- Gross splitting of mental functions and loosing connection between these functions.

Epidemiology: - incidence (about 1% male = female) - 50% of male admitted < 25 - 30% of female admitted <25 - peak age of onset 15-25 in males. - Peak onset 25-35 in females . - Rare <10ys >50ys - Seasonality: more in winter - Suicide : 10 – 15 % - Substance abuse : (cigarette – alcohol –marijuana – cocaine ) - From DSMIV Schizophrenia: Two or more of the following symptoms for at least one month a) delusions. b) hallucinations. c) disorganized speech(incoherence or derailment). d) grossly disorganized or catatonic behavior. e) negative symptoms (affective flattening, alogia ,or avolition.) - significant social/occupational dysfunction since the disorder began. positive and negative symptoms a) positive symptoms - formal thought disorder(derailment-tangential-incoherent-irrelevant answers-illogical) - bizarre behavior(in clothing –appearance- social and sexual behavior-agitated or aggressive –repetitive or stereotyped behavior ) - delusions - hallucinations. b) negative symptoms. - alogia(poverty of speech or contents-blocking-increased latency) - flattening of affect (poor facial expression –decreased spontaneous movements and expressions-poor eye contact ) - avolition (impaired hygiene-anergia-lack of persistence at work or school) - anhedonia (decreased interests –impaired intimacy-few relationships) - impaired attention (social inattentiveness- or during testing) Etiology: 1) genetic : 1st degree relatives (one parent 13% – two parents 46% ) - Monozygotic twins 50% - mode of inheritance unclear 2) Neurochemistry and neuroanatomy: - low blood flow. - Low metabolism in brain cells specially in frontal cortex(PET) - Electrical activity shows hypo function. - Hypersensitivity of dopamine receptors. - Widening of ventricles. - Faulty metabolism . 3) psychosocial factors History : 1) emil kraepelin ( named it dementia praecox comes in early life with downhill course due to organic pathology , comes with hallucinations , delusions, affecting thought, speech, with poor insight and judgment, and reduced attention to outside world.). 2) bleuler : it is splitting in mind with 4 fundamental and 3 accessory behavior - fundamental: associative disturbance , autism, ambivalence , affective flattening. Accessory : delusions , hallucinations , catatonic posturing. 3) Freud : schizophrenia is reaction to frightening unbearable idea. 4) Sullivan: it is originated from impaired interpersonal relations to parents , or a significant people .

constipation and EPS EPS Extra pyramidal . importance of treatment and side effects. excess motor activity not influenced by external stimuli.Jealous and infidelity : delusions that ones sexual partner is unfaithful.infected having a disease .that does not meet the criteria of the above groups.no florid psychotic symptoms or present in attenuated form . 3) setting reasonable expectations.client preoccupied by one or more delusions or auditory hallucinations. deceived .5) Schneider’s: schizophrenia is syndrome characterized by(3 hallucinations audible thoughts. knowledge.not having criteria for catatonic type. and behavior is not obviously odd or bizarre.Somatic : delusions that one has some physical defect . urine retention.dance or music (e)evaluation efficacy of procedures. loved at distance . Delusional disorder Diagnostic criteria: 1.Grandiose : delusions of inflated worth. 3 thoughts insertion. 3 made feelings . Types: . poisoned . how to manage stress.Erotomanic: delusions that another person usually higher status is in love with the individual.Dystonias: muscle spasm.has never met a criteria a of schizophrenia for more than few hours. 6) managing dependence . service providers . 4) expressing emotions.Peculiarities of involuntary movement. . withdrawal . 5) crisis intervention.passivity . (c) linking : helps the patients and families to get access to services required for comprehensive care (d) therapeutic care : 1) education teaching patient about his illness . . b) disorganized . no disorganized speech or catatonic behavior. third person voice. 3. dry mouth. psychiatric. identity . crisis intervention. and delusional perception. . (b) planning :overall plan includes management. power.apart from impact of delusions or its ramifications . . art .Typical antipsychotics: . and outcome. 7) illness self management. Schizophrenia subtypes: a) paranoid . . c) catatonic .Persecutory: delusions that one usually close to him is being malevolently treated in some way . Serenace (Haloperidol ). e) residual . or special relationship with diety or famous person. 2) focusing on problem solving. . no flat or inappropriate affect. functions are not markedly impaired . social .information’s and needs to include them in overall coordinated plan. impulses .e.broadcasting. . .g. Largactil (Chlorpromazine ). . . Antipsychotics A. d) undifferentiated . with one or more negative symptoms .motor immobility . of at least one month duration .and financial . to ensure continuity of care.disorganized speech or behavior . 8) good selection for recreational activities e. second person voice.Mixed : has more than one character of the above types but none of them predominates.Unspecified. Nursing role in management of schizophrenia: (a) assessment :collecting all medical .None bizarre delusions involving situation that could occur in real life such as being followed .Side effects: sedation. 2. or got a message from Allah . echolalia or echopraxia.g. flat or inappropriate affect .

Atypical antipsychotic: .Respiredal ( EPS. .com/2011/08/schizophrenia-and-nursing-care-plan. .Altered level of consciousness.Akathesia: Motor restlessness.lanzepine ( weight gain. rigidity and akinesia. .Inability to talk. .O..Muscle rigidity. hyperprolactenemia) .Quetiapine ( weight gain ) .Tremors.Clozapin ( weight gain.nursing-lectures.Drug induced parkinsonism: tremors. DM.Hyperthermia. . Neuroleptic malignant syndrome A.Autonomic dysfunction . . B. . AGRANULOCYTOSIS.Leukocytosis. . orthostatic hypotension) Source: http://www. sedation.Fatal Side effect. dyslipidemia) . DM.appearing and irreversible movements. .html .Tardive dyskinesia: late.