Introduction of schizophrenia

Schizophrenia

Schizophrenia is a functional psychiatric disorder. It is characterised by abnormality in behaviour, thinking or emotion.


Schizophrenia is a fragement mind state. 


Schizophrenia term are coined by  two greek word.

  • Schizo :- split
  • Phren:- behaviour 

It is classify into F20- F29 in ICD-10 classification.


The schizophrenia terms are use in 1908 by eugen bleuler (swiss psychiatrist).


Schizophrenia eugen bleuler
Eugen bleuler schizophrenia


Definition of schizophrenia


Schizophrenia is a group of mental disorder which is characterised by psychotic feature like disturb thought,emotion, behaviour and unable to trust others and disturb inter-personal relationship for last 6 months.


Etiology of schizophrenia

  • Increase the level of dopamine  
  • low socio-economic status 
  • Genetic factor 
  • low IQ level 
  • Change into life style 
  • Having a family history of schizophrenia
  • Pregnancy and birth complication


Sign and Symptoms of schizophrenia


According to Blueuler sign and symptoms of schizophrenia:- 

Bleuler given the 4A symptom It means
  1. Autism (difficulty in social interaction
  2. Ambivalence ( showing mixture of feeling )
  3. Association looseness of idea 
  4. Affect are improper / inappropriate 

    The other name of 4A symptom is primary symptom, fundamental symptom of schizophrenia and chief symptom of schizophrenia.


    Secondary symptoms of schizophrenia:-

    Primary symptoms are included into 4A by bleuler and remaining symptoms include in secondary symptoms of schizophrenia eg.

    Abnormal motor activity :-

    • very flexibility
    • stereotype movement
    • Aktaxia
    • Echolelia
    • Ecopraxia


    Emotional disorder:-

    • Apathy

    Altered thought process:-


    Disorder of perception:- 

    • illusion
    • Hallucination

    Disorder of consciousness:- 

    • Stooper

    Disorder of insight :-

    • Insight are absent 


    Sing and symptoms of schizophrenia according to  recent concept:-

    According to recent concept symptoms of schizophrenia are divided into 3 types...... 
    1. Positive symptoms of schizophrenia
    2. Negative symptoms of schizophrenia
    3. Cognitive symptoms of schizophrenia

    (1) Positive symptoms of schizophrenia:-

    Positive symptoms means symptoms are increased the patient behaviour.   

    Example :-
    • Hallucination
    • Illusion
    • Catatonia

    (2) Negative Symptoms of schizophrenia:-

    Negative symptoms means symptoms decrease the patient's behaviour. 

    Example:-
    • Apathy ( we of emotion)
    • Lack of motivation
    • Anhedonia ( we of ploure)
    • Poor hygiene and grooming habit
    • We of social interaction
    • Avoilition 
    • Lack of emotion


    (3) Cognitive symptom of schizophrenia:-

                 

    cognitive symptoms are develope due to impairment in cognitive function  of mind. 


    Example :-

    • Thinking disorder
    • Memory disorder
    • Attention disorder
    • Focusing or paying attention


    Classification of schizophrenia :- 


    1-Paranoid schizophrenia :-


    It is the most common type of the schizophrenia in which paranoid illusion aggressiveness are present. 

    • Auditory hallucination commonly are seen in paranoid schizophrenia.
    • Some time illusion or grandiosity are present.


    2- Disorganised Schizophrenia :-

    • It is usually occur before 25 years of age.
    • Wendering behaviour is present (wendering behaviour means purposeless or unplanned shifting of place.
    • Disorganised thought, speech or daily routine activity.
    • Personal hygiene are not maintained.
    • Recovery is very slow compared to other than schizophrenia.


    3- Catatonic Schizophrenia :- 


    Catatonic schizophrenia is characterised by significant psychomotor disturbance.

    Example:-

    • Very flexibility,
    • stooper
    • echolalia
    • echopraxia.


    4- Undifferentiated schizophrenia :-


    If schizophrenia are not complete criteria of paranoid, catatonic or disorganised schizophrenia is known as Undifferentiated schizophrenia.


    5- Post schizophrenic depression :-


    In this type of schizophrenia depressive episode occur after the schizophrenia illness.


    6- Residual schizophrenia :-


    The episode of schizophrenia or symptoms of schizophrenia experienced after the treatment of schizophrenia.


    7- Simple Schizophrenia :-


    This type of schizophrenia is characterized by development of negative symptoms with no history of psychosis. 


    Diagnostic evaluation of schizophrenia

    1. History taking.
    2. Developmental history taking.
    3. M.S.E. ( mental status examination )

                                                                                        Treatment of schizophrenia

    1.Pharmacological treatment :-

    •  Antipsychotic medication :- Schizophrenia is a condition in many psychotic symptoms are occur so the antipsychotic medication helps to reduce these symptoms.   Example :- Haloperidol

    • Anti-tremor :- Anti-tremor medication helps to reduce tremor in schizophrenia patients. 

        2. Nonpharmacological treatment:-

             • ECT
             • Skill training  
             • CBT
             • Family support system

        3.Therapies that use in schizophrenia:- 

            • Cognitive therapy
            • Group therapy
            • Psychoeducation
            • Behaviour psychotherapy


          Some Common Facts of Schizophrenia

          • Schizophrenia is a biological disorder which likely results from imbalance in brain chamber 
          • 1% of population will develop schizophrenia. 
          • People with schizophrenia are dangerously. 
          • There's no definitive diagnostic test for schizophrenia 
          • About 10% of people with schizophrenia commit suicide are more likely to have a drug or alcohol abuse problem. 
          • People with schizophrenia do not work. 
          • Men are more likely to develop schizophrenia than women. 
          • Schizophrenia typically appears when a person in his or her teen to elderly. 

          Is schizophrenia genetic

          • Yes most of people having schizophrenia due genetic.if you have a family history of schizophrenia.like your father and grandfather and any other person of your family have schizophrenia. 

          Nursing management of schizophrenia


          Nursing Diagnosis of schizophrenia :-

          1. Self care deficit related to schizophrenia symptoms.
          2. Social isolation related to illusion or illogical thinking.
          3. Impaired verbal communication related to unrealistic thinking evident by matism.
          4. Disturb thought process related to impaired cognitive function.
          5. Sensory or perceptual alteration related to neurochemical imbalance.
          6. Imbalance nutrition related to lose of body weight.
          7. Potential for violence related to neurochemical imbalance. 

            Nursing intervention of schizophrenia :-

            1. Perform the history taking or mental status examination
            2. Fulfill the patient's need
            3. Observe the patient's environment and provide positive environment to the patient.
            4. To plan the skill training program.
            5. Don't make false promises that can not be fulfill.
            6. Provide support to patient.
            7. Place patient in calm and quite enviornment. 
            8. Talk to patient in a quite manner and speak slowly and explain all over to establish verbal communication. 
            9. Educate patient and family members to take a healthy diet properly to fullfill the nutritional needs. 
            10. Provide electro convulsion therapy to the patient to controll violent behavior. 
            11. Ask the family members for time spend with patient and improve patient cognitive function by talking him.