2. Group Presentation on Schizophrenia By Karina, Tina, Annita and Dan

3. Topics to be covered Karina will present information on Description & Definitions of Schizophrenia. Tina will present information regarding the Signs and Symptoms of Schizophrenia. Annita will deliver information pertaining to the Treatment of Schizophrenia: Including medication, therapies, ECT and more. Dan will examine Nursing Interventions appropriate to Schizophrenia. Topics to be Covered

4. Description / Definition of Schizophrenia by Karina Description / Definition of Schizophrenia by Karina

5. Description / Definition of Schizophrenia by Karina Description / Definition

6. Schizophrenia Categories Schizophrenia can be categorized by the following:  Paranoid Schizophrenia:  Abnormal reality interpretation.  Delusions  Auditory & Visual Hallucinations.  Disorganized Schizophrenia:  Illogical & Incoherent thoughts & behavior.  Catatonic:  Extreme behaviors at two ends of the spectrum  Inability to speak, move, or respond OR  Over-excitement, hyperactivity, involuntary sounds or movements Description / Definition

7. Signs & Symptoms of Schizophrenia by Tina Signs & Symptoms of Schizophrenia by Tina

8. Signs & Symptoms of Schizophrenia by Tina Schizophrenia is a variable illness:  In some people, Schizophrenia appears suddenly and without warning.  For most it comes on slowly with subtle warning signs.  A gradual decline in functioning is often present long before the first episode.  Many friends and family members report knowing early on that something was not right with their loved ones.

9. General & Less Obvious Signs and symptoms  Social Withdrawal  Decline in Motivation  Lack Of Drive  Diminished Emotional Response  Incoherent Speech / Broken Speech  Abnormal Personal Hygiene

10.  Positive Signs & Symptoms:  Are unusual thoughts and perceptions that often involve a loss of contact with reality.  These are symptoms people wouldn’t “normally” experience.  Negative Signs & Symptoms:  Represent a loss or decrease in emotions or behavioral abilities or a “blunted” effect. Signs Of Schizophrenia Positive & Negative Signs

11. Common Early Signs of Schizophrenia (Negative Signs)  Depression  Social Withdrawal  Hostility – Suspicion / Paranoia  Flat Expressions  Odd Statements  Inappropriate Response to Situations  Forgetfulness / Inability to Pay Attention  Over Sleeping / Lethargy  These signs are a definite cause for concern

12. Symptoms Of Schizophrenia (Positive Signs)  Physical:  Movement disorders - such as repeating movements, clumsiness or involuntary movements.  Cognitive signs and symptoms:  Problems making sense of information  Difficulty paying attention  Memory problems …Continued

13. Symptoms Of Schizophrenia (Positive Signs)  Delusions:  Beliefs not based on reality.  They may believe they are victims of conspiracy.  They may think they can read minds or have special powers.  Hallucinations:  Seeing and Hearing things that don’t exist.  Thought & Speech Disorders:  Disorganized speech.  Fragmented thinking.  Switching from one subject to another with no link or reference to previous subject or thought.

14.  The following video gives some insight into one person coping in her life with Schizophrenia. Coping With Schizophrenia

15. Skip Video

16. Treatment of Schizophrenia by Annita Treatment of Schizophrenia by Annita

17. Treatment of Schizophrenia

18. Psychosocial treatment:  Helps with communication, motivation, self- care, work, establishing and maintaining relationship with others.  Aids in patients sticking to their medication schedule.  Have the benefit of the patient having fewer relapses and hospitalization. Psychosocial Treatment

19. Illness management skills:  Must know basics about the disease.  Must know principals of Schizophrenia treatment.  Can make decisions about their care once they are aware of the disease and treatment.  Taught how to distinguish warning signs of relapse. Illness Management Skills

20. Integrated treatment for Co-occurring substance abuse.  Depend more on the prescribed drugs.  Most common occurring but not recognized. Do you mean drug abuse is the most commonly occurring symptom?  They produce a better outcome. Meaning correct use of prescribed meds produces the least relapses? Integrated treatment for Co-occurring substance abuse.

21. Rehabilitation: Rehabilitation for Patients can include:  Social and vocational training.  Programs including vocational counseling, job training, money management, counseling.  Assistance inusing public transport.  Practicing social and workplace communication skills. Rehabilitation

22. Family education:  Patients with Schizophrenia usually get discharged into the care of their family.  Families must know the importance of the disease and know as much about the disease as possible.  Families should be taught know different kinds of treatment and coping strategies. Family Education

23. Cognitive behavioral therapy: Cognitive Behavioral Therapy Can:  Be more effective for patients where symptoms still persist even after medication.  Teaches how to test their reality.  Be more effective as they reduce severity of symptoms.  Decrease the risk of relapses. Cognitive Behavioral Therapy

24. Self- help groups: These Groups:  Do not involve professional therapists.  Are a source of mutual support.  Include people that are aware others are facing same problems.  Generate social actions.  Do not draw public attention and does not let the public discriminate against them. Self-Help Groups

25. Antipsychotic medication: Antipsychotic Medication:  Reduces the likelihood of relapses.  Normalizes chemical balances that cause Schizophrenia.  Two major types of antipsychotic medication:  Traditional medication  New Antipsychotic medications. Antipsychotic Medication

26. Traditional Medication May:  Effectively control hallucinations and delusions.  Control the confusion of Schizophrenia.  Treat positive symptoms of Schizophrenia. Traditional Medication

27. New antipsychotic medication: New Antipsychotic Medication May:  Treat a broader range of symptoms.  Treats both “positive” and “negative” symptoms. New Antipsychotic Medication

28. Side effects for both types of medication may include any or all of the following:  Mild Effects - dry mouth, blurred vision, constipation, diarrhea drowsiness and dizziness.  Serious Effects - trouble with muscle control, frequent and unmanageable muscle spasm and cramps. Negative changes to Mental Health.  Side Effects of Medication

29. Nursing Interventions for Schizophrenia by Dan Nursing Interventions for Schizophrenia by Dan

30. Nursing interventions for Schizophrenia include:  Assistance with Activities of daily living.  Provision of a safe physical environment.  Supervision.  This will often include restriction of drugs.  Medications. Continued... Nursing interventions for Schizophrenia by Dan

31.  Psychotherapy.  This is used to help patients improve their relationships, integrate into society and help assist with Daily Living.  Psychotherapy is generally used after the acute phase has passed. Nursing interventions for Schizophrenia by Dan

32.  Definition of Psychotherapy  Psychotherapy: “The treatment of a behavior disorder, mental illness, or any other condition by psychological means. Psychotherapy may utilize insight, persuasion, suggestion, reassurance, and instruction so that patients may see themselves and their problems more realistically and have the desire to cope effectively with them.” (http://www.medterms.com 2009 MedicineNet, Inc.}http://www.medterms.com Psychotherapy

33. An example of the use of psychotherapy on a schizophrenic patient would be:  Following medication therapy the patient remains withdrawn. The patient is screened for depression and found to be severely anxious.  A Psychiatric nurse would then be called to discuss their withdrawal and find & treat the symptoms. …Continued Psychotherapy

34.  The psychiatric nurse discusses and teaches coping strategies. Some options include:  Positive suggestion and social activities.  Group therapy can provide perspective.  Teaching Communication skills.  Emphasize the need for a healthy diet and personal hygiene. Psychotherapy

35. References 2004 by Donald J Franklin, PhD - http://www.psychologyinfo.com/Schizophrenia/cognitive.htm Video courtesy of http://mindyourmind.ca & patient’s video. Clipart is royalty-free and courtesy of various sources. Mayo Clinic - http://www.mayoclinic.com/health/catatonic-schizophrenia/ds00863 References