Mental Health Exam #2 Psychotic Disorders Positive &
Negative Symptoms,Typical & Atypical
Antipsychotics,Grief,Depression,Suicide,Antidepressants,Ma
nia,Mood Stabilizers,Lithium, Therapeutic Communication
(responses)
Positive and Negative Symptoms of Schizophrenia
-classified as postive and negative for the purpose of treatments and medications
Positive Symptoms of Schizophrenia
- reflect EXCESS or distortion of normal function
-halucinations, delusions, disorganized thinking and behavior
-MORE than accepted normally
Negative Symptoms of Schizophrenia
-reflect LESSENING or loss of normal function
-flat affect
-apathy- lack of emotion
-alogia- short simple sentences
-avolition-lack of motivation
-anhedonia- lack of pleasure
-social isolation
-LESS than what is accepted normally
Types of Schizophrenia and Other Psychotic Disorders
1. Delusional Disorder
2. Brief Psychotic Disorder
3. Schizoaffective Disorder
4. Schizophreniform Disorder
5. Catatonic Disorder due to another medical condition
6. Substance/Medication induced psychotic Disorder
7. Psychotic Disorder due to Medical Condition
Delusional Disorder
-characterized by delusions of real-life situations(grandiose, jealous, persecutory and
somatice) which persist for a least one month
-main symptom is delusions
Subtypes- Erotomanic, Grandiose, Jealous, Persecutory, Somatic, Mixed
Brief Psychotic Disorder
-characterized by short and acute period of psychotic behavior, usually in response to a
major stressor and lasts LESS THAN one month.
Schizoaffective Disorder
- characterized by symptoms of schizophrenia and mood or affective
disorder(depression, mania or bipolar)
Schixophreniform Disorder
- characterized by symptoms of schizophrenia that lasts LESS THAN 6 months
Substance/Medication-induced Psychotic Disorder
,-psychosis that develops from abuse or withdrawal from substances such as alcohol,
cocaine, and methamphetamine(most common)
Psychotic Disorder due to Medical Condition
- psychosis resulting from medical conditions that affects brain function. ex head injury,
brain tumor
Shared Psychotic Disorder- folie a deux- characterized by delusions developed thru a
relationship with another person who is delusional
Paraphrenia- schizophrenia that develops late in life(elderly)
Major Symptoms of Psychotic Disorders
Major: Hallucinations and Delusions
Other Symptoms
-disorganized/incoherent speech
-confused thinking
-bizarre behavior
-slowed/unusual movements
-loss of interest in ADLS
-problems with socializations/relationship
-problems in school/work
-lack of emotional response
Schizophrenia
Dementia Praecox
-term was coined by Alfred Bleulet from the words schizoid which means splt and phren
which means mind
-a split between the cognitive and emotional aspects
**NCLEX INCREASE of DOPAMINE is a factor
**NCLEX- Onset is late adoleescence to early adulthood
-not the environment but it is genetic
Theories of Etiology of Schizophrenia
1. Biologic- abnormalities in frontal lobe, biochemical-excess of dopamine, and genetic
2. Psychoanalytic- weak/impaired ego because of too many stressors
3. Interpersonal-poor mother child relationship- NOT ME slef concept
4. Psychosocial- development of mistrust as a baby will lead to mistrust as an adult
5. Family- enmeshment, family dysfunction/problems
6. Socio-cultural- absence of prenatal care, unstable family, poor social conditions-
environment
7. Transactional Theory- multiple causation what is acceptable in the psych world,
their are many causes not just one
Phases of Schizophrenia
1. Premorbid Phase/Schizoid Personality
2. Prodromal Phase- social withdrawal, impairment in role functioning, poor hygiene and
grooming, communication disturbances, bizarre ideas
3. Schizophrenia- the ACTIVE phase
4. Residual- periods of remissions and exacerbations- symptoms similar to prodromal
phase
DSM 5 Criteria of Schizophrenia
, 1. Characteristics Symptoms 2 or more- delusions, hallucinations, disorganized speech,
grossly disorganized or catatonic behavior, negaitve symptoms/flat affect, alogia,
avolition
2. Social/Occupational Dusfunction
3. Duration- at least 6 months
4. No mood episodes
5. Not due to substances or medical condition
Bleulers 4-5 A's of Schizophrenia
1. Autism-withdrawn in own world
2. Ambivalence- coexistance of 2 opposites love/hate
3.**NCLEX Affective disturbances- flat
4. Associative Looseness-disorganized thoughts
5. Attention defects and Activity disturbances
Types of Schizophrenia
1. Disorganized
2. Catatonic
3. Paranoid
4. Undifferentiated
5. Residual Schizophrenia
Disorganized(hebephrenic) Schizophrenia
- onset before age 25
-don't have desire to perform ADL's, hygiene is not a concern
NCLEX- do not force them to take a shower, it is not life threatening if they don't
Characteristics- regressed/primitive behavior, flat and inappropriate affect with periods
of silliness and giggling, facial grimaces, and bizarre mannerisms, incoherant
communication, neglected hygenie and grooming
Catatonic Schizophrenia
-NCLEX alert- physiological is our 1st priority, VS, I & O, temp
-characterized by marked abnormalities in motor behaviors
2 types: 1st Catatonic Stupor- extreme psychomotor retardation-waxy
flexibility(immobile posture), suggestibility, posturing, mutism, negativim, rigid
2nd- Catatonic Excitement- extreme psychomotor agitation- frenzied & purposeless
movements often destructive and violent, shouting: usually happens suddenly, need to
try to calm pt. down
Paranoid Schizophrenia
- Characteristics- delusions of persecution or grandeur, auditory hallucinations,
suspicious, guarded, may be argumentative, hostile, aggressive
Undifferentiated Schizophrenia
- symptoms not classified into any of the 1st 3 types
Schizophrenia Nursing Diagnosis
-Sensory/Perceptual Alteration
-Altered Thought Process
-Risk for Violence to self or others
-Social Isolation
-Impaired Verbal Communication
-Self-Care Deficit
Negative Symptoms,Typical & Atypical
Antipsychotics,Grief,Depression,Suicide,Antidepressants,Ma
nia,Mood Stabilizers,Lithium, Therapeutic Communication
(responses)
Positive and Negative Symptoms of Schizophrenia
-classified as postive and negative for the purpose of treatments and medications
Positive Symptoms of Schizophrenia
- reflect EXCESS or distortion of normal function
-halucinations, delusions, disorganized thinking and behavior
-MORE than accepted normally
Negative Symptoms of Schizophrenia
-reflect LESSENING or loss of normal function
-flat affect
-apathy- lack of emotion
-alogia- short simple sentences
-avolition-lack of motivation
-anhedonia- lack of pleasure
-social isolation
-LESS than what is accepted normally
Types of Schizophrenia and Other Psychotic Disorders
1. Delusional Disorder
2. Brief Psychotic Disorder
3. Schizoaffective Disorder
4. Schizophreniform Disorder
5. Catatonic Disorder due to another medical condition
6. Substance/Medication induced psychotic Disorder
7. Psychotic Disorder due to Medical Condition
Delusional Disorder
-characterized by delusions of real-life situations(grandiose, jealous, persecutory and
somatice) which persist for a least one month
-main symptom is delusions
Subtypes- Erotomanic, Grandiose, Jealous, Persecutory, Somatic, Mixed
Brief Psychotic Disorder
-characterized by short and acute period of psychotic behavior, usually in response to a
major stressor and lasts LESS THAN one month.
Schizoaffective Disorder
- characterized by symptoms of schizophrenia and mood or affective
disorder(depression, mania or bipolar)
Schixophreniform Disorder
- characterized by symptoms of schizophrenia that lasts LESS THAN 6 months
Substance/Medication-induced Psychotic Disorder
,-psychosis that develops from abuse or withdrawal from substances such as alcohol,
cocaine, and methamphetamine(most common)
Psychotic Disorder due to Medical Condition
- psychosis resulting from medical conditions that affects brain function. ex head injury,
brain tumor
Shared Psychotic Disorder- folie a deux- characterized by delusions developed thru a
relationship with another person who is delusional
Paraphrenia- schizophrenia that develops late in life(elderly)
Major Symptoms of Psychotic Disorders
Major: Hallucinations and Delusions
Other Symptoms
-disorganized/incoherent speech
-confused thinking
-bizarre behavior
-slowed/unusual movements
-loss of interest in ADLS
-problems with socializations/relationship
-problems in school/work
-lack of emotional response
Schizophrenia
Dementia Praecox
-term was coined by Alfred Bleulet from the words schizoid which means splt and phren
which means mind
-a split between the cognitive and emotional aspects
**NCLEX INCREASE of DOPAMINE is a factor
**NCLEX- Onset is late adoleescence to early adulthood
-not the environment but it is genetic
Theories of Etiology of Schizophrenia
1. Biologic- abnormalities in frontal lobe, biochemical-excess of dopamine, and genetic
2. Psychoanalytic- weak/impaired ego because of too many stressors
3. Interpersonal-poor mother child relationship- NOT ME slef concept
4. Psychosocial- development of mistrust as a baby will lead to mistrust as an adult
5. Family- enmeshment, family dysfunction/problems
6. Socio-cultural- absence of prenatal care, unstable family, poor social conditions-
environment
7. Transactional Theory- multiple causation what is acceptable in the psych world,
their are many causes not just one
Phases of Schizophrenia
1. Premorbid Phase/Schizoid Personality
2. Prodromal Phase- social withdrawal, impairment in role functioning, poor hygiene and
grooming, communication disturbances, bizarre ideas
3. Schizophrenia- the ACTIVE phase
4. Residual- periods of remissions and exacerbations- symptoms similar to prodromal
phase
DSM 5 Criteria of Schizophrenia
, 1. Characteristics Symptoms 2 or more- delusions, hallucinations, disorganized speech,
grossly disorganized or catatonic behavior, negaitve symptoms/flat affect, alogia,
avolition
2. Social/Occupational Dusfunction
3. Duration- at least 6 months
4. No mood episodes
5. Not due to substances or medical condition
Bleulers 4-5 A's of Schizophrenia
1. Autism-withdrawn in own world
2. Ambivalence- coexistance of 2 opposites love/hate
3.**NCLEX Affective disturbances- flat
4. Associative Looseness-disorganized thoughts
5. Attention defects and Activity disturbances
Types of Schizophrenia
1. Disorganized
2. Catatonic
3. Paranoid
4. Undifferentiated
5. Residual Schizophrenia
Disorganized(hebephrenic) Schizophrenia
- onset before age 25
-don't have desire to perform ADL's, hygiene is not a concern
NCLEX- do not force them to take a shower, it is not life threatening if they don't
Characteristics- regressed/primitive behavior, flat and inappropriate affect with periods
of silliness and giggling, facial grimaces, and bizarre mannerisms, incoherant
communication, neglected hygenie and grooming
Catatonic Schizophrenia
-NCLEX alert- physiological is our 1st priority, VS, I & O, temp
-characterized by marked abnormalities in motor behaviors
2 types: 1st Catatonic Stupor- extreme psychomotor retardation-waxy
flexibility(immobile posture), suggestibility, posturing, mutism, negativim, rigid
2nd- Catatonic Excitement- extreme psychomotor agitation- frenzied & purposeless
movements often destructive and violent, shouting: usually happens suddenly, need to
try to calm pt. down
Paranoid Schizophrenia
- Characteristics- delusions of persecution or grandeur, auditory hallucinations,
suspicious, guarded, may be argumentative, hostile, aggressive
Undifferentiated Schizophrenia
- symptoms not classified into any of the 1st 3 types
Schizophrenia Nursing Diagnosis
-Sensory/Perceptual Alteration
-Altered Thought Process
-Risk for Violence to self or others
-Social Isolation
-Impaired Verbal Communication
-Self-Care Deficit
