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Schizophrenia-Mental health nursing

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Schizophrenia-Psychiatric Nursing

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  • October 6, 2021
  • 6
  • 2020/2021
  • Class notes
  • Sir ivan
  • All classes
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SCHIZOPHRENIA
 A diagnostic term used to describe a major psychotic disorder characterized
by disturbances in perception, thought processes, reality testing, feeling,
behavior, attention, and motivation.
 Appears in late adolescence or early adulthood; peak incidence of onset is
between 15-25 years old in women and 25-35 years old women.
 The term schizophrenia was coined by Bleuler’s and has identified the four
primary symptoms.

Bleuler’s 4 A’s

1. Affective disturbance – Inappropriate, blunted, or flattened affect
2. Autism – Preoccupation with the self, with little concern for external
reality.
3. Associative looseness – The stringing together or unrelated topics.
4. Ambivalence – Simultaneous opposite feelings.


A. COURSE OF ILLNESS

1. Acute Phase
> Presence of severe psychotic symptoms.

2. Stabilizing Phase
> Client is getting better.
3. Stable Phase
> Hallucinations and delusions are not as severe than what was
experienced by the client during the acute phase.

Criteria for Schizophrenia

A. Criteria A. At least two of the following characteristics symptoms.

,  Delusions
 Hallucinations
 Disorganized speech
 Grossly disorganized or catatonic behavior
 Negative Symptoms

B. Criteria B. Social-occupational dysfunction: work, interpersonal, and
self-care functioning below the level achieved before onset.

C. Criteria C. Duration: Continuous signs and symptoms of disturbance for
at least 6 months.

D. Criteria D. Schizoaffective and mood disorders not present and not
responsible for the signs and symptoms.


E. Criteria E. Not caused by substance abuse or a general medical disorder.


Schizophrenia Subtypes
1. Paranoid – Preoccupied with one or more delusions or frequent auditory
hallucinations (persecutory and/or grandiose)

2. Disorganized – With disorganized speech, disorganized behavior, flat or
inappropriate affect.
3. Catatonic – At least two of the following must be present:
a. Motoric immobility, waxy flexibility, or stupor
b. Excessive motor activity
c. Extreme negativism or mutism
d. Peculiar movements, stereotype of movements, prominent mannerisms,
or prominent grimacing
e. Echolalia or echopraxia

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