Please enable JavaScript.
Coggle requires JavaScript to display documents.
PSYCHOSIS
(Schizophrenia), Structural anatomic alterations
decreased…
-
Structural anatomic alterations
- decreased volume of gray matter
- alterations in cerebral blood flow and glucose metabolism
Neurotransmitter abnormalities
- alterations in dopaminergic system
- decreased nicotinic acetylcholine receptors
- abnormally low levels of glutamate in CSF
Immunologic and inflammatory pathways
- microglia produce inflammatory cytokines
- interruption of metabolic processes
- increased levels of cytokines
Etiology
- exact cause is not understood
- theorized that specific patterns of interactions in families
-
Evaluation
- history
- examination
- screening tool
- psychometric tests
Medical Tests
- laboratory values
- imaging studies
- DSM-5 tests
- ruling out other mental disorders
Biomarkers
- certain brain image findings for schizophrenia
- used for research purposes
Observation and patient interview
- noticing deteriorating personal appearance, neglect for personal hygiene, weight loss, unusual gestures
- lack of insight is characteristic, so patients unaware of changes/actions
- interview to identify early signs
- discover family history and paternal age, exposure to any trauma, and history of any comorbidities
Physical Examination
- overall physical condition
- remain alert for possible metabolic problems, cardiovascular problems, drug/alcohol abuse, poor self-care
- evidence of side effects from meds
Mental Status Examination
- should receive a thorough mental status examination
- can choose between assessment tools
- keep cultural and religious background in mind
Pharmacologic
- first line intervention with antipsychotic meds
- decrease positive symptoms
- do not cure and relapse is common
- extrapyramidal symptoms are common (acute dystonia, akathisia, and secondary parkinsonism)
Family Intervention
- psychoeducation and counseling
- more positive atmosphere
Social Skill Training
- helps to teach reading social cues and appropriate responses
- group intervention
Cognitive-behavioral therapy
- teaches coping with symptoms
- problem solving techniques
Cognitive remediation
- addresses cognitive deficits associated with schizophrenia
Complementary health approaches
- uses of nutritional interventions
- supplements use of mind-body practices
Early-onset
- symptoms before 17-18 years, only 4-5%
- onset before puberty is very rare
- more difficult to diagnose
- increased risk of side effects with psychotropic medications
Late-onset
- 20-30% do not experience symptoms until after 40
- greater in women
- cognitive and negative manifestations
Decreased self-care
- often pts with schizophrenia find it harder to take care of themselves
- can lead to further complications with other medical diagnoses
Substance abuse
- often times substance abse can help to "numb" manifestations of schizophrenia
- can lead to further health complications