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How long do you have to have the symptoms to classify as schizophrenia?
Symptoms X30 days for >6Months
How long for schizophrenoform DO?
Symptoms < 6 months
What is SAFD?
- Schizoaffetive Disorder….
- Symptoms with & without mood episode
What is a delusional disorder?
Non-bizarre delusion x 1month
How long is a brief psychotic disorder?
> 1 day <1 month
What is a shared psychotic disorder?
It takes on other delusions
Some other psychotic disorders can be caused by what?
What is the diagnosis criterion for schizophrenia?
- 1. Positive or negative symptoms for 30 days for greater than 6 months
- 2. Marked social/vocational dysfunction
- 3. NOT due to:
- …….. medical
- …….. drugs
- …….. SAFD
- …….. Manic Depressive Disorder (MDD) with psychotic features
What are the 4 types of POSITIVE symptoms?
- 1. Delusions
- 2. Hallucinations
- 3. Disorganized Speech
- 4. Catatonia
Grandiosity, persecution, somatic, reference, thought insertion/withdrawal/broadcasting, ect?
auditory, visual, tactile, olfactory, gustatory?
clang, neologisms, thought block, loose assoc, perseveration?
stupor, posture, excitation?
What are the NEGATIVE symptoms of schizophrenia? *Hint-Crazy 8's*
- Affective blunting
What are the subtypes of schizophrenia?
Negative symptoms persist in
spite of resolution of positive symptoms
What is the scope of schizophrenia?
- •40 % attempt suicide within 10 yrs.
- •10 % actually complete suicide
- leading cause of disability
- •60-70% never marry/have children
- •Occupy 25% of all hospital beds
- •70%–80% are unemployed or underemployed
- •10% of permanently disabled Americans
- • 20%–30% of the homeless population
Schizophrenia vs. Violence
- •Evidence mixed
- •Media sensationalized?
- •Schizophrenics 14% more likely to be victim
- rather than comit violent crime
What are the demographics of Schizophrenia?
- •0.5 - 1.5 % of population
- •Urban > Rural
- •Uniform rates across racial and ethnic groups
- in US, except for higher rates with racial minorities in large cities
- •Higher rates with maternal malnutrition
What are the gender differences of Schizophrenia?
- •Male > Female (up to 20%)
- •Onset: male (18-25 yr); female (25-35 yr)
- •Second peak in onset women after 45 yrs.
- •Pre-morbid function females > males
- •Males – More positive symptoms
- •Females – More negative symptoms
- •Women have more
- symptoms – misdiagnosed MDD or SAFD
What are the etiological theories concerning Schizophrenia?
- •Genetic – familial ; 10% greater chance
- •Hormonal – onset S/P puberty, thyroid, DM
- •Apoptosis/Excessive pruning
- •Virus – selectivity; dormancy; triggered by
- stress/hormonal; alter cellular process without destroying cells
- •Neurotransmitter – drugs can either mimic or eleviate
What is the pathology behind Schizophrenia?
What are the 4 stages of progression when dealing with Schizophrenia?
- 1. Premorbid
- 2. Prodromal
- 3. Psychotic
- 4. Recovery
Premorbid (0-35 yrs.)
Insidious decline in
Prodromal (2-5 yrs.)
Abrupt onset of (+) &
significant worsening of (-) symptoms.
Often hospitalized due to unable to care for self.
Exacerbations & remissions
with 80% relapse rate. Degree of illness/level of functioning plateau after 10
What are some ways to treat Schizophrenia without medications?
- •Supportive psychotherapy
- •Family therapy
- •Socialization/social skills training
- •Cognitive Behavioral Therapy
What are the two types of pharmacotherapeutics that treat Schizophrenia?
These Alleviate positive symptoms, have More side effects, but are Less
These will alleviate positive symptoms, offer some help with negative symptoms, have fewer side effects, and MIGHT have neuroprotective effects????
What are the medication forms that treat Schizophrenia?
- •Orally disintegrating tabs (ODT)
What are the drug side effects for drugs that treat Schizophrenia?
- •Histaminic effects – Sedation
- •Adrenergic effects – Orthostasis
- •Anticholenergic effects – Dry mouth
- •Hyperprolactinemia – Sexual
- •Metabolic effects:
- - Weight gain
- - Hyperglycemia/diabetes
- - Hyperlipidemia
What are the other med risks?
- •Sudden death (dementia)
- Prolongation (Geodon & Melaril)
- •Extrapyramidal symptoms (EPS)
- •Tardive dyskinesia
- •Neuroleptic malignant disorder (NMS)
- •Agranulocytosis (Clozaril)
What does the nurse need to monitor the patient for that is receiving treatment for Schizophrenia?
- •Vital signs – include orthostatic BP (falls)
- •Weight & BMI
- •AIMS – Abnormal Involuntary Movement
- Scale (TD)
- •Labs – CBC, renal function,lipids, glucose, Hgb
- A1C, LFTs, TFTs, prolactin