SCHIZOPHRENIA

FOR NOW A DAYS PEOPLE NEED TO KNOW ABOUT IT.
It is a mental disorder in which people interpret reality abnormally.so how can we mange or diagnose this slide help you . it is basically written in easy language and also help mhn students to cover up syllabus fast in exam.

1. SCHIZOPHRENIA

2. WHAT IS SCHIZOPHRENIA ??

3. PSYCHOTIC CONDITION CHARACTERIZED BY DISTURBANCE IN THINKING, EMOTIONS,VOLITIONS IN PRESENCE OF CLEAR CONSCIOUSNESS.

4. 3-4/1000 in every community Men = Women Rarely in children Men > Women Appear in late teen or early adulthood

5. 2/3 cases in range of 15-30 years PEAK AGE: Men = 15-25 yr women = 25-35 yr Common = lower socio economic group

6. CLASSIFICATION ( DSM- IV ) Delusions Hallucinations Disorganized speech Catatonia behavior Negative symptom(flat affect, alogia)

7. CLASSIFICATION ( ICD-10 TYPE) F20- Schizophrenia F20.0- Paranoid schizophrenia F20.1- hebephrenic schizophrenia F20.2- catatonic schizophrenia F20.3-undifferentiated schizophrenia F20.4- post-schizophrenic schizophrenia F20.5- residual schizophrenia F20.6- simple schizophrenia

8. CAUSE

9. BIOLOGICAL THEORIES 1. BIOCHEMICAL THEORIES : Dopamine Hypotheses 2. NEUROSTRUCTURAL THERIES : Undeveloped brain parts(pre frontal and limbic cortex) 3. GENETIC THEORIES 4. PRE NATAL RISK

10. Genetic theories Most common = among consanguineous marriages Identical twin affected 50% fragmental twins affected 15% brother/ sister affected 10% one parent affected 15% both parents effected 35% general population 1%

11. PRE-NATAL RISKS Maternal influenza Pregnancy complication ( during labor and delivery) Exposure to viral infection Low oxygen level during birth

12. PSYCHODYNAMIC THEORIES Developmental theories- According Freud, in oral stage regression present with use of defense mechanism (denial, projection, reaction) Individual have ego boundaries, inadequate ego development, super ego, regression, love hatred relationship.

13. Family therapies – Mother child relationship Dysfunction family system Double blind communication Stress models- Stimulus based model Response based model Transaction based model Social factor- more prevalent in areas of high mobility, member of low socio economic classes. Conditions associated with living in poverty, congested housing facilities, absence of prenatal care, dealing with stressful event , changing lifestyle.

14. PHASES OF SCHIZOPHRENIA Prodromal phase (Social withdrawal, neglect personal hygiene, grooming, disturb in communication, unusual perceptual experiences, lack of interest and energy, inappropriate effect , eccentric behavior . Last for many years.) Active phase ( delusions, hallucination, positive symptoms , catatonic behavior, disorganized speech, disorder of thought ) Residual phase (occurs between episodes of psychosis, negative symptom, odd thinking and behavior)

15. SYMPTOMS POSITIVE SYMPTOM NEGATIVE SYMPTOM OTHERS- 1] Cognitive deficits 2]mood symptom 3]thought and speech disorder 4] disorder of affect 5]motor behaviour disorder 6] perception disorder 7] other

16. Positive symptom hallucination delusion bizarre behavior thought disorder suicidal thinking

17. NEGATIVE SYMPTOM A logia Flat Effect A volition [ apathy] Inattention Self care deficit

18. COGNITIVE DISORDER ( Attention deficit , memory loss, executive functions) MOOD DISORDER (Depression, dysphoria, BPAD ,dysthymia) THOUGHT AND SPEECH DISOREDER ( Autistic thinking, loosening of association, neologism, poverty of speech ,poverty of idea, thought blocking)

19. DISORDER OF AFFECT ( apathy, emotional blunting, inappropriate emotional responses, anhedonia) DISORDER OF MOTOR BEHAVIOR ( / in psychomotor activity , grimacing, poor grooming, self care deficit, mannerisms) OTHERS (decreased work function, excitement, insomnia tension, withdrawal, loss of ego boundary, suicide, poor judgment , loss of insight)

20. TYPES OF SCHIZOPHRENIA

21. 1.PARANOID SCHIZOPHRENIA Paranoid means delusions . Characterized by some features: > delusion of persecution >delusion of jealousy >delusion of grandiosity >somatic delusion > auditory hallucination

22. 2.HEBEPHRENIC SCHIZOPHRENIA ( Known as disorganized schizophrenia) A. Thought disorder B. extreme social impairment C. inappropriate emotions, laugh D. senseless giggling E. mirror gazing F. grimacing -It begins mostly in adolescent age or young adult.

23. 3.CATATONIC SCHIZOPHRENIA ( marked disturbance of motor behavior) FORMS : A. Catatonic stupor B. Catatonic excitement C. Catatonic alteration FEATURES: increase psychomotor activity, Increased speech mutism, Posturing , negative symptoms, stupor echolalia, rigidity,echopraxia, loosening association.

24. 6.RESIDUAL SCHIZOPHRENIA When a person has a past history of at least one episodes of schizophrenia, but has no currently symptoms they are considered residual schizophrenia. But other symptoms are- 1.Emotional blunting 2.Illogical thinking 3.Odd beliefs 4.Loosening association 5.Social withdrawal

25. 5.UNDIFFERENTIATED SCHIZOPHRENIA (In this, when a person exhibits behaviors which fit into 2 or more type of schizophrenia including symptoms such as delusions , hallucination, disorganized speech , catatonic behave)

26. 6. POST-SCHIZOPHRENIC DISORDER ( It has depressive features in presence of residual or simple schizophrenia . It has increased risk of suicide.)

27. 7. SIMPLE SCHIZOPHRENIA ( It is characterized by negative symptom like avolition , apathy , anhedonia, lack of motivation , low activity with absence of hallucination or delusions. SYMPTOMS we can see- A. aimless activity B. Self absorbed idleness

28. HOW CAN WE DIAGNOSE IT?? -HISTORY -PHYSICAL EXAMINATION -NEUROLOGICAL EXAMINATION -MENTAL STATUS EXAMINATION -BLOOD TEST

29. HOW WILL WE TREAT A SCHIZOPHRENIC PATIENT ?? OR WHAT IS TREATMENT MODALITIES??

30. A. PHARMACOTHERAPY Anti anxiety drugs : thiopentone, oxazepam Anti depressants : sertraline, imipramine Mood stabilizer : lithium , carbamazepine Antipsychotics : clozapine, haloperidol

31. B.THERAPIES ECT (electro convulsive therapies) Psychological therapies are included A. Psychosocial therapy B. Group therapy C. Behavior therapy D. Social skill training E. Cognitive therapy F. Family therapy

32. C. REHABILITATION > Develop working habit >Training new skills >Vocational guidance >Independent job placement >Chosen goal setting >Maintain focusing

33. NURSING DIAGNOSIS FOR A SCHIZOPHRENIA PATIENT Impaired verbal communication related to panic, anxiety , delusional thinking. Disturbed thought process related to inability to trust, anxiety , biochemical factors. Self care deficit related to poor grooming, not properly dressing, not maintaining hygiene , disorganized daily living. Risk for self inflicted related to suicidal ideas, plans or attempts.

34. THANK YOU