Schizophrenia & Other Related Disorders
Q: What is schizophrenia?
A: A psychotic spectrum disorder characterized by distorted thoughts, perceptions, emotions, movements, and behaviors.
Q: How is schizophrenia commonly conceptualized in modern medicine?
A: As a brain disease or syndrome affecting cognition, perception, and behavior.
Q: What social issue has historically surrounded schizophrenia?
A: Significant stigma and fear toward individuals with the disorder.
Q: What is catatonia?
A: A condition marked by severe psychomotor disturbances such as excessive movement or immobility.
Q: What term describes the immobility seen in catatonia where limbs remain in positions placed by others?
A: Waxy flexibility.
Q: What behaviors may occur in catatonia?
A: Mutism, negativism, echolalia, and echopraxia.
Q: What is echolalia?
A: Repeating another person’s words.
Q: What is echopraxia?
A: Imitating another person’s movements.
Q: In catatonia, can clients usually process what is happening around them?
A: Yes, they can often hear and process events even if they appear unresponsive.
Q: What is delusional disorder?
A: A disorder characterized by one or more non-bizarre delusions.
Q: What is a non-bizarre delusion?
A: A belief that could occur in real life but is false.
Q: What are common types of delusions seen in delusional disorder?
A: Persecutory, grandiose, erotomanic, and somatic.
Q: How is psychosocial functioning typically affected in delusional disorder?
A: It is usually not significantly impaired.
Q: What is brief psychotic disorder?
A: A sudden onset of psychotic symptoms lasting between 1 day and 1 month.
Q: What may trigger brief psychotic disorder?
A: Severe stressors such as childbirth or life crises.
Q: What is shared psychotic disorder?
A: A condition in which two closely related individuals share the same delusion.
Q: What is another name for shared psychotic disorder?
A: Folie à deux.
Q: In shared psychotic disorder, whose symptoms typically improve when separated?
A: The more submissive individual.
Q: What type of etiology is associated with schizophrenia?
A: Multifactorial, involving genetic and environmental factors.
Q: What is the risk of schizophrenia in identical twins if one twin has the disorder?
A: About 50%.
Q: What is the risk of schizophrenia in fraternal twins if one twin has the disorder?
A: About 15%.
Q: What is the risk of schizophrenia in children if both parents have the disorder?
A: About 46%.
Q: What neuroanatomical brain changes are associated with schizophrenia?
A: Less brain tissue, enlarged ventricles, and cortical atrophy.
Q: What metabolic brain change is often observed in schizophrenia?
A: Reduced glucose metabolism in frontal cortical areas.
Q: What is the primary neurochemical theory of schizophrenia?
A: Excess dopamine activity causes psychotic symptoms.
Q: What neurotransmitter besides dopamine may influence schizophrenia symptoms?
A: Serotonin.
Q: What prenatal viral exposure has been linked to schizophrenia risk?
A: Maternal influenza infection.
Q: What immune-related substances are associated with schizophrenia risk?
A: Cytokines.
Q: What birth season has been linked to a higher incidence of schizophrenia?
A: Winter.
Q: What environmental setting is associated with increased schizophrenia risk?
A: Urban environments.
Q: What social factors may increase schizophrenia risk?
A: Poverty and severe stress.
Q: What are positive symptoms of schizophrenia?
A: Psychotic symptoms added to behavior.
Q: What are examples of positive symptoms?
A: Hallucinations, delusions, and disorganized speech.
Q: What is a hallucination?
A: A false sensory perception without external stimulus.
Q: What are auditory hallucinations?
A: Hearing voices or sounds that are not present.
Q: What is a delusion?
A: A fixed false belief not based in reality.
Q: What is disorganized speech?
A: Speech that is difficult to understand due to disordered thinking.
Q: What are loose associations?
A: Thoughts that shift from one topic to another with little connection.
Q: What are neologisms?
A: Newly invented words that only have meaning to the client.
Q: What is word salad?
A: Incoherent, jumbled speech with no logical meaning.
Q: What are negative symptoms of schizophrenia?
A: Capabilities or normal behaviors that are diminished or absent.
Q: What is anhedonia?
A: The inability to experience pleasure.
Q: What is alogia?
A: Poverty of speech or lack of meaningful conversation.
Q: What is avolition?
A: Lack of motivation or goal-directed behavior.
Q: What is apathy?
A: Lack of interest or concern.
Q: What social behavior is common with negative symptoms?
A: Social withdrawal.
Q: What is flat or blunted affect?
A: Reduced or absent emotional expression.
Q: Do antipsychotic medications cure schizophrenia?
A: No, they manage symptoms but do not cure the disorder.
Q: What are typical antipsychotics?
A: First-generation medications that block dopamine receptors.
Q: What are examples of typical antipsychotics?
A: Chlorpromazine and haloperidol.
Q: What symptoms do typical antipsychotics mainly treat?
A: Positive symptoms.
Q: How effective are typical antipsychotics for negative symptoms?
A: They have little to no effect.
Q: What are atypical antipsychotics?
A: Second-generation medications affecting dopamine and serotonin.
Q: What are examples of atypical antipsychotics?
A: Clozapine, risperidone, and olanzapine.
Q: What symptoms do atypical antipsychotics help treat?
A: Both positive and negative symptoms.
Q: What is the focus of acute schizophrenia management?
A: Immediate safety and symptom control.
Q: What type of hallucinations require urgent attention?
A: Command hallucinations instructing harm to self or others.
Q: What is the focus of long-term schizophrenia management?
A: Preventing relapse and supporting daily functioning.
Q: What is the most common reason for relapse?
A: Medication nonadherence due to side effects.
Q: What are extrapyramidal side effects (EPS)?
A: Movement disorders caused by antipsychotic medications.
Q: What is acute dystonia?
A: Painful muscle spasms.
Q: What is akathisia?
A: Severe restlessness and inability to stay still.
Q: What is pseudoparkinsonism?
A: Parkinson-like symptoms such as tremors and rigidity.
Q: What medications treat extrapyramidal side effects?
A: Benztropine or diphenhydramine.
Q: What is tardive dyskinesia?
A: Irreversible involuntary movements caused by long-term antipsychotic use.
Q: What is neuroleptic malignant syndrome (NMS)?
A: A life-threatening reaction to antipsychotics.
Q: What are key symptoms of NMS?
A: High fever, severe muscle rigidity, and altered mental status.
Q: What metabolic risk is associated with atypical antipsychotics?
A: Metabolic syndrome and weight gain.
Q: What serious blood disorder can occur with clozapine?
A: Agranulocytosis.
Q: What lab value must be monitored for clozapine therapy?
A: Absolute neutrophil count (ANC).
Q: Why does schizophrenia require lifelong management?
A: Because symptoms can recur and the disorder is chronic.
Q: What major shift occurred in schizophrenia treatment history?
A: Movement away from long-term institutionalization to community care.
Q: Where do many clients with schizophrenia live today?
A: Independently, with family, or in residential programs.
Q: What is Assertive Community Treatment (ACT)?
A: A program providing intensive community-based support.
Q: What does ACT aim to reduce?
A: Hospital admissions.
Q: What services does ACT help coordinate?
A: Medication management, vocational assistance, and social support.
Q: What is case management for schizophrenia?
A: Assistance with daily living needs and healthcare navigation.
Q: What areas does case management often help with?
A: Housing, transportation, finances, and appointments.
Q: What is Cognitive Enhancement Therapy (CET)?
A: A treatment combining computer-based cognitive training and group sessions.
Q: What skills does CET aim to improve?
A: Social and adaptive functioning.
Q: What is the goal of schizophrenia care plans?
A: Balance professional support with client independence.
Q: Why is medication education important for clients with schizophrenia?
A: To encourage adherence and prevent relapse.
Q: What should clients learn about relapse prevention?
A: Early warning signs and symptom monitoring.
Q: What can help relieve dry mouth caused by antipsychotics?
A: Ice chips.
Q: What dietary change can help with medication-induced constipation?
A: Increasing fiber intake.
Q: How should caregivers respond to a client's delusion?
A: Do not argue or try to prove the delusion wrong.
Q: What communication technique is recommended with delusions?
A: Acknowledge feelings but state your own reality.
Q: What is an example of stating your reality with hallucinations?
A: “I don’t hear those voices.”
Q: What should caregivers avoid when responding to delusions?
A: Agreeing with or reinforcing the delusion.
Q: What should interactions focus on when clients express delusions?
A: Real and present activities or topics.
Q: Why must nurses examine their own beliefs about schizophrenia?
A: Personal biases can affect quality of care.
Q: What misconception does society often have about schizophrenia?
A: That individuals are dangerous or “crazy.”
Q: How should nurses reframe their understanding of schizophrenia?
A: As an organic brain disease.
Q: What attitude is essential for nurses caring for these clients?
A: Nonjudgmental empathy.
Q: What qualities improve therapeutic relationships with schizophrenia clients?
A: Sincerity, empathy, and objectivity.
Q: Why must safety assessments always be prioritized in schizophrenia care?
A: Because command hallucinations may lead to harm to self or others.