Which statement is correct about a 25-year-old client with newly diagnosed schizophrenia?
(January 2022) Schizophrenia is a chronic and severe brain disorder that interferes with a person’s ability to think clearly, manage emotions, make decisions and relate to others. Although it affects barely 1% of the population, it is one of the most disabling diseases affecting humankind. Show Schizophrenia is a chronic and severe neurological brain disorder estimated in 2020 to affect 1.1 percent of the population or approximately 2.8 million adults in the United States aged 18 or older. An estimated 40 percent of individuals with the condition are untreated in any given year. Abnormalities that characterize schizophrenia include:
Psychotic disorders nearly always emerge in late adolescence or early adulthood, with onset peaking between the ages of 18 and 25. The reasons for its appearance in this age range have not been identified. Some consensus already has emerged around the concept that psychotic breaks are not, as they may seem, abrupt but rather are the climax of a long buildup. In this model, they are rooted in molecular changes in the brain that begin as much as a decade before symptoms occur and progress to an end-stage psychosis in which reality surrenders to delusion, paranoia, hallucinations or other forms of disordered thinking. For decades, research on the causes of schizophrenia has been dominated by theories related genetics and neurotransmitters. In the mid-2010s, a third theory–the infectious/inflammatory theory—became a major new addition to schizophrenia study. Symptoms of SchizophreniaIn healthy people, the brain functions in such a way that incoming stimuli are sorted and interpreted, followed by a logical response (e.g., saying "thank you" after a gift is given, realizing the potential outcome of arriving late to work, etc.). Conversely, the inability of patients with schizophrenia to sort and interpret stimuli and select appropriate responses is one of the hallmarks of the disease. The symptoms of schizophrenia are generally divided into three categories: positive, negative and cognitive. The
National Institute of Mental Illness (NIMH) publishes the following about the three categories of symptoms:
Negative symptoms: “Negative” symptoms are associated with disruptions to normal emotions and behaviors. Symptoms include:
Cognitive symptoms: For some patients, the cognitive symptoms of schizophrenia are subtle, but for others, they are more severe and patients may notice changes in their memory or other aspects of thinking. Symptoms include:
Diagnosing SchizophreniaAlthough there are numerous abnormalities in the brain structure and function of individuals with schizophrenia, there is no single condition that can be tested or measured to produce a definitive diagnosis. Without such measures, the disease is diagnosed by its symptoms. Prior to a medical diagnosis, it is critically important that a doctor rule out other problems that may mimic schizophrenia, such as psychotic symptoms caused by the use of drugs or other medical illnesses; major depressive episode or manic episode with psychotic features; delusional disorder (no hallucinations, disorganized speech or thought or "flattened" emotions) and autistic disorder or personality disorders (especially schizotypal, schizoid, or paranoid personality disorders). Schizoaffective disorder is a diagnosis used to indicate that the person has an illness with a mix of symptoms of both schizophrenia and bipolar disorder. “Although there is no single symptom that is found only in schizophrenia, there are several that are found very uncommonly in diseases other than schizophrenia,” Dr. Torrey writes in Surviving Schizophrenia, now in its sixth edition as the authoritative book on the subject. “When they are present they should elevate the index of suspicion considerably….” Precise diagnosis is of “utmost importance,” he writes. “It both determines the appropriate treatment for the patient and provides the patient and family with an informed prognosis. It also makes research on the disease easier because it allows researchers to be certain they are talking about the same thing.” It is important to diagnose and treat schizophrenia as early as possible to help people avoid or reduce frequent relapses and re-hospitalizations. Several promising, large-scale studies suggest early intervention may forestall the worst long-term outcomes of this devastating brain disorder. Treatments and TherapiesWhile there is no cure for schizophrenia, it is a highly treatable disorder. In fact, according to the National Advisory Mental Health Council, the treatment success rate for schizophrenia is comparable to the treatment success rate for heart disease. People who experience acute symptoms of schizophrenia may require intensive treatment, sometimes including hospitalization, to treat severe delusions or hallucinations, serious suicidal inclinations, inability to care for oneself or severe problems with drugs or alcohol. It is critical that people with schizophrenia stay in treatment even after recovering from an acute episode. About 80 percent of those who stop taking their medications after an acute episode will have a relapse within one year, whereas only 30 percent of those who continue their medications will experience a relapse in the same time period. Because the causes of schizophrenia are still unknown, treatments focus on eliminating the symptoms of the disease. Antipsychotic drugs typically are used in the treatment of schizophrenia because they help relieve the positive symptoms. No treatments exist for negative symptoms of the disease. The NIMH publishes the following on treatments and therapies for schizophrenia:
Schizophrenia and MortalityIndividuals with schizophrenia die at a younger age than do healthy people. Males have a 5.1 greater than expected early mortality rate than the general population, and females have a 5.6 greater risk of early death. Suicide is the single largest contributor to this excess mortality rate, which is 10 to 13 percent higher in schizophrenia than the general population. Suicide is in fact the number one cause of premature death among people with schizophrenia, with an estimated 10 percent to 13 percent killing themselves. The extreme depression and psychoses that can result due to lack of treatment are the usual culprits in these sad cases. These suicides rates can be compared to the general population, which is somewhere around 0.01%. Other contributors to excess mortality include:
Additional information about schizophrenia is available from the following resources:
Which symptom does the nurse identify as a positive symptom of schizophrenia?positive symptoms – any change in behaviour or thoughts, such as hallucinations or delusions. negative symptoms – where people appear to withdraw from the world around then, take no interest in everyday social interactions, and often appear emotionless and flat.
Which positive symptoms of schizophrenia should the nurse document in the client's chart?Positive Symptoms
Primarily include delusions and hallucinations.
What are negative symptoms of schizophrenia?Negative Symptoms of Schizophrenia: Things That Might Stop Happening. Lack of pleasure. ... . Trouble with speech. ... . Flattening: The person with schizophrenia might seem like they have a terrible case of the blahs. ... . Withdrawal. ... . Struggling with the basics of daily life. ... . No follow-through.. How do people with schizophrenia cope?Many people with schizophrenia have trouble with sleep, but getting regular exercise, reducing sugar in your diet, and avoiding caffeine can help. Avoid alcohol and drugs. It can be tempting to try to self-medicate the symptoms of schizophrenia with drugs and alcohol.
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