SCHIZOPHRENIA
Case presentation
Gandilan, Shiela A.
Go, Ella Nicole
Hamja, Nesreen
Agenda
Topics Covered
Description
Signs and
Symptoms
Laboratory work
ups
Nursing
Management
history
Schizophrenia was actually first identified in 1887 but can be traced
back to thousands of years ago which means that it has been
recurring throughout history.
Was coined in 1911 by the Swiss psychiatrist Eugen Bleuler
Comes from the Greek roots, schizo means split and phrenia means
mind, to describe the fragmented thinking of people with the disorder.
hereditary tendency rate
Sibling
5%
Child with 1 parent w/ schizophrenia
10%
Dizygotic (Fraternal) co-twin
10%
Monozygotic (Identical) co-twin
50%
Child of 2 parents w/ schizophrenia
40%
WHAT IS
SCHIZOPHRENIA?
Schizophrenic disorders are characterized in general by fundamental and
characteristic distortions of thinking and perception, and by inappropriate or
blunted affect.
Schizophrenia is a serious mental disorder in which people interpret reality
abnormally. Clear consciousness and intellectual capacity are usually maintained,
although certain cognitive deficits may evolve in the course of time.
Schizophrenia patients often experience non-existent stimuli that create
perceptions of things that do not exist, such as voices.
WHAT IS
SCHIZOPHRENIA?
WHO--
Schizophrenia causes psychosis and is associated with considerable disability
and may affect all areas of life including personal, family, social, educational, and
occupational functioning.
Stigma, discrimination, and violation of human rights of people with schizophrenia
are common.
More than two out of three people with psychosis in the world do not receive
specialist mental health care.
A range of effective care options for people with schizophrenia exist and at least
one in three people with schizophrenia will be able to fully recover.
5 types of schizophrenia
residual
schizophrenia
Paranoid
schizophrenia
hebephrenic or
disorganized
schizophrenia
CATATONIC
SCHIZOphrenia
undifferentiated
schizophrenia
paranoid
schizophrenia
Present the most common form of
Schizophrenia
Characterized by predominantly positive
symptoms of schizophrenia, including
delusions and hallucinations. These
debilitating symptoms blur the line
between what is real and what isn’t,
making it difficult for the person to lead a
typical life.
catatonic
schizophrenia
Rare severe mental disorder characterized by striking
motor behavior, typically involving either significant
reductions in voluntary movement or hyperactivity
and agitation.
In some cases, the patient may remain in a state of
almost complete immobility, often assuming
statuesque positions. Patients may remain motionless
in a rigid posture for hours or even days
Little to no movement, vegetative state
hebephrenic or
disorganized
schizophrenia
Was characterized by inappropriate emotional
responses,
delusions
or
hallucinations,
uncontrolled or inappropriate laughter, and
incoherent thought and speech.
Typically develop when you are 15-25 years
old.
residual
schizophrenia
Long term schizophrenia where most
symptoms have disappeared, negative
symptoms (detractions from normal
behavior) often remain such as flat affect or
a refusal to talk
Residual-type
schizophrenia
is
characterized by a past history of a least
one episode of schizophrenia, but the
person will currently have no positive
symptoms
(delusions,
hallucinations,
disorganized speech or behavior).
undifferentiated
schizophrenia
Does not fit in one of the above
categories because the patient suffers
from symptoms of multiple types
Involves thought disorder or any
features
of
different
types
of
schizophrenia
SIGNS AND SYMPTOMS
SIGNS AND SYMPTOMS
SIGNS AND SYMPTOMS
Paranoid
schizophrenia
SIGNS AND SYMPTOMS
catatonic
schizophrenia
SIGNS AND SYMPTOMS
hebephrenic or
disorganized
schizophrenia
SIGNS AND SYMPTOMS
residual
schizophrenia
SIGNS AND SYMPTOMS
undifferentiated
schizophrenia
Lab work ups
How is schizophrenia diagnosed?
There are no laboratory tests to specifically
diagnose schizophrenia.
Nursing management
Nursing
Assessment
Recognize schizophrenia
Nursing Diagnosis
Impaired Physical Mobility related
to depressive mood state and
reluctant to initiate movement
Nursing Care
Planning and Goals
Reduce severity of psychotic
symptoms
Nursing
Intervention
Evaluation
Establish trust and rapport
Evaluate effectiveness of
drug therapy( absence of
acute episodes and
psychotic symptoms)
Maximize level of
functioning
Evaluate compliance to
health instructions ( taking
medications on time,
showing independence on
activities, involvement of
family)
Establish trust and rapport
Impaired Social Interaction related
to problems in thought patterns
and speech
Maximize level of functioning
Decreased Cardiac Output related
to orthostatic hypotensive drug
effects
Meet patient's physical and
psychosocial needs
Promote social skills
Level of patient’s
functioning (ability to
engage in social
interactions).
Assess positive symptoms
Risk for Suicide related to
impulsiveness and marked
changes in behavior
Help patient gain optimum level of
function
Ensure Safety
Patient’s mental status
(oriented to reality).
Assess negative symptoms
Risk for Injury related to
hallucinations and delusions
Increase client's compliance to
treatment and nursing plan
Ensure adequate nutrition
Assess support system
Prevent recurrence of acute
episodes
Keep it real
Assess medical history
Risk for Imbalanced Nutrition: less
than body requirements related
self-neglect and refusal to self care
Deal with hallucinations by
presenting reality
Promote compliance and
monitor drug therapy
Encourage family
involvement
Documentation and guidelines
The following are to be documented in the patient’s chart:
Document
the
assessed
presenting
signs
and
symptoms (e.g., positive and negative signs).
In
instituting
suicide
precaution,
document
behavior 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.
Thank you!
“I have schizophrenia. I am not schizophrenia. I am not my
mental illness. My illness is a part of me.”
– Jonathan Harnisch, (Novelist, artist, filmmaker and author
of Jonathan Harnisch: An Alibiography)