Management of schizophrenia [autosaved]

management of schizophrenia

1. MANAGEMENT OF SCHIZOPHRENIA Prepared by : Ms. nimisha Chacko

2.   Schizophrenia literally means “Fragmented Mind ”. Schizophrenia is one of the most complex, chronic and challenging of psychiatric disorders that affects how a person thinks, feels, behaves. introduction

3. A disorder where it becomes difficult to act normally in social situations, think rationally, and differentiate between what is real and unreal. Definition of schizophrenia

4. It affects 1.1% of the population above age 18, which is estimated to be 51 million people worldwide. In the United States alone, 2 million Americans each year are affected, with 7.2 in 1000 persons developing it during their lifetime. Affects both men (late teens or early 20s) and women (mid-20s to early 30s) equally Prevalence is higher than  diabetes mellitus , Alzheimer’s disease, and  multiple sclerosis . INCIDENCE

5.   No known cause , but research has focused on Genetic factors Schizophrenic spectrum disorders Neurodevelopmental model Family studies CAUSES OF SCHIZOPHRENIA

6. TYPES OF SCHIZOPHRENIA PARANOID SCHIZOPHRENIA

7. 2. CATATONIC SCHIZOPHRENIA CONTI..

8. 3.UNDIFFERENTIATED SCHIZOPHRENIA CONTI..

9. 4. DISORGANIZED SCHIZOPHRENIA CONTI..

10. Signs and symptoms of schizophrenia Positive Symptoms Cognitive Symptoms Negative Symptoms

11.   Positive Symptoms DELUSION HALLUCINATION DISORGANIZED SPEECH & THINKING CATATONIA SIGNS AND SYMPTOMS OF SCHIZOPHRENIA

12. Cognitive Symptoms POOR EXECUTIVE FUNCTIONING POOR WORKING MEMORY CONTI…

13. Negative Symptoms FLAT EFFECT ALOGIA AVOLITION ANHEDONIA ASOCIALITY CONTI…

14. Prodromal Phase Active Phase Residual Phase Phases of Schizophrenia

15. mental status examination psychiatry history careful clinical observation . Diagnostic test results.    (CT scan  and MRI) Ventricular-brain ratio  : may find elevated VBR in schizophrenic patients. Brain scans reveal functional cerebral asymmetries in a reverse pattern. Diagnostic evaluation

16. Management

17. Antipsychotics 1 . Typical antipsychotics Chlorpromazine , Trifluoperazine , Haloperidol, Droperidol , Pimozide, 2 . Atypical antipsychotics Olanzapine , Risperidone , Quetieapine , Amisulpiride , Ziprasidone , Aripiprazole , Clozapine Pharmacological management

18. Availability Side effect profile Symptoms Specific contra indications Familiarity Cost Selection of drugs depends on;

19. Electroconvulsive Therapy.   Rarely used but is for patients with acute schizophrenia and those who can’t tolerate or don’t respond to  medication . It is effective in reducing depressive and catatonic symptoms of schizophrenia . Other treatments   include compliance promotion programs, psychosocial treatment and rehabilitation, vocational counseling, supportive psychotherapy, and appropriate use of community resources. Non pharmacological management

20. Psycho Education Supportive psychotherapy CBT for resistant hallucinations and delusions- Cognitive remediation Social skills training Psychosocial management

21. Nursing Assessment Recognize schizophrenia   ;Note characteristic signs and symptoms of schizophrenia Establish trust and rapport.  Maximize level of functioning.   Nursing Management

22. Assess positive symptoms.  Assess negative symptom Assess medical history.   Assess support system Conti…

23. Impaired Physical Mobility   related to depressive mood state and reluctance to initiate movement. Impaired Social Interaction  related to problems in thought patterns and speech. Decreased Cardiac Output  related to orthostatic hypotensive drug effects. Risk for  Suicide  related to impulsiveness and marked changes in behavior . Risk for Injury  related to hallucinations and delusions. Risk for  Imbalanced Nutrition :less than body requirements related to self- neglect  and refusal for self-care Nursing diagnosis

24. Reduce severity of psychotic symptoms Prevent recurrence of acute episodes Meet patient’s’ physical and psychosocial needs Help patient gain optimum level of functioning Increase client’s compliance to treatment and nursing plan Nursing Care Planning  and Goals

25. Establish trust and rapport.  Maximize level of functioning.   . Promote social skills . Ensure safety.  . Ensure adequate nutrition.  Keep it real. Nursing Interventions

26. Deal with hallucinations by presenting reality . Promote compliance and monitor drug therapy.   Encourage family involvement.   Conti…

27. Evaluate effectiveness of drug therapy. Evaluate compliance to health instructions Level of patient’s functioning Patient’s mental status evaluation

28. Document the assessed presenting signs and symptoms In instituting suicide precaution, document behaviour and your precautions. In instituting homicide precaution, document patient’s comment and who was notified. Be sure to notify the doctor and the potential victim. In using restraints, document time of application and release documentation

29. Schizophrenia is a relatively common chronic mental illness, which results in substantial disability and has a 10% risk of suicide. It has several symptom clusters including positive symptoms, negative symptoms, cognitive impairments, and affective deregulations . conclusion