impairment of:

- social relationships

- communications

- sensory and perceptual input

- development

- pervasive and usually severe impairment in reciprocal social interaction skills and communication skills

- restricted sterotypical behavioral patterns

Genetic: many austic children have a relative with autism

Biological: maternal rubella, anoxia, fragile X syndrome, increased brain development in 1st years of life

Epigentic: dopamine overactivation, elevated serotonin

mental retardation -- savants

IQ is not correlated with severity of autism

mutism

parrot speech

echolalia

reverse pronounds

literal use of words

sensory deficits

hallucinations

may act deaf

aversion to touch

- marked psychomotor disturbance, motionless, or excessive motor activitiy

- extreme negativisim

- mutism

- pecularities of voluntary movement: echolalia, echopraxia

- at least one previous psychotic episode but not currently

- social withdrawel

- flat affect

- loose associations

- risk for injury

- impaired social interactions

- disturbed thought processes

- maintain routine, work closely with family to determine habits and preferences

- maintain consistent staff for child

- determine way child communicates

- provide family support; sucure additional resources as needed

- genetic factors

-neuroanatomic theories

- neurochemical theories: overactive dopamine, and more

- immunovirolgic factors

- ideas that are delusional in one culture may be accepted by another culture

- auditory or visual hallucinations may be a normal part of religious experiences in some cultures

- AA, CA, and HA appear to require comparable therapeutic doses of antipsychotic medications

- Asian clients need lower doses of drugs such as haloperidol (Haldol) to obtain the same effects

- disorganized

-catatonic

-paranoid

-residual

-undifferentiated

- inappropriate or silly emotions

- incoherent speech

severe:

- regression

- hypochondriasis

- hallucinications and delusions

- extreme social withdrawel

- chronic

- cataonic posturing

- catatonic rigidity

- waxy flexibility

- catatonic stupor

- catatonic excitment

When do people with SCCT go catatonic?

Is it of their own volition?

How should they be medicated?

- when they are ill

- no

- ativan/benzo when in catatonic state

least - catatonic

most - paranoid

- suspiciousness

- overuse of projection

- delusions of persecution or grandeur

- auditory hallucinations

- unaffected IQ

- homicidal or suidical ideation is often present

- partial remission

- no obvious psychotic symptoms

- may exhibit isolation, associate looseness, illogical thinking, or eccentric behavior

- mixture of symptoms: delusions, hallucinations, disorganized behavior

- can't be classified elsewhere

How does schizophrenia affect perceptions?

How should a nurse deal with a pt experiencing hallucinations?

- auditory hallucinations, visual hallucinations

- assure them that the pt is safe and you beleive they are experiencing these things

- ask if voices are mean/derogatory or if they are commanding anything

- tell the pt to "let me worry" and "tell me if the voices tell you to do something"

flat, apathetic

not a choice

don't think of self as seperate, unique being

echolalia

echopraxia

patient feels little motivation

hard to maintain hygiene and cleanliness

apathy

lack of affect

difficulty with interpersonal interaction

avolition

social withdrawal or discomfort

apathy

alogia

hallucinations

delusions

disorganized thought, speech and behavior

- delusions

- religiosity

- paranoia

- magical thinking

- associative looseness

- neologisms

- concrete thinking

- clang associations

- word salad

- tangentiality

thoughts are ordered

fully functional

family may start to notice changes

- slow and gradual onset of symtpoms

- younger age of onset associated with poorer outcomes

- first years after diagnosis, client may have relatively symptom free periods between psychotic episodes or fairly continuous psychosis with some shift in severity of symptoms

- most clients have difficulty functioning in the community and few lead fully indepedent lives

- early detection and aggressive treatment of the first psychotic episode improves outcomes

- 20 to 30 % experience dementia resulting in steady, deteriorating decline in health

- 20 to 30 % experience a reduction in positive symtpoms, somewhat like a remission

- 40 to 60 % remain mostly unchanges

- previous hx with schizophrenia

- previous suicidal ideation

- current support system

- client's perception of current situation

- general appearance, motor behavior, speech

- mood and affect

- though processes and content

- delusions

- sensorium and intellectual processes: hallucinations, disorienation, concrete or literal thinking

- judgement and insight

-self concept

- roles and relationships

- physiologic and self care considerations

- risk for other directed violence

- risk for suicide

- disturbed thought processes

- disturbed sensory perception

- disturbed personal identity

- impaired verbal communication