Schizophrenia • Positive Symptoms Disorganized thought Disorganized speech Disorganized behavior Catatonia Hallucinations Delusions
• Negative Symptoms Affective flattening Alogia Avolition
Atypicals treat both positive and negative symptoms 5/19/2011
J. Honsky, APRN, MSN, M.Ed, BSN
Schizophrenia Prevalence • 1 in 100 adults – Average age of onset is 18 in men and 25 in women – 10% in a first degree relative – 50% in an identical twin
• 1 in 40,000 children
5/19/2011
J. Honsky, APRN, MSN, M.Ed, BSN
Schizophrenia Medications • First Generation Antipsychotics – Haldol
• Atypical Antipsychotics – – – – – –
Abilify Geodon Orap Risperdal Seroquel Zyprexa
• Generic – Thiodorazine 5/19/2011
J. Honsky, APRN, MSN, M.Ed, BSN
Schizophrenia Medication Side Effects • Weight gain – hyperglycemia – diabetes – Close metabolic monitoring – Dietary education
• Movement disorders – Less frequent in atypical antipsychotics – Extra Pyramidal Symptoms (EPS) – Tardive Dyskinesia (TD)
5/19/2011
J. Honsky, APRN, MSN, M.Ed, BSN
Anxiety Disorders • “Anxiety is distinguished from fear on the basis of its diffuse apprehension in response to less specific stimuli”. • “Anxiety that persists at high levels and leads to maladaptive behaviors warrant diagnosis & treatment”. (Burns, Brady, Dunn & Starr, 2000,510,513)
5/19/2011
J. Honsky, APRN, MSN, M.Ed, BSN
Anxiety Disorders • Childhood fears are a part of normal development • 90% of 2-14 year-olds were found to have at least one specific fear. • Adolescents (15-17years ) average 2 to 3 intense fears. • “It is essential to attend to cues that a traumatic experience or situation underlies symptoms of anxiety”. (Burns, Brady, Dunn & Starr, 2000,510,513)
5/19/2011
J. Honsky, APRN, MSN, M.Ed, BSN
Anxiety Disorders • • • • • • • •
Phobias General Anxiety Disorder (GAD) Post Traumatic Stress Disorder (PTSD) Social Phobia Panic Disorder Obsessive Compulsive Disorder Separation Anxiety Disorder Dissociative Disorder
5/19/2011
J. Honsky, APRN, MSN, M.Ed, BSN
Anxiety Disorders • Neuronal dysregulation – GABA
5/19/2011
J. Honsky, APRN, MSN, M.Ed, BSN
Schizophrenia • Positive Symptoms Disorganized thought Disorganized speech Disorganized behavior Catatonia Hallucinations Delusions
• Negative Symptoms Affective flattening Alogia Avolition
Atypicals treat both positive and negative symptoms 5/19/2011
J. Honsky, APRN, MSN, M.Ed, BSN
Schizophrenia Prevalence • 1 in 100 adults – Average age of onset is 18 in men and 25 in women – 10% in a first degree relative – 50% in an identical twin
• 1 in 40,000 children
5/19/2011
J. Honsky, APRN, MSN, M.Ed, BSN
Schizophrenia Medications • First Generation Antipsychotics – Haldol
• Atypical Antipsychotics – – – – – –
Abilify Geodon Orap Risperdal Seroquel Zyprexa
• Generic – Thiodorazine 5/19/2011
J. Honsky, APRN, MSN, M.Ed, BSN
Schizophrenia Medication Side Effects • Weight gain – hyperglycemia – diabetes – Close metabolic monitoring – Dietary education
• Movement disorders – Less frequent in atypical antipsychotics – Extra Pyramidal Symptoms (EPS) – Tardive Dyskinesia (TD)
5/19/2011
J. Honsky, APRN, MSN, M.Ed, BSN
Anxiety Disorders • “Anxiety is distinguished from fear on the basis of its diffuse apprehension in response to less specific stimuli”. • “Anxiety that persists at high levels and leads to maladaptive behaviors warrant diagnosis & treatment”. (Burns, Brady, Dunn & Starr, 2000,510,513)
5/19/2011
J. Honsky, APRN, MSN, M.Ed, BSN
Anxiety Disorders • Childhood fears are a part of normal development • 90% of 2-14 year-olds were found to have at least one specific fear. • Adolescents (15-17years ) average 2 to 3 intense fears. • “It is essential to attend to cues that a traumatic experience or situation underlies symptoms of anxiety”. (Burns, Brady, Dunn & Starr, 2000,510,513)
5/19/2011
J. Honsky, APRN, MSN, M.Ed, BSN