disorder emerges

  • Acute Phase: Presence of severe symptoms including delusions, hallucinations

  • Stabilization Phase: Symptoms decrease in severity

  • Maintenance Phase: Symptoms are under control, goal is relapse prevention

Positive vs. Negative Symptoms

  • Positive Symptoms: Hallucinations, delusions, disorganized speech/behavior

  • Negative Symptoms: Affective flattening, alogia, anhedonia, avolition

  • Cognitive Symptoms: Impaired memory, attention, executive functioning

Symptoms of Schizophrenia

  • Positive Symptoms- Hallucination

    • Delusions

  • Negative Symptoms- Emotional Flatness

  • Cognitive Symptoms- Memory

    • Lack of Motivation

    • Attention Problems

    • Social Withdrawal

    • Disorganized Thoughts

    • Catatonia (Rare)

    • Decision-Making Difficulties

Hallucinations and Delusions

  • Hallucinations: Sensory perceptions without external stimuli (e.g., auditory)

  • Delusions: False fixed beliefs (e.g., paranoia, grandeur, reference)

  • Important to validate feelings without reinforcing the delusion

Nursing Interventions

  • Promote safety and monitor for risk of harm

  • Use clear, simple communication

  • Encourage reality-based conversations

  • Establish trust through consistency and presence

  • Support self-care and social skills

  • Prioritize safety and risk of violence or self-harm!

  • Do not argue with delusions, focus on feelings

  • Respond to hallucinations calmly and supportively

  • Assess medication side effects regularly

  • Promote structured environment and daily routine

Medications

  • Typical Antipsychotics: Haloperidol, chlorpromazine (higher risk of EPS)

  • Atypical Antipsychotics: Risperidone, olanzapine, quetiapine (fewer EPS, monitor metabolic side effects)

  • Monitor for side effects: Neuroleptic malignant syndrome (NMS), extrapyramidal symptoms (EPS), weight gain, sedation

Patient and Family Education

  • Importance of medication adherence

  • Recognizing early signs of relapse

  • Coping strategies and support groups

  • Avoid alcohol and illicit drugs

  • Education about managing side effects

Nursing Diagnoses

  • Disturbed thought processes

  • Impaired verbal communication

  • Self-care deficit

  • Social isolation

  • Risk for self-directed or other-directed violence

Conclusion

  • Schizophrenia is a complex mental disorder requiring comprehensive care, including medication, therapeutic interventions, and strong patient/family education.

  • Early identification of symptoms and consistent adherence to treatment plans are crucial for managing the condition and preventing relapse.

  • Nursing care focuses on ensuring patient safety, promoting effective communication, and supporting daily living skills to enhance quality of life.

  • Important to remember: Always approach individuals with schizophrenia with empathy, respect, and a focus on maintaining their dignity and autonomy.