Term
| Eugen Bleuler’s 4 A’s of Schizophrenia |
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Definition
| Affect, Associative looseness, Autism, Ambivalence |
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Term
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Definition
Lifetime prevalence of schizophrenia 1% worldwide
No difference related to
Race
Social status
Culture |
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Term
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Definition
Substance abuse disorders
- Nicotine dependence
Anxiety, depression, and suicide
Physical health or illness
Polydipsia |
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Term
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Definition
Biological factors: Genetics
Neurobiological
- Dopamine theory
- Other neurochemical hypotheses
Brain structure abnormalities
Psychological and environmental factors
-Prenatal stressors
-Psychological stressors
-Environmental stressors |
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Term
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Definition
Phase I – Acute
- Onset or exacerbation of symptoms
Phase II – Stabilization
- Symptoms diminishing
- Movement towards previous level of functioning
Phase III – Maintenance
- At or near baseline functioning |
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Term
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Definition
During the prepsychotic phase
General assessment
- Positive symptoms
-> Bizarre behavior (p. 312, 313)
- Negative symptoms (something that should be present in pt’s life but is not)
-> Poor thought process, anhedonia (not able to find pleasure)
- Cognitive symptoms (r/t ability to think)
-> Judgment, disorganized
- Affective symptoms
-> Emotions or expressions |
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Term
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Definition
Alterations in thinking
- Delusions are false, fixed beliefs.
- Concrete thinking(Black & White) is an inability to think abstractly.
- Thinking, speech, perception, or behavior
Alterations in speech
- Neologisms (신조어)
- Echolalia (반향언어; 남의 말을 그대로 흉내)
- Echopraxia (반향동작)
- Clang associations (음향연상; cling ring)
- Word salad (단어들이 일관성없이 튀어나옴)
Alterations in perception
- Depersonalization (비인격화)
- Derealization (현실감 상실)
- Hallucinations
-> Auditory hallucinations
-> Command hallucinations
-> Visual hallucinations
- Boundary impairment
Alterations in behavior
- Catatonia
- Motor retardation
- Motor agitation
- Stereotyped behaviors
- Automatic obedience
- Waxy flexibility
- Negativism
- Impaired impulse control |
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Term
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Definition
Affect
- Flat
- Blunted
- Inappropriate
- Bizarre |
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Term
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Definition
Difficulty with
- Attention
- Memory
- Information processing
- Cognitive flexibility
- Executive functions |
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Term
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Definition
Assessment for depression crucial
- May herald impending relapse
- Increases substance abuse
- Increases suicide risk
- Further impairs functioning |
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Term
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Definition
1. Any medical problems
2. Abuse of or dependence on alcohol or drugs
3. Risk to self or others
4. Command hallucinations
5. Belief system
6. Suicide risk
7. Ability to ensure self-safety
8. Co-occurring disorders
9. Medications
10. Presence and severity of positive and negative symptoms
11. Patient’s insight into illness
12. Family’s knowledge of patient’s illness and symptoms |
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Term
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Definition
Phase I - Acute
- Patient safety and medical stabilization
Phase II - Stabilization
- Adhere to treatment
- Stabilize medications
- Control or cope with symptoms
Phase III - Maintenance
- Maintain achievement
- Prevent relapse
- Achieve independence, satisfactory quality of life |
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Term
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Definition
Phase I – Acute
- Best strategies to ensure patient safety and provide symptom stabilization
Phase II – Stabilization
Phase III – Maintenance
- Provide patient and family education
Relapse prevention skills are vital |
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Term
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Definition
Phase 1 – Acute Settings
- Partial hospitalization
- Residential crisis centers
- Halfway houses
- Day treatment programs |
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Term
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Definition
Acute Phase
- Psychiatric, medical, and neurological evaluation
- Psychopharmacological treatment
- Support, psychoeducation, and guidance
- Supervision and limit setting in the milieu
Stabilization and Maintenance Phase
- Milieu management
- Activities and groups
- Safety
- Counseling and communication techniques
- Hallucinations
- Delusions
- Associative looseness
- Health teaching and health promotion |
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Term
| Pharmacological Interventions |
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Definition
Antipsychotic medications
- Conventional (typical) antipsychotics
-> Typical or first-generation
-> Altered to atypical due to High SE in newborns
- Atypical antipsychotics
-> Second-generation
-> Agranulocytosis (WBC becomes reduced) |
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Term
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Definition
- Treat both positive and negative symptoms
- Minimal to no extrapyramidal side effects (EPSs) or tardive dyskinesia
- Disadvantage – tendency to cause significant weight gain
- Examples
Clozapine (Clozaril) – use declining
Risperidone (Risperdal)
Olanzapine (Zyprexa)
Quetiapine (Seroquel)
Ziprasidone (Geodon)
Aripiprazole (Abilify) |
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Term
| Conventional Antipsychotics |
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Definition
Dopamine antagonists (D2 receptor antagonists)
Target positive symptoms of schizophrenia
Advantage
- Less expensive than atypical antipsychotics
Disadvantages
- Do not treat negative symptoms
- Extrapyramidal side effects (EPSs)
- Tardive dyskinesia
- Anticholinergic side effects
- Lower seizure threshold |
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Term
| Extrapyramidal Side Effects |
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Definition
Acute dystonia
- Tightened neck muscle (not very common)
Akathisia(안절부절 못함)
Pseudoparkinsonism
Tardive dyskinesia – Abnormal Involuntary Movement Scale (AIMS) |
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Term
| Potentially Dangerous Responses to Antipsychotics |
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Definition
Neuroleptic malignant syndrome (NMS)
- Fever, lvl of consciousness is affected
- Emergency; needs to get help soon
Agranulocytosis |
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Term
| Adjuncts to Antipsychotic Drug Therapy |
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Definition
Antidepressants
Antimanic agents |
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Term
| Specific Interventions for Catatonia |
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Definition
Catatonia – Withdrawn Phase
- Communication guidelines
- Self-care needs
- Milieu needs
Catatonia – Excited Phase
- Communication guidelines
- Self-care needs |
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Term
| Specific Interventions for Disorganized Schizophrenia |
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Definition
Communication guidelines
Self-care needs
Milieu needs |
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Term
| Undifferentiated Schizophrenia |
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Definition
Active signs of disorder
- Positive symptoms
- Negative symptoms
Individual does not meet criteria for any other subtype |
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Term
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Definition
Active-phase symptoms no longer present
Evidence of two or more residual symptoms persists
- Reduced initiative, interests, or energy
- Social withdrawal
- Impaired role function
- Speech deficits
- Odd beliefs |
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Term
| Advanced Practice Interventions |
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Definition
Psychotherapy
Cognitive-behavioral therapy (CBT)
Group therapy
Medication
Social skills training
Cognitive remediation
Family therapy |
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