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Ch. 15- Schizophrenia Spectrum and Other Psychotic Disorders

Terms in this set (63)

severe mental condition in which there is disorganization of the personality, deterioration in social functioning, and loss of contact with or distortion of reality
psychosis
disturbances in thought process, perception, and affect invariably results in severe deterioration of social and occupational functioning
Schizophrenia
What are the characteristics in Phase 1 (premorbid phase) of schizophrenia?
-occurs before clear evidence of illness
-shy and withdrawn
-poor peer relationships
-doing poorly in school
-antisocial behavior
What are the characteristics in phase 2 (prodromal phase) of schizophrenia?
-more clearly manifests signs of developing illness
-can be a few weeks or months
-significant deterioration in function
-social withdrawal and cognitive impairment
-sleep disturbances, anxiety, and irritability
-depressed mood, poor concentration, fatigue
-perceptual abnormalities, ideas of reference, and suspiciousness causes onset of psychosis
What are the characteristics in phase 3 (schizophrenia) of schizophrenia?
-active phase, psychotic symptoms are prominent
-hallucinations, delusions, disorganized speech, grossly disorganized or catatonic behavior, and negative symptoms
-impairment in work, social relations, and self-care
What are the characteristics in phase 4 (residual phase) of schizophrenia?
-periods of remission and exacerbation
-usually follows active phase
-negative symptoms may remain and flat affect and impairment in role of functioning are common
presence of delusions that have been experienced by individual for at least 1 month; hallucinations are not prominent and behavior is not bizarre
delusional disorder
What are the subtype of delusional disorder?
Erotomanic, grandiose, jealous, persecutory, somatic, and mixed type
subtype of delusional disorder where the individual believes that someone, usually of a higher status, is in love with them
erotomanic type
subtype of delusional disorder where individual has irrational ideas about their own worth, talent, knowledge, or power
grandiose type
subtype of delusional disorder where an individual centers on the idea that their sexual partner is unfaithful
jealous type
subtype of delusional disorder where the individual believes they are being persecuted or malevolently treated in some way
persecutory type
subtype of delusional disorder where individual believes they have some type of medical condition
somatic type
subtype of delusional disorder where individuals delusions are prominent, but no single theme is predominant
mixed tpye
What are the characteristics of brief psychosocial disorder?
-sudden onset of psychotic symptoms that may or may not be preceded by a severe psychosocial stressor
-lasts at least 1 day but less than a month
-returns to premorbid level
-experiences turmoil or overwhelming perplexity or confusion
-impaired reality testing may include incoherent speech, delusions, hallucinations, bizarre behavior, and disorientation
What other disorders may catatonic features be associated with?
brief psychotic disorders, schizophreniform disorder, schizophrenia, schizoaffective disorder, and substance-induced psychotic disorder
What are the s/s of catatonic disorder due to another medical condition?
stupor and muscle rigidity or excessive, purposeless motor activity, wavy flexibility, negativism, echolalia, echopraxia
same s/s of schizophrenia with the exception that duration of this disorder has been at least one month but less than 6 months
Schizophreniform Disoder
manifested by s/s of schizophrenia, along with strong element of symptomatology associated with the mood disorders either mania or depression
Schizoaffective Disorder
What is the clinical picture of schizoaffective disorder?
may appear depressed with psychomotor retardation and suicidal ideation, or symptoms may include euphoria, grandiosity, and hyperactivity
positive symptom of schizophrenia; false personal beliefs that are inconsistent with the person's intelligence or cultural background
delusions
type of delusion where individual feels threatened and believes others intend harm or persecution toward them
delusions of persecution
type of delusion where individual has an exaggerated feeling of importance, power, knowledge, or identity
Delusions of grandeur
type of delusion where all events within environment are referred by psychotic person to himself/herself
Delusions of reference
type of delusion where individual believes certain objects or persons have control over their behaviors
Delusion of Control or Influence
type of delusion where an individual has false ideas about functioning of their body
Somatic Delusions
type of delusion where an individual has false idea that the self, a part of the self, others, or the world is nonexistent
Nihilistic Delusions
positive symptom of schizophrenia; extreme suspiciousness of others and their actions or perceived intentions
Paranoia
positive symptom of schizophrenia; believes their thoughts or behaviors have control over specific situations or people
magical thinking
positive symptom of schizophrenia; unaware that the topics are related; speech may be incoherent if condition is severe
Associative looseness
positive symptom of schizophrenia; invents new words that are meaningless to others but have symbolic meaning to the individual
neologisms
positive symptom of schizophrenia; literal interpretations of environment
concrete thinking
positive symptom of schizophrenia; choice of words governed by sound (rhyming)
Clang associations
positive symptom of schizophrenia; group of words put together randomly
word salad
positive symptom of schizophrenia; delay in reaching point of communication due to introduction of many new topics
circumstantiality
positive symptom of schizophrenia; inability to get to the point of communication due to introduction of many new topics
Tangentiality
positive symptom of schizophrenia; inability or refusal to speak
mutism
positive symptom of schizophrenia; persistent repetition of same word or idea in response to different answers
preservation
positive symptom of schizophrenia; false sensory perceptions not associated with real external stimuli
hallucinations
What are the different type of hallucinations?
Auditory, visual, tactile, gustatory, olfactory
positive symptom of schizophrenia; misperceptions of real external stimuli
illusions
positive symptom of schizophrenia; uniqueness and individuality a person feels
sense of self
repeating words that are heard
echolalia
imitate movements made by others
echopraxia
taking on the form of behavior one observes in another
identification and imitation
feelings of unreality
depersonalization
negative symptoms of schizophrenia; feeling state or emotional tone
affect
emotions incongruent with circumstances
inappropriate affect
emotional tone is week
bland affect
appear to be void of emotion
flat affect
negative symptoms of schizophrenia; inability to initiate goal-directed activity
volition
coexistence of opposite emotions toward same object, person, or situation
emotional ambivalence
impaired personal grooming and self-care activities
deterioration in appearance
negative symptoms of schizophrenia; clinging and intruding on personal space of others, exhibiting behaviors that are not culturally and socially acceptable
impaired social interaction
negative symptoms of schizophrenia; focus inward on the self to exclusion of the external environment
Social isolation
negative symptoms of schizophrenia; lack awareness of there being any illness or disorder even when s/s are obvious to others
lack of insight or anosognosia
negative symptoms of schizophrenia; allows body parts to be placed in bizarre or uncomfortable positions
waxy flexibility
negative symptoms of schizophrenia; voluntary assumption of inappropriate or bizarre postures
posturing
negative symptoms of schizophrenia; inability to experience pleasure
anhedonia
negative symptoms of schizophrenia; retreat to earlier level of development
regression
What are the treatment modalities for schizophrenia
Individual psychotherapy, group therapy, behavior therapy, social skills training, family therapy, assertive community treatment, recovery model, RAISE, psychopharmacology
use of role play to teach client appropriate eye contact, interpersonal skills, voice intonation, posture; aimed at improving relationship development
Social skills training
What are some client and family education for antipsychotics?
-do not stop taking abruptly
-use sunscreen and wear protective clothing when outside
-report weekly to have blood levels drawn
-be aware of risks of taking these medications with pregnancy
-Do not drink alcohol
-Do not consume other medications without physicians knowledge
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