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Mental Health 2

Schizophrenia and Other Psychotic Disorders (FN)

A psychotic disorder, characterized by impaired ability to recognize reality and the presence of hallucinations, and/or delusions. schizophrenia
The first episode of schizophrenia usually makes an untimely debut in late adolescence or early adulthood.
Schizophrenia is most likely caused by a convergence and interaction of genetic and environmental factors.
The acute onset of schizophrenia is often associated with recent major psychosocial stressors
In some individuals, the first psychotic episode is triggered by drug experimentation or use
_______ is the defining characteristic of schizophrenia and must be present to make the diagnosis of schizophrenia. psychosis
______ symptoms represent a distortion or excess of normal function and include delusions, hallucinations, disorganized thinking/speech, and disorganized or catatonic behavior positive
______ symptoms represent a decrease, loss, or absence of normal function and include flat affect, alogia, and avolition. negative
How long must tha persistent disturbance exist for a patient to be diagnosed with schizophrenia? 6 months with 1 month of active phase symptoms
The person with ______ affect demonstrates little or no emotional responsivity. flat
_________ disturbances may include hallucinations, illusions, and boundary and identity problems. perceptual
It is important for staff to thoroughly assess the ______ ______ type of hallucination so that they can initiate protective interventions. auditory commands
In _____ the individuals have the sense that their own bodies are unreal, as if they are estranged and unattached to the world or the situation at hand. depersonalization
The experience that external environmental objects are strange or unreal. derealization
Restricted in thought and speech production alogia
Opposing thoughts, ideas, feelings, drives, or impulses occurring in the same person at the same time. ambivalence
The distinguishing characteristics of ______ ______ are persistent delusions with a single or closely associated, tightly organized theme, usually of persecution or grandeur and auditory hallucinations about single or closely associated themes. paranoid schizophrenia
The distinguishing characteeristics of ____- _____ are grossly inappropriate or flat affect, incoherence, and grossly disorganized primitive and uninhibited behavior. disorganized schizophrenia
The distinguishing characteric of ______ ______ is marked disturbance of psychomotor activity. catatonic schizophrenia
This associated type of schizophrenia must have a duration of at least 1 month but less than 6 months and social/occupational function may not be impaired. Schizophreniform Disorder
This associated type of schizophrnia has symptoms of both schizophrenia and a mood disorder. The episode must last at least 1 month. Schizoaffective Disorder
The theme of this delusional disorder centers around belief and conviction that another person is in love with them, which in fact is untrue. erotomanic
The theme of this delusional disorder is that the individual's lover or spouse is unfaithful without real evidence to support the belief. jealous
The theme of this delusional disorder is that the individual has extraordinary or important talent or special knowledge. grandiose
The theme of this delusional disorder centers on the belief that the individual is a victim of conspiracy, poisooning, spying, harassment, or cheating. persecutory
The theme of this delusional disorder focuses on bodily sensations or functions. somatic
The defining characteristic of _____ ____ disorder is at least on e of the following symptoms: hallucinations, delusions, disorganized speech, or behavior disturbance. brief psychotic disorder
A delusional disorder when a person who is involved in a relationship with another individual who already has a psychotic disorder with prominent delusions has a psychotic disorder. Shared Psychotic Disorder
________ is aimed at alleviation of symptoms, improvement in quality of life, and restoration of productivity within the client's capacity. Treatment
Antipsychotic medications are also called neuroleptics
A variety of motor-related side effects that result from the dopamine-blocking effects of antipsychotic medications (most commonly the typical group). EPS
Spasms affecting various muscle groups may be frightening and result in difficulty swallowing, jeopardizing the person's airway. dystonia
How is dystonia treated? oral anticholinergic drugs or Cogentin and Benadryl
A variety of symptoms including tremors, slowed or absent movement, muscle jerks, shuffling gait, loss of facial muscle movement, and drooling. pseudoparkinsonism
What is pseudoparkinsonism treated with? anticholinergic drugs or dopamine agonists.
Motor restlessness, pacing, rocking, foot-tapping, inability to lie down, or sit still. Can be confused with anxiety, so keen assessment is critical. akathisia
How ia akathisia treated? Reduction in antipsychotics, beta blockers and benzodiazepines, occasionally bentropine if patient can tolerate.
Late occuring abnormal movements. tardive dyskinesia
Rapid, jerky movements that occur anywhere in the body. tardive syskinesia
How is tardive dyskinesia treated? Prevent by monitoring during treatment, withdraw antipsychotic meds over time, benzodiazepines, Vitamin E
This is believed to result from dopamine blockade in the hypothalamus. NMS
In NMS, muscle necrosis can be so severe that it causes myoglobinuric renal failure
What lab abnormalities will you find in a patient with NMS? Elevated creatinw phosphokinase and leukocytosis.
How is NMS treated? Discontinue antipsychotic meds, hydrate patient, antipyretics and cooling blankets if hyperthermia exists, treat arrythmias, low doses of heparin to decrease risk of pulmonary emboli, Bromocriptine Mesylate (dopamine agonist) and dantrolene.
What are the characteristics of Type 1 schizophrenia? positive rapid acute onset of symptoms, responds well to drugs and the tend to suffer more from positive symptoms.
What are the characteristics of Type 2 schizophrenia? poorly adjusted before it overtakes them, withdrawl from others, slowing of mental and physical reactions.
Because it is severe, ______ is placed under psychosis on the mental health continum. schizophrenia
What is the dopamine hypothesis? A theory derived from the study of antipsychotic drugs that block the activity of D2. The D2 receptors are blocked and the reduces some of the symptoms of schizophrenia.
What is the glutamate factor? Whe PCP induces a schizophrenic-like state", indicating the role of glutamate in schizophrenic pathology.
What neuroanatomical findings are present in a patient with schizophrenia? Enlarged lateral cerebral ventricles, cortical atrophy, cerebellar atrophy, frontal lobe atrophy, increased size of sulci on the brain surface.
The course of schizophrenia is characterized by the acute exacerbations of psychosis
_____ symptoms appear early in the 1st phase and often precipitate hospitalization; usually respond to medication positive
_______ symptoms of schizophrenia have an incidious onset, impair abilities, and are ______ because of a decrease or loss of norma functions. negative, negative
What atypical antipsychotic produces agranulocytosis and seizures and requires WBC's weekly for 6 months? Clozapine
_______ is the most sedating conventional/traditional antipsychotic and has less EPS. Thorazine
_______ is the least sedating conventional/traditional antipsychotic and has more EPS's and reduces assaultive behavior. Haldol
What do the use of antimanic drugs like lithium and valproate do for patients with schizophrenia? The suppress episodic violence.
What are benzodiazapines used for with schizophrenia? The improve positive and negative symptoms by 50%.
Children with schizophrenia are often mistaken for children with autism
Children have a ______ prognosis than adults with schizophrenia. worse
____ or _____ ______ is caused by substances, toxins, ETOH, or caused by the consequences of a medical condition. Induced or secondary psychosis