Tiêu đề HANDOUTS - PSYCH (MR. ARZADON) ✅

2 Prof. Kenneth Arzadon, RN (UK-CBT Passer) SYMPTOMATOLOGY (Signs and Symptoms of Psychiatric Disorders) Disturbances in PERCEPTION • Illusion - misinterpretation of EXTERNAL stimulus • Hallucination - misinterpretation of SENSORY stimulus Visual (psychedelics) – marijuana use Tactile (formication) – alcohol withdrawal Olfactory (phantosmia) – post traumatic stress disorder Gustatory (spontaneous dysgeusia) – epilepsy [aura of seizure] Auditory (command auditory) – paranoid schizophrenia Management Hallucination must be recognized “It seems that you are talking to someone, are you hearing voices again? Assess the content “What are the voices telling you? Reality presentation “I know the voices are real to you, but I don’t hear them.” Divert the attention Engage in reality-based activity Reintegrate with the milieu TALK BACK to the voices – “practice saying GO AWAY!” • Synesthesia – mixing of senses (hears the color, sees the sound, tastes the words) Disturbances in THOUGHT • DELUSION – false belief Grandiose – superiority or invulnerability Persecutory – “to be harmed by others” Somatic – bodily functions are abnormal Nihilistic – a part of the body is missing Erotomanic – “a person is in love with her/him.” Ideas of Reference / Referential delusion – giving meaning to events or actions of others Management: Clarification the meaning Acknowledge the feelings, but NOT the DELUSION Voice doubt, but DO NOT CHALLENGE Engage in reality-based activities Circumstantiality – fullness of detail, ____ answer the question Tangentiality – lack of focus, ____ answer the question Looseness of Association (derailment) – fragmented ideas Flight of Ideas – rapid speech, jumping from one topic to another UNUSUAL SPEECH PATTERNS Neologisms – coining of new words Schizophasia – word salad, mixing of words without rhyme Clang associations – rhyming of words Echolalia – repeating the words of others Palilalia – repeating own words (fast and decreasing audibility) Verbigeration – repeating phrases Stilted language – use of flowery words Perseveration – adherence to a single topic
3 Prof. Kenneth Arzadon, RN (UK-CBT Passer) Disturbance in AFFECT Flat - no emotion response (Withdrawn) Blunt - minimal emotional response (Major Depression) Inappropriate - emotions are opposite to the context of the situation (Schizophrenia) Restrictive - single emotional response (Paranoid) La bile - sudden shift of emotions (Bipolar disorder) Disturbances in MEMORY Amnesia – loss of memory Retrograde – inability to recall memories formed before a traumatic event (Reminiscence therapy) Anterograde – inability to make new memories after a traumatic event (Reorient the client) Confabulation – making stories that are not true to fill the gap between memory loss PSYCHOSIS NEUROSIS Term used in DSM-5 Term used in clinical diagnosis Organic cause Contact with reality Hallucinations and Delusion Disorganized speech Disorganized behavior Hospitalization
4 Prof. Kenneth Arzadon, RN (UK-CBT Passer) SCHIZOPHRENIA Diagnostic Criteria: 2 or more of the following for at least __________. - Hallucinations - Delusions - Disorganized speech - Disorganized behavior - Negative symptoms BIOLOGIC THEORY Genetics: 1 parent (15%); 2 parents (35%) Neuroanatomy: less CSF and brain tissue Social Causation Hypothesis: ↑risk (low income) Neurochemistry: ______ DOPAMINE AND SEROTONIN SIGN AND SYMPTOMS OF SCHIZOPHRENIA POSITIVE Signs of Schizophrenia Hallucinations, Delusions, and other disturbances in thought and perception NEGATIVE Signs of Schizophrenia Asociality – lack of relationships Avolition – lack of motivation Anhedonia – lack of pleasure Alogia – lack of speech Abnormal affect Absence of movement (catatonia) - waxy flexibility, stupor and mutism ANTIPSYCHOTICS / NEUROLEPTICS 1 st generation 2 nd generation Mode of action: decreases DOPAMINE Indication: to manage _____ signs Chlorproma _______ Thiorida _______ Fluphena _______ Mode of action: decreases DOPAMINE AND SEROTONIN Indication: to manage _____ signs Olanza _______ Risperi _______ Quetia _______ Ziprasi _______ Cloza _______ Lurasi _______ 3 rd generation Long Term Injection Mode of action: regulates dopamine receptors Advantage: less side effects Aripipra _______ Brexpipra _______ Indication: NON – COMPLIANCE Common cause: side effects 4As of Schizophrenia (Prof. Eugene Bleuler) Autism – indifference Ambivalence – 2 opposing feelings Associative looseness Abnormal affect Other Related Disorders: Brief Psychotic Disorder – psychosis (<1 month) Schizophreniform – psychosis (1 – 6 months) Shared Psychotic Disorder (Folie à Deux) - 2 people sharing similar delusion