Schizophrenia

SHIZOPHRENIA- ALTERATIONs OF THOUGHT And other Personality Disorders

HALLUCINATION – NEGATIVE STIMULUS ILLUSION – POSISITVE STIMULUS DELUSION - False belief

Types of delusion

Jealousy – irrational Persecution - threat Erotomanic –very ambitious Grandiose – pretending

to be rich but actually not

Somatic- part of his body that is altered

(natunaw ang paa ko eh)

Onset of schizo phrenia– male 15-25 yrs old Females – 25-35 yrs old Why females? – strong feelings, emotions...scientific reason – progesteron level – slows down the dopamine---dopamine –neurotransmitter loss in alzheimer -

Alteration of dopamine will lead to schizophrenia Narcicistic, histrionic younger than 25 yrs old

Causes of schizophrenia A. Biological perspective 1. hereditary – i.e . mongoloidism –alteration in chromosome 21, # 8 and 13 (+)mother (-) father = 20 % of acquiring schizo.

Neurotransmitter – dopamine for shizophrenia Virus – while pregnancy, affects the neural tube while infant is developing Risk factors : a. double bind communication – friends Accepted THEIR FRIEND AS A GAY , BUT outside the house, they will call him , huy bading!!! b. Schizophrenigenic parents c. Environmental factors – i.e. single parents d. Organic cause –i.e. brain damage, virus e. Vitamin deficiency - B complex

Types of Schizo 1. Paranoid - 2 or more signs of JPEGS = paranoid (see page 1) 2. Disorganized / hebephrenic- disorganized speech, mummbling while talking, brief in their heads 3. Catatonia – purposeless activity i.e. lakad ng lakad, walis ng walis then kinalat ulit, extreme negativism,waxy flexibility (odd posturing i.e. BP flex elbow,after BP, remain in that position, echopraxia ) 5. 4. Undifferentiated- presence of each type Residual – history of schizo, prolonged signs of hallucinations and illusins but can handle those Sx/ symptoms Signs and sx of schizo Positive signs (hard sx) – inc. Dopamine at mesocortical area resp for emotions and urges responsible 1. (+) facial grimacing 2. HALLUCINATION

3. Ambivalence – presence of two opposite feelings, namatay ang dyowa,,,,i.e. talaga, hahahha 4. Perseveration – repetition of words 5. Ideas of reference 6. Flight of ideas –jumping from one idea to another 7. Associative of looseness –joining of two ideas into one 8. Delusion 9. Echolalia/echopraxia

NEGATIVE SIGNS- decrease dopamine Blunted affect Alogia - tends to speak very little catatonia lack of volition /avolition – lack of goal /aim Anhedonia –lack of pleasure FLAt affect –

Nursing management 1. NPI - hallu/illu/ a.

call the attention of the cleint,present reality

b. Divert attention c. Struggling - hands at the sides not croSsing the arm nor other position 2. Millieu therapy 3. Psychopharma Antipsychotic –tranquilizers a. Conventional b. Secondary

c.

novel

Conventional Chlorpuphenazine Perphenazine Loxapine Molindone fluphenazine tHiotixene tri fluphenazine mesordazine

Secondary Clozapine Risperidone Ziprasidone Aripiprazole Quetiapine Olanzapine

Novel Aripriprazole