NURBN Psychotic Illness and Schizophrenia Assessment 2022

NURBN 2024 Module 4
Week 4 - psychotic illness and schizophrenia
Mark as done
Introductio
Intended learning outcomes
On completion of this unit, participants will be able to:
 Have an understanding of psychotic illness & schizophrenia
 Discuss the use of anti-psychotic medication & management of side-effects
 Explore the care & support for a client with a psychotic illness
 Understand the issues around challenging behaviour / aggression
 Understand solution focused therapy interventions
What is psychosis?
Key Concept
Psychosis is a syndrome or group of symptoms that may be associated
with schizophrenia and other mental illnesses including depression,
bipolar disorder, dementia and borderline personality disorder.
Psychosis may also be caused by a brain injury, neurological problem,
or other health problem.
Major Symptoms:
 Hallucinations
 Delusions
Other Symptoms:

 Difficulties concentrating, completing tasks, or making decisions
 Thoughts may feel ‘jumbled’ or confused.
 Difficulty following conversations or speaking clearly.
 May affect physical movement and emotional expression.
Precipitating Factors
 Extreme stress,
 Severe lack of sleep, or trauma
 Using or withdrawing from certain drugs or medications
Stages of psychosis - usually experienced in schizophrenia
Premorbid – no signs or symptoms
Prodrome – a period of pre-psychotic disturbance with changes in feelings,
thoughts and perceptions - it tends to develop earlier in males e.g. late teens
and later in females - in mid 20's
Acute – characterised by positive psychotic symptoms
Recovery and Late Recovery – acute symptoms remit and later functional
recovery occurs
Relapse – often occurs within five years of the onset of the acute phase
What is schizophrenia?
Schizophrenia - is a psychotic illness & the focus of our study in this
module
•Schizophrenia (s’a) is not defined as a single illness but is thought of
as a group of severe, disabling psychotic disorders marked by
withdrawal from reality, illogical thinking, possible delusions and
hallucinations and other emotional, behavioural or intellectual
disturbances (it is important to understand this definition)
•There is currently no physical or laboratory test that can definitively diagnose
schizophrenia – diagnosis is arrived at by a psychiatrist, based on clinical
symptoms.
•Disturbances may affect everything from speech, affect, psycho-motor
behaviour, interpersonal relationships and sense of self
•Prevalence is 1% of the population & affects men & women equally
•Onset between 15 – 25 years of age (usually for males) and 25 years onwards
(for females)
•Incidence and lifetime prevalence is roughly the same world-wide
Facts and myths about schizophrenia
Facts and myths about schizophrenia

 Schizophrenia is not caused by bad parenting, childhood trauma, poverty
or alcohol
 Schizophrenia is not contagious
 Although people with schizophrenia sometimes hear “voices” that others
can’t hear, this illness does not mean that you have “split” or “multiple”
personalities
 Schizophrenia is not a person’s fault; it is a chemical brain disorder
caused by a combination of biological and genetic factors, and often
triggered by environmental stressors
 Schizophrenia is not a developmental disability or intellectual disability
 Those with a diagnosis of schizophrenia who are undergoing treatment
are no more violent or aggressive than those who do not have
schizophrenia
 There is no cure for schizophrenia
 Aggression may occur among a minority of patients during an
untreated acute episode. However, this is uncommon and often
unfairly portrayed in the media. People with schizophrenia are
more likely to be victims of violence rather than perpetrators.
 Possible causes of schizophrenia are:-
 Genetic factors - (runs in families, a person with a first degree relative
with the disease stands a 15% chance of developing it themselves
compared to the 1% amongst the general population)
 •Biochemical – abnormalities in the neuro-transmitters dopamine and
glutamate e.g. dopamine theory. This theory proposes that dopamine is
overactive in the brain thereby explaining hallucinations, agitation,
delusional thoughts & grandiosity
 •Vulnerability / stress – a biologically susceptible person experiencing a
stressful event can trigger symptoms of schizophrenia

What is psychosis?
Symptoms of schizophrenia
Symptoms include:
• Hallucinations
• Delusions
• Thought disorder
• Social withdrawal
• Lack of motivation
• ‘Blunted’ emotions
• Inappropriate responses
• Impaired thinking and memory
• Lack of insight
• Grossly disorganised or abnormal motor behaviour including catatonia

What are positive symptoms? (make sure you know what this means)
What are negative symptoms? (make sure you know what this means)
Below is a brief overview for you
Positive Symptoms Negative Symptoms Cognitive Symptoms
- Hallucinations
- Delusions
- Racing &
disorganised thoughts
(expressed through
Apathy(avolution)
Lack of emotion
Poor or non-existent
social functioning
Difficulty concentrating
and/or following instructions
Difficulty completing
tasks