Schizophrenia and Other

Psychoses
Care of Clients with Maladaptive Patterns of Behavior
 Schizophrenia
The word
schizophrenia comes
from the Greek words
schizo meaning split,
and phrene meaning
mind, to describe
fragmented thinking.
 Three inescapable “facts” about schizophrenia:
• 1. Age at onset: late adolescent and early adulthood
• 2. Role of stress: Onset and relapse always related to
stress
• 3. Efficacy of Dopamine Antagonist: Drugs that block
dopamine receptors are therapeutic
• Psychosis – is a disruptive mental state in which an
individual struggles to distinguish the external world from
internally generated perception.
Differentiate Neurosis from Psychosis as to:
• Personality Psychosis- (+) changes
Neurosis- (-) changes

• Reality Psychosis- not aware

Neurosis- aware

• InsightPsychosis- (-) insight

Neurosis- (+) insight

• Delusion Psychosis- (+) delusion

Neurosis- (-) delusion

• Causes Psychosis- (+) organic cause

Neurosis- (-) organic cause-
substance abuse
Schizophrenia
• Is a diagnostic term used to describe a major psychotic disorder
characterized by disturbances of the following:
• Perception (hallucinations)
• Thought processes (thought derailment)
• Reality testing (delusions)
• Feeling (flat or inappropriate affect)
• Behavior (social withdrawal)
• Attention (inability to concentrate)
• Motivation (cannot initiate or persist in goal-directed activities)
Schizophrenia
• Formerly known as Dementia Pracox (Emil
Kraeplin)
• Age of onset in men is typically 4 to 6 years
earlier than it is in women
• Men have a more severe course
• Women have more positive symptoms
• Estrogen modulates dopamine function
• Women are more compliant with medications
• Women tend to have lower blood levels and
longer half-lives of medications
Epidemiology of Schizophrenia
• 1% of the population develops schizophrenia
• 95% suffer lifetime
• 50% experience serious side effects from
medications they are suicidal, because

• 10% kill themselves

of the increase in
dopamine.
Four A’s of Schizophrenia (Bleuler)
• A – ffective disturbance – inappropriate, or flattened
affect
• A – utism – preoccupation with the self, with little
concern for external reality
• A – ssociative looseness – the stringing together of
unrelated topics
• A – mbivalence – simultaneous opposite feelings
Course of Illness (overlapping phases)
• Acute Phase – the patient experience severe
psychotic symptoms
• Stabilizing Phase – the patient is getting better
• Stable Phase – the patient might still experience
hallucinations and delusions but not as severe or
disabling as they were during the acute phase
DSM IV TR Criteria
• A. Characteristics Symptoms (at least 2 of the
following)
• Delusions
• Hallucination
• Disorganized speech
• Grossly disorganized or catatonic behavior
• Negative Symptoms
 Types of Delusion
• •
Erotomanic- eros (love)
Erotomatic -inlove Religious False God, they claim that
they met God

• Grandiose Extravagant
- pinaka • Nihilistic - They act like they are dead
- They believe that some of
their body part is missing

• JealousTheir partner having an

affair. • Delusion of Influence
• Persecutory Paranoid (someone is
monitoring them) • Delusion of Reference
Delusion of influence- they

•
believe that they can control
Somatic Medical illness that
cannot be explained by
doctors.
things.

Delusion of Reference-

• Mixed or Unspecified 2 or more delusions. feeling niya gina storyhan sa

DSM V TR Criteria
• B. Social – occupational dysfunction: work,
interpersonal, and self-care functioning below the level
achieved before onset
• C. Duration: continuous signs of the disturbance for at
least 6 months
• D. Schizoaffective and mood disorders not present and
not responsible for the signs and symptoms
• E. Not caused by substance abuse or a general medical
disorder.
 Positive versus Negative Schizophrenia
Type 1: Positive Symptoms Type 2: Negative Symptoms
• Alogia
• Hallucination • Anergia
• Asocial behavior
• Delusion • Attention deficits
• Avolition
• Incoherence • Blunted affect
• Communication difficulties
• Difficulty with abstraction
• Passive social withdrawal
• Poor grooming and hygiene
• Poor rapport
• Poverty of speech