ETIOLOGY

Predisposing

Present/

Factors

Absent

Genetic

Present

Theory

Rationale

Justification

The consequence of a chromosome

There are histories of

deletion referred to as the 22q1

mental illness on the father

deletion syndrome has been

side. His grandmother and

identified. The risk of developing

the youngest sibling of his

schizophrenia in the presence of this

father, his aunt, are known

syndrome appears to be

to have mental illnesses.

approximately 25% accorfing to Dr.

Basset of the University of Toronto.
Scientists may also be close to
identifying genetic locations of
schizophrenia, which are believed to
be on human chromosomes 13 and 8.
One of the studies have found that
mothers od schizophrenic clients had
a high incidence of the gene type
H6A-B44.
Shives & Isaacs, Psychiatric-Mental
Health Nursing
Trinucleotide repeat amplificationmutation in which a certain stretch of
DNA occurs more than once when
genes are copied. This could explain
some of the differential rates of
occurrence of schizophrenia. If one
child in a family carrying a gene for

schizophrenia happens to have one

trinucleotide repeat than the others,
the other children could have the
tendency of having mental illness.
Stuart & Laraia, Principles and
Neurobiology

Probable

Theory

Practice of Psychiatric Nursing

The two most consistent

The patient did not have a

neurobiological research findings in

laboratory result of

schizophrenia are imaging studies

undergoing any imaging

showing decreased brain volume and

tests that may prove the

abnormal function, neurochemical

patient has lesions to the

studies showing alterations of

brain, but the patient had a

numerous neurotransmitter systems.

history of fall and may

Psychotic behaviors may be related to have affected or

Neurodevelop
mental Theory

Probable

lesions in the frontal, temporal, and

contributed some lesions to

limbic regions of the brain, and

the regions of his brain that

dysregulation of neurotransmitter

caused dysregulation of

systems connecting these regions.

neurotransmitter systems

Stuart & Laraia, Principles and

connecting to these regions.

Practice of Psychiatric Nursing

Several brain structures are abnormal

The mother stated that she

in patients with schizophrenia as

has not experienced any

compared to people who dont

complications during her

manifest the symptoms of

pregnancy nor has used

schizophrenia. Research suggests that

alcohol or any maternal

some disruption of fetal neural

problems but factors such

development may change the way the

as poor nutrition, exposure

brain matures. Some research has

to stress and cigarette

found a greater frequency of prenatal

smoke are inevitable as we

and perinatal complications among

do our daily activities

people with schizophrenia, including

especially with their

pre eclampsia; trauma; oxygen

capabilities in terms

deprivation at the time of delivery;

financial status. These

maternal problems such as poor

factors may also have

nutrition, stress, use of tobacco,

contributed to the abnormal

alcohol, caffeine, and use of

development of the

teratogenic pharmacological agents.

developing fetus that

Stuart & Laraia, Principles and

caused neurodevelopmental

Practice of Psychiatric Nursing

that may have triggered to

manifest the symptoms of
Schizophrenia

SYMPTOMATOLOGY
Precipitating

Present/ Absent

Rationale

Justification

Present

The biochemical and

The patients mother

Influences

neurostructural theory

claims that the patient

(Intake of drugs,

includes dopamine

has not taken any

substances or

hypothesis; excessive

illegal drugs. Also, his

chemicals which

dopamine allows nerve

laboratory results

increase levels of

impulses to bombard the

shows no presence of

dopamine.)

brain, resulting to

methamphetamine and

development of symptoms

marijuana.

of schizophrenia. The

Even though the

Factors
Biochemical

cause of the release of high patients chart did not

levels of dopamine has not

show any laboratory

yet been found.

results to confirm the

Shives & Isaacs,

existence of such

Psychiatric-Mental Health

anomalies if such are

Nursing

present in the patient.

But the family of the

The dopamine hypothesis

patient the patient

theory suggests that

strongly claims that he

schizophrenia may be

has the history of

caused by an excess of

inhaling rugby

dopamine-dependent
neuronal activity in the
brain. This excess activity
may be related to
increased production or
release of the substance at
nerve terminals, increased
receptor sensitivity, too

much dopamine receptors,

or combination of these
mechanisms. The
manifestations of
schizophrenic symptoms
may be relatred to
increased number of
dopamine receptors.

Sociocultural and

Present

Some theorists proposed

The patients family is

Environmental

that poverty, society, and

not well off and the

Theory

cultural disharmony could

patient works as a

cause schizophrenia or that

kargardor in the

people chose to become

market place which is

schizophrenic to cope with

a very low source of

the insanity of the modern

income. They live in a

world.

congested around the

slum area and their

Stuart & Laraia,

relationship with the

Principles and Practice of

neighbors are not that

Psychiatric Nursing

good especially
because of the
symptoms he
manifests as
schizophrenic.

Symptoms

Present

Rationale

Justification

/Not
Present
Hallucinations Probabl
e

A hallucination is a perception

It was indicated

experienced without external

on the nurses

stimulation of the sense organs.

progress notes

Sensory hallucinations can be

that the patient

auditory, tactile, visual,

classified the

gustatory, and olfactory. When

flies and

occurrence of increase dopamine

mosquitoes

production occurs, dopaminergic

along with

receptors, they were found to be

stimuli

associated with increased

butterflies but

activity in a widely distributed

there were

network of brain regions,

instances that the

especially in the visual cortex in

patient is talking

the occipital lobe, but also in

by himself.

regions of the frontal and

temporal lobes.
Illusions

Present

Illusions are misinterpretations

It was indicated

of stimuli. Like hallucinations,

on the nurses

illusions also occur as a result of

progress notes

hyperdopaminergic state in

that the patient

limbic areas.

classified the flies

and mosquitoes as

Flight of Ideas Present

Flight of ideas is characterized

butterflies.
Communication

by overproductivity of talk and

skills of the

verbal skipping from one idea to

patient show

another which tangential

constant

associations occur quickly

incoherent

frequently (every one to two

statements,

sentences or so) resulting from

circumstantiality,

increased activity in a widely

tangentiality and

distributed network of brain

the like which are

regions.

highly indicative
of inadequate and
inappropriate
communication.
Associative
looseness was
observed during

Associative

Not

Thinking is characterized by

interview.
Loose

looseness

Present

speech in which ideas shift from

associations can

one unrelated subject to another

be traced in many

and the individual is unaware

of the statements

that the topics are unconnected.

made by the

As a neurotransmitter, dopamine

patient in

transmits chemical signals from

conversations.

the dopamine-containing

Details which do

neurons to target cells that

not have anything

contain dopamine receptors. In

to do with the

the brain, dopamine controls

topic are being

memory thus there will be

mentioned by the

manifestations such as speech

patient.

Ambivalence

Absent

disorders.
The coexistence of opposite

This symptom is

emotions toward the same

not exhibited by

object, person, or situation.

the patient.

Overproduction of
neurotransmitters will cause
abnormalities to the networks

medial prefrontal cortex and the

posterior cingulate cortex,
regions that are associated with
self-reflection and
autobiographical memories and
which become connected into a
synchronously active network
when the mind is allowed to
Apathy

Present

wander
Apathy is another symptom

As the informant

associated with the affective

could remember

alterations brought about by

the patient used to

schizophrenia. It can be defined

play sports like

as a lack of concern or interest. It basketball

is the inability to generate a

together with his

normal response to people,

friends. The

situations or the environment.

patient has

Overproduction of

diminished or lost

neurotransmitters will cause

interest in

abnormalities to the networks

communicating

medial prefrontal cortex and the

with people and

posterior cingulate cortex,

isolates himself

regions that are associated with

from the society.

self-reflection and
autobiographical memories and
which become connected into a
synchronously active network
when the mind is allowed to
Alogia

Not

wander
The absence of spontaneous

The patient did

Present

speech production for the

not exhibit this

purpose of answering questions

symptom

Flat Affect

Not

or expressing oneself.
The near absence of emotional

The patient did

Present

or facial expressions throughout

not exhibit this

a conservation or in different

symptom

situations
Anhedonia

Present

The inability to experience

pleasure which is highly
associated with the detrimental
effects of schizophrenia in the
affect of individuals suffering
from schizophrenia. Dopamine
transmits chemical signals from
the dopamine-containing
neurons to target cells that
contain dopamine receptors.
Dopamine release in the nucleus
accumbens is so consistently tied
with pleasure that neuroscientists
refer to the region as the brain's

Autism

Present

pleasure center.pleasure
Difficulty in communicating and

The patient has

forming relationships with other

troubled

people and in using language

relationship with

and abstract concepts. It is

other people

characterized by qualitative

including his

alterations in three behavioral

family.

areas: social reciprocity,

communication, and breadth of
interests manifest by repetitive
behaviors or restricted
interests. There is evidence in

autistic children for reduced

brain serotonin synthesis during
Delusion

Probabl

periods of peak synaptogenesis

A persistent belief contrary to

Delusions of

the educational and cultural

grandeur are

background of the individual.

highly evident in

When occurrence of increase

the patients

dopamine production occurs,

verbalizations

dopaminergic receptors, they

and actions

were found to be associated with

described by the

increased activity in a widely

informants.

distributed network of brain

regions, especially in the visual
cortex in the occipital lobe, but
also in regions of the frontal and
temporal lobes.

The patient
believes that his
mother is his
yaya, as
verbalized
kanang mamamamahan nako
akoa man nang
yaya. He also
believes that
someone took his
money as stated
by the patient
gikuha akuang
kwarta, which
was indicated on
the nursess
progress notes