Mental Health Exam #2
Psychotic Disorders Positive &
Negative Symptoms,Typical &
Atypical
Antipsychotics,Grief,Depression
,Suicide,Antidepressants,Mania,
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
-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
-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
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