SCHIZOPHRENIA (a long-term mental disorder) Part-2

SCHIZOPHRENIA (a long-term mental disorder) Part-2

Positive symptoms - Disorders of form & content of thoughts
 Neologism : new words without meaning
 Verbigeration : words and statements repeated again and again
 Thought broadcasting
 Thought insertion
 Thought withdrawal
 Ecolalia : repeating doctors statements
Neologisms:
 New, seemingly meaningless words that are formed by combining words and only have meaning to the person using them.
 Example: I like to read books. I read a book about a gilzbok…but they have nothing to interest me.. .It is just an amudence all over again”
 Verbigeration / Perseveration
 The repeating of words and statements again and again.
 Example:
 It’s time for supper, supper, supper.
 Supper is on the supper room.
Positive symptoms - Disorders of behaviour
 Stereotype : Repetitive patterns of movement or walking in circle or repetitive performance of strange gestures…
 Echopraxia : Imitating gestures and movements of the examining doctor
Positive symptoms – Loss of interest of self - care
 Odd and strange appearance
 Inappropriate clothing and poor personal hygiene

Negative symptoms
 Disturbances in mood
 Disturbances in behaviour
Negative symptoms - Disturbances in mood
Affective flattening : Decreased expression of emotion
 Alogia : “lack of word” i.e. poverty of speech
 Asociality : few friends, activities, interests impaired
 Anhedonia : inability to enjoy anything
 Suicide : 30% attempt, 10% successful
 Schizophrenia

• Some descriptions of patients
   Example : Hallucinations
   “I had one particular friend. I called him the ‘Controller’, only I could see him and hear him, but no one else could.
   He would punish me if I did something he didn't like. He spent a lot of time yelling at me and making me feel wicked. I didn't know how to stop him from screaming at me and ruling my existence. It got to the point where I couldn't decipher reality from what the ‘Controller’ was screaming.”
   Support for Patients
  Care of persons with schizophrenia can be provided at community level & with active family involvement.
  Important people who can support to help the patients come out of the disorder.
   Family
   Professional residential or day program caregivers
   Friends or room mates
   Professional case managers
   Issue :
   People with schizophrenia often resist treatment , believing that their delusions or hallucinations are real & Psychiatric help is not required .
   Help
   If a crisis occurs, family & friends may need to take action to keep their loved one safe .
  
  Issue :
  A Person with mental illness who does not want treatment may hide strange behavior or ideas from a professional
  Help
   Family members & friends should ask to speak privately with the person conducting the patient's examination & explain what has been happening at home.
   The Professional will then be able to question the patient & hear the patient's distorted thinking for themselves.

 Should ensure that the person with Schizophrenia continue to get treatment
 It is important to ensure that the patient take their medication after they leave the hospital also.
 If the patients stop taking their medication or stop going for follow-up appointments, their symptoms will return.
 If these symptoms become severe, they may become unable to care for their own basic needs for food, clothing, shelter.
 They may neglect personal hygiene
 Family & friends can also help patients set realistic goals & regain their ability to function in the world.
 Each step toward these goals should be small enough to be attainable,& the patient should pursue them in an atmosphere of support.
 People with mental illness who are pressured & criticized usually regress & their symptoms worsen.
 Telling them what they are doing right is the best way to help them move forward.
 How to respond when someone with schizophrenia makes statements that are strange or clearly false ???
 Because these bizarre beliefs or hallucinations are real to the patient, it will not be useful to say they are wrong or imaginary.
 Going along with the delusions will not be helpful , either
 It is best to calmly say that you see things differently than the patient does
 But that you acknowledge that everyone has the right to see things in his or her own way .