Schizophrenia

what symptoms of schizophrenia are not observable

positive symptoms

positive vs negative symptoms of schizophrenia

positive: adds a behavior, thought, or feeling negative: takes away a thought, behavior, or feeling, lack of emotion

a decrease in function prior to the onset of schizophrenia =____pattern of symptoms

premorbid

negative symptoms of schizophrenia may____over time

increase

list some precautions of schizophrenia

-impulsivity -suicide -homicide -non-compliance -Extrapyramidal syndromes -tardive dyskinesia -postural hypotension -substance use -mortality

Two or more of the following symptoms must be present for a significant amount of time during a ____ month period for a person to be diagnosed with schizophrenia

1 month: 1. delusions 2. hallucinations 3. negative symptoms 4. disorganized speech 5. catatonic behaviors

classification of longitudinal course occurs after at least ___year has elapsed since the initial onset of active-phase symptoms

1 year

What are the three types of pharmcotherpay for schizophrenia

1. Acute Psychosis 2. Stabilization/Maintanence 3. Poor Responders

3 types of classification of longitudinal course of schizophrenia

1. Episodic with Interepisode Residual Symptoms 2. Episodic with No interepisdode residual symptoms 3. Continuous with prominent negative symptoms

4 types of etiology hypothesis of schizophrenia

1. Genetic Factors 2. Biochemical Factors (Serotonin, dopamine, GABA, glutamate, acetylcholine) 3. Neuropathology "silent lesion in the brain" (Cerebral ventricle enlargement, reduced symmetry, limbic system, prefrontal cortex abnormality) 4. Psychoneuroimmunology

four examples of negative symptoms of schizophrenia are

1. affective flattening 2. impoverished speech 3. ambivalence 4. anhedonia

what are some examples of mood symptoms of schizophrenia?

1. anxiety 2. dysphoria 3. agitation 4. suicidality

list 4 examples of positive symptoms of schizophrenia

1. hallucinations 2. delusions 3. thought disorganization 4. paranoia

the four different "symptoms of schizophrenia are

1. positive 2. negative 3. mood 4. neurocognitive

What are the typical 3 phases of schizophrenia

1. prodromal phase 2. active phase 3. residual phase

three phases of hearing voices

1. startle phase 2. organization phase 3. stabilization

the life expectancy of someone with schizophrenia is about_____--_____ years less than population

25-30

List three medications that would be given to a patient during the stabilization/maintenace phase

2nd generation antipsychotics, anti depressants, mood stabilizers

continuous signs of the disturbance must persist for at least _____months and must include at least ___ month of symptoms that meet criterion A

6 months 1 month

>___% of people with schizophrneia describe having a poor outcome

> 50%

what are some occupational therapy treatment approaches to schizophrenia

ADL training social skills training community integration work education home management leisure exploration and participation sensory motor activities health management and maintene e coping skills training financial management link to community resources cogntitive remediation hearing voices support group

During __________ a schizophrenic is giving an IM antipsychotic such as Haldol, prolixin, or zyprexa

Acute Psychosis

______requires stringent blood work and is only for patients who are not responding to the other medications

Clorazil

the six month period (duration) must include at least one month of symptoms that meet ________ and may include periods of ___ and ___ symptoms

Criterion A [active-phase symptoms] periods of prodromol or residual symptoms

What are some medications that would be administered to a patient in an acute stage of psychosis?

Intermuscular injection: Haldol, proxlin, zyprexa

positive symptoms of schizophrenia are____

NOT OBSERVEABLE

negative symptoms of schizophrenia are ____

OBSERVEABLE

An example of psychoneuroimmunology is people with Schizophrenia

People born in the winter/early spring are at greater risk for schizophrenia/if mom has flu while pregnant

Clozaril is known as a ____

Poor responder medication

During ______a patient with schizophrenia would be given a 2nd generation antipsychotic, antidepressant or mood stabilizer

Stabilization/Maintanence phase

what is the recovery approach to hearing voices?

accept voices as apart of the person

acute = ___prognosis

acute

acute or insidious onset = good prognosis ?

acute

prevent harm is the main goal during ___phase of illness

acute

prevent harm, control disturbed behavior, reduce psychotic symptoms, patient/family alliance, and connect to community aftercare are all implemented during what phase>

acute

if there is a history of ____ disorder or ______disorder, additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations are present for at least ___month

autism disorder, pervasive developmental disorder

clorazil requires stringent _____

blood work

____is the highest level anti psychotic

clorazil

What is an example of a medication that is given only when the others don't work and are considered a "poor responder"

clozaril

positive symptoms of schizophrenia may ____over time

decrease

cognitive impairment, practical barriers (finances, transportation) culutral beliefs and lack of family support might contribute to _________ to their treatment

decreased adherence

believing in something that is false even when evidence points to the fact that it is not true "Being chosen by GOD" is an example of a ___

delusion

difference between delusions and hallucinations

delusions: believing in something that is false even when evidence points to the fact that it is not true. "chosen by God" hallucinations: false sensory perceptions "hearing voices"

what is extra pyramidal syndrome?

drug-induced movement disorders from taking antipsychotics that include acute and tardive symptoms.

females or males have a better prognosis with schizophrenia and why?

females bc of their later onset

examples of negative symptoms

flat affect, alogia, avolition

with each psychotic episode, patient with schizophrenia moves ___from baseline

further--their functioning gets worse

there is a ____incidence of schizophrenia in urban areas

higher

having a late or early onset of schizophrenia -->better prognosis?

late onset = good prognosis

dysphoria, anxiety, agitation and suicidality are all examples of _____symptoms of schizophrenia

mood

what is better for prognosis: having withdrawn, autistic behavior or having mood disorder symptoms (depressive disorders?)

mood disorder depressive disorders

What are the side effects of 1st generation anti psychotics?

motor side effects (tardive dyskensia, extrapyramidal syndromes)

_____symptoms of schizophrenia give way to a poor prognosis

negative

affective flattening, avolition, agolia, ambivalence and anhedonia are examples of what symptom of schizophrenia

negative

ambivalence and impoverished speech are two examples of what symptoms of schizophrenia

negative

what symptoms of schizophrenia are observeable

negative symptoms

flat affect, avolition and agolia are examples of ____

negative symptoms of schizophrenia

During the prodromal or residual periods, the signs of the disutrbance may be manifested by only___________

negative symptoms or two or more symptoms listed in criterion A

during the prodromal or residual periods, the signs of disturbance may be manifested by only ________ or _______

negative symptoms or two or more symptoms listed in criterion A

distractability, learning deficits, memory deficits, and abstract thinking impairment are all examples of what symptom of schizophrenia

neurocogntive

If the delusions are bizzare or hallucinatioons consist of a voice keeping up a running commentary on the person's behavior or thoughts, or two or more voices are conversing with each other than only ___criterion A symptom is required for effective diagnosis

only one

insidious onset = ___prognosis

poor

young/early onset = ____Prognosis

poor

Hallucinations, delusions, paranoia, thought disorganization are all examples of ___symptoms of schizophrenia

positive

_____symptoms of schizophrenia give way to a good prognosis

positive

people born in the winter/early spring months are at risk for schizo+if their mothers develop the flu while pregnant is an example of what etiology

psychoneuroimmunology etiology

what two disorders must be ruled out when diagnosing schizophrenia?

schizoaffective disorder and mood disorder with psychotic features

examples of premorbid symptoms

social, sexual and work dysfunction

during______ the therapist tries to minimize the patient's risk of relapse, maximized adaptation to return to the community, continue symptom reduction and promote recovery

stabilization and maintence

mood stabilizers would be given to a patient in the ___phase

stabilization and maitence phase

2nd generation antipsychotics would be given to a patient in the ____phase

stabilization and maitenene phase

antidepressants would be given to a patient in the ___ phase

stabilization and maitenene phase

A correct diagnosis of schizophrenia must NOT be due to the physiological effects of _____

substance (drug, medication, etc)

the goalS of the stable phase is to ______

sustain remission, maintain and imporve functioning, address symptoms of relapse, monitor for side effects

repetitive involuntary movements of the tongue, rapid blinking, lip smacking

tardive dyskensia

often, people with schizophrenia experience hallucinatory voices commenting or discussing the patient in ___person

third person

what kind of thoughts do people with schizophrenia hear?

thought echo thought insertion thought broadcasting

What is the main goal during the acute phase of the illness

to prevent harm

there is a higher incidence of schizophrenia in ___areas

urban

what are side effects of 2nd generation anti psychotics

weight gain

when is the risk of suicide in people with schizophrenia the highest?

when they start to gain insight of their illness/doing well in recovery

For a signficiant portion of time, one or more of major areas of functioning such as __,___,___ are markedly below level of achieved prior to the onset of schizophrenia

work, interpersonal relationships, self-care

prodromal syndrome may last a ____ or more before psychotic symptoms onset

year