Schizophrenia

She dances down the hallway with the grace of a Giselle. Her sweatshirt, knotted and twisted, adorns her head like a showgirl’s mantilla. A hospital gown serves only as a chameleon-like accessory to her ill-fitting clothing. Her feet are encased in institutional issue blue “slippers” unless she has removed them to watch her sore ridden, blood encrusted feet breathe. She is in constant motion pausing only to continue an endless discussion with the voices heard only by her. She appears to be listening to her thoughts out loud. When addressed she responds unintelligibly and laughs inappropriately at jokes that have not been told. Lost amongst the chaos, the patient admitted with schizophrenia is exhibiting characteristic signs and symptoms of this isolating and debilitating condition. Schizophrenia is a mental disorder that results in disturbed thought processes, associative looseness, hallucinations, delusions, and limited socialization (asociality). The nurse assesses the patient for positive symptoms, negative symptoms, cognitive symptoms and mood symptoms.

The management of schizophrenia focuses on reducing the severity of psychotic symptoms; preventing recurrences and functional decline; and meeting the physical and psychosocial needs of the patient. Antipsychotic medications are administered to control symptoms. Conventional antipsychotic medications control primarily the positive symptoms of schizophrenia. On the other hand, the newer atypical antipsychotic medications act selectively on the brain regions involved in schizophrenia; relieve the positive symptoms; improve the negative symptoms; and are less likely to cause motor adverse effects.

Mood Symptoms

Depression, suicidality, and hopelessness are common in schizophrenia and contribute to the suffering experienced by the individual.