Schizophrenia

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May 19, 2011 - J. Honsky, APRN, MSN, M.Ed, BSN. Schizophrenia. • Positive Symptoms ... women. – 10% in a first degree relative. – 50% in an identical twin.

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

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