Mental Health Exam Study Guide
Schizophrenia-Ch.26 ATI 14, 22 Watch 2 videos on Blackboard Somatoform and Dissociative Ch.30, Personality Disorder
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Anxiety Ch.29 (Blackboard PDF Anxitey) ATI 4, 11, 15, 19, 20, 22-left
Schizophrenia (split mind) (15?s)
Distorted and bizarre thoughts, perceptions, emotions, movements, behavior…considered a disease process
Extreme cost to patient and families…high suicide rates as much as 50x average. 1 in 100≈2.5 million Americans…prospects are improving due to medications Onset average is between 15-25y.o. for men and 25-35y.o. for women
Abnormal Perception
Inaccurate identification and interpretation of stimuli
Hallucinations
Experiences sensory distortion as real and responds accordingly
No identifiable external or internal stimulus
Misidentification /perception of faces
contribute to fear, aggressiveness, withdrawal from interactions, hostility
Affect
Can be observed by the examiner
Describe:
Broad
Restricted
Blunted
Flat
Inappropriate
Remember cultural implications
Emotional Expression
Hypo-expression of feelings…generally described as flat or blunted is typical
May say they no longer have any feelings
Alexithymia- inability to identify and describe emotions in the self
Anhedonia
Apathy
Comorbid mood disorders
Suicide risk (x50)
Behaviors
Behaviors
Appearance
Aggression/agitation/violence
Sign of violence, not typical
Be proactive if present
Repetitive or stereotyped behavior
Avolition-lack of drive/goals/participation
Lack of persistence at work/school
Behaviors Causing Socialization Problems
Inability to communicate coherently
Loss of drive and interest
Deterioration of social skills
Poor personal hygiene
Paranoia
Movements
Catatonia, waxy flexibility, posturing
EPS 2° to meds
Abnormal eye movements
Grimacing
Apraxia-can’t execute what would be a VOLUNTARY movement
Echopraxia-INVOLUNTARY mimicking of other’s body movements/expressions
Abnormal gait…shuffling, peculiar walk…
exacerbated by meds
Mannerisms
Symptoms may prevent socializing within accepted sociocultural norms
Stigma
Loss of ego boundaries, potentially expose themselves, invade personal space, touch others without permission and display odd and socially unacceptable behaviors…protect patient and others when this occurs…keep in mind their right to privacy and dignity if they lose control…don’t cast judgment
Physical Health (lack thereof)
People with schizophrenia have:
Shorter life span
High risk lifestyle: sedentary, obsessive smoking, or dietary habits; obesity resulting in diabetes, hypertension, coronary artery disease…poor self-care
Disparity of health care
Types of Schizophrenia
Paranoid type
Characterized by paranoid delusions, persecutory delusions…sometimes of religious nature
Client may be argumentative, hostile, and aggressive… hostility may present, especially if they feel threatened
Disorganized type
Chronic variety with flat or inappropriate affect
Silliness and incongruous giggling common
Behavior bizarre; social interaction is often extremely impaired
Catatonic type
Catatonic stupor: characterized by extreme psychomotor retardation; patient usually mute; posturing common…waxy flexibility or statue-like…odd positions with very rigid muscles…Excitement variation displays frenzied movement and often yelling incoherent things which typically requires protecting patient from self and intervention with physical control and meds
Undifferentiated type
Bizarre behavior that does not meet the criteria outlined for the other types of schizophrenia; delusions and hallucinations prominent…mixed symptoms not easily classified to another diagnosis…frequently used
Residual type
Used to diagnose a person who has a history of at least one episode of schizophrenia with prominent psychotic symptoms,
but not currently present
Psychotic Disorders
Schizophrenia…as well as…
Schizophreniform Disorder
o Same symptoms as schizophrenia, with exception that the duration of the disorder has been at least 1 month
but fewer than 6 months
Schizoaffective Disorder-the “Bipolar-Schizo”
o Schizophrenic symptoms accompanied by a strong element of symptomatology associated with mood disorders, either manic or depressive
o An uninterrupted period of illness including a major depressive episode or manic episode concurrent with symptoms of schizophrenia.
o During the same period of illness, there have been delusions or hallucinations for at least 2 weeks in the absence of prominent mood symptoms.
o Symptoms of a mood episode are present during a substantial part of the illness.
Delusional Disorder
o The existence of prominent, non-bizarre delusions…they may hold down jobs and appear to function normally to those not close to them
Subtypes
o Erotomanic type: the individual believes that someone, usually of a higher status, is in love with him or her
o Grandiose type: person has irrational ideas regarding own worth, talent, knowledge, or power
o Jealous type: person has the irrational idea that the sexual partner is unfaithful
o Persecutory type: person believes he or she is being malevolently treated in some way
o Somatic type: person has an irrational belief that he or she has some physical defect, disorder, or disease
Brief Psychotic Disorder
o Sudden onset of psychotic symptoms usually following a severe psychosocial stressor
o Symptoms persist less than 1 month; client returns to the full premorbid level of functioning. Often occurs with pregnancies I’d call it post-partum psychosis [Show Less]