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