Schizophrenia
Comorbidities of schizophrenia
What is substance use disorders (tobacco, alcohol, marijuana), anxiety, depression, suicide, and physical illnesses?
Involves consumers working with a multidisciplinary team. One team member available 24 hours/day for crisis care. Eliminates the need for multiple departments or agencies to provide services. Helps improve quality of life, reduce inpatient admissions, incarceration, and homelessness among people with SMI.
What is assertive community treatment (ACT)?
Absence of happiness or the inability to feel pleasure in aspects of life that once made a person happy.
What is anhedonia?
Automatic coping styles that protect people from anxiety and enable them to maintain their self-image by blocking feelings, conflicts, and memories,
What is defense mechanisms?
(See Table 15.2)
Major features of posttraumatic stress disorder (PTSD) in adults
What is flashbacks, avoidance, persistent symptoms of increased arousal, and alterations in mood?
The absence of qualities that should be present.
Include blunted affect, poverty of thought (alogia), loss of motivation (avolition), and/or inability to experience pleasure or joy (anhedonia).
What are negative symptoms of schizophrenia?
Issues confronting individuals with serious mental illness.
What are establishing a meaningful life, comorbid conditions (physical disorders, suicide, substance use), social problems (stigma, isolation & loneliness, victimization), economic challenges (unemployment & poverty, housing instability), caregiver burden, and treatment issues (anosognosia, nonadherence, medication side effects)?
Primary risk factors for depression
What is female gender; adverse childhood experiences; stressful life events; first-degree family members with MDD; neuroticism; substance use; anxiety; personality disorders; and chronic or disabling medical conditions?
The most extreme level of anxiety and results in markedly dysregulated behavior.
What is panic?
(Table 15.1)
A term that means a balance between sympathetic and parasympathetic arousal.
What is window of tolerance?
Choosing words based on their sound rather than their meaning and often involves words that rhyme or have a similar beginning sound.
(On the track...have a Big Mac" or "Click, clack, clutch, close")
What is clang association?
Examples of interventions to improve adherence to treatment
What is establish trust & support, simplify treatment regimens, tie treatment adherence to achieving the patient's goals to increase motivation, involve patient in support groups with members who have greater insight...
(See Table 12.3 & Box 32.1)
Symptoms of a manic episode of bipolar disorder
What is a persistently elevated, expansive, or irritable mood; inflated self-esteem or grandiosity; decreased need for sleep; more talkative than usual or pressure to keep talking; flight of ideas or racing thoughts; distractibility; increase in goal-directed activity; and excessive involvement in activities that have a high potential for painful consequences?
Assessment guidelines for anxiety
What is determine the patient's current level of anxiety, ensure that a physical & neurological exam is conducted, assess for potential for self-harm & SI, and perform a psychosocial assessment?
An unconscious defense mechanism that protects an individual against overwhelming anxiety through emotional separation. However, this separation results in disturbances in memory, consciousness, self-identity, and perception.
What is disassociation?
This type of hallucination must be monitored carefully because they may be dangerous. For example, telling a patient to "hit that nurse."
What is a command hallucination?
The perception that an individual is flawed, resulting in social isolation and loneliness.
What is stigma?
Interventions for mania
What is use short & concise statements; encourage frequent rest periods during the day; maintain low level external stimuli; offer frequent, high-calorie protein drinks & finger foods; encourage appropriate clothing choices; give step-by-step reminders for hygiene & dress?
A first line pharmacotherapy for treating anxiety and depression.
What is selective serotonin reuptake inhibitors (SSRIs)?
Disorders included under the trauma umbrella
What is posttraumatic stress disorder (PTSD), reactive attachment disorder, disinhibited social engagement disorder, acute stress disorder, and adjustment disorder?
Serious side effect of antipsychotic meds. Acute, life-threatening medical emergency. Severe muscle rigidity, dysphasia, decreased responsiveness, HTN, tachycardia, diaphoresis
Hyperpyrexia is main feature: temp over 103
What is neuroleptic malignant syndrome (NMS)?
This model stresses hope, strengths, quality of life, patient involvement as an active partner in treatment, and eventual recovery.
What is the recovery model?
A medication combined with a common antidepressant to eliminate the risk of bringing on a manic episode during bipolar depression
What is a mood stabilizer?
Patient and family teaching for antianxiety drugs
What is these meds may make it unsafe to handle mechanical equipment; avoid using alcohol; avoid caffeine; review RX meds that may cause or increase anxiety; discuss w/ provider risks to fetus & breastfeeding; quitting a benzo after 1 month of use may cause withdrawal symptoms; meds should be taken with or shortly after meals/snacks to avoid GI discomfort? (BOX 15.1)
Treatment for trauma is effective when the patient...
What is recognizes symptoms as r/t the trauma; able to use newly learned strategies to manage anxiety; experiences no flashbacks or intrusive thoughts about the traumatic event; is able to sleep adequately without nightmares; and can assume usual roles & maintains satisfying interpersonal relationships?