PSYCHOPATHOLOGY

1. Mental Health Awareness
Education Summit
January 23, 2016
PUBLISHED BY T.B MFETI

2. MHICM RANGE
• Mental Health Intensive Case Management (MHICM)
Rural Access Network for Growth Enhancement
(RANGE)
• We are the only RANGE in Wisconsin
• Team of 4: Psychiatrist, RN and Social Workers
• Eligibility:
– Veteran
– Enrolled in VA Healthcare
– Reside 65 miles from Waupaca, WI
– Currently underserved
– Clinically Appropriate

3. MHICM RANGE
• Program Foundation: 10 Fundamental
Components of Recovery
• What we do:
– Weekly appointments
– Work together in partnership
– Focus on recovery

4. Veterans We Serve
Diagnosed with a Several Mental
Illness (SMI)
• Schizophrenia
• Schizoaffective
• Bi-Polar Disorder
• Major Depressive Disorder w/ Sever
Psychosis

5. Scope of Psychosis

6. Risk Factors
• Psychosis may affect persons of all types
regardless of age, gender, race, and/or
ethnicity
• Individual risk factors (dependent on the
diagnosis)
• Familial and genetic factors: many psychotic
disorders
• Impaired physical and/or mental health

7. Risk Factors continued…..
• Substance or alcohol abuse
• Stress intolerance
• Ineffective coping

8. Acute Psychosis
• Depends on internal factors such as loss, trauma,
pain and environment.
• In many cases, psychosis is reversible and there
are no residual effects
• Problems with daily activities
• Cognitive Dysfunction
• Impairment in personal, social, and/or
occupational function
• Risk for violence to self/and or others

9. Chronic Psychosis
• Dependent on internal factors
• High rates of recidivism, homelessness,
incarceration, joblessness, and long term
disability
• Danger to self and/or others
• Premature mortality
• Costly to family and society

10. Schizophrenia
• 1% of population has schizophrenia
• Most common psychotic disorder
• Increased risk of suicide
• Increased risk factor with positive family
history of schizophrenia
• First break-adolescence or young adulthood
• Neurotransmitter involved-Dopamine

13. Positive Symptoms of Schizophrenia
• Hallucinations
• Delusions
• Psychosis
• Illusions
• Agitation
• Hostility
• Bizarre Behaviors
• Association Disturbances
• Disorganized Speech

14. Negative Symptoms of Schizophrenia
• Alogia, Affective Blunting, Avolition ,
Anhedonia and Restricted emotion
• Social withdrawal
• Dependency
• Lack of ego boundaries
• Concrete thought processes
• Lack of self-care
• Sleep disturbance

15. The nurse working with a client who is newly diagnosed with
schizophrenia would include which of the following in the client's
teaching?
a. “Schizophrenia is curable if the correct medication and
dosages are achieved.”
b. “Schizophrenia has been found to be nonresponsive to
medications, and we will work mostly on helping you with daily
activities.”
c. “Schizophrenia is caused by pathology in the cerebellum, and
there are medications that are helpful in this area.”
d. “Schizophrenia is an illness that involves neurotransmitters,
most particularly the dopamine system.”

16. Treatment Helps Mindy Manage
Schizophrenia
• https://maketheconnection.net/conditions/schiz
ophrenia?condition_id=8&story_id=517
• Mindy joined the Navy, but her enlistment was
cut short with the onset of schizophrenic
symptoms. After her military discharge, she
began counseling at VA. Her medical team helped
her understand her condition and find ways to
manage her symptoms. Consistent professional
support enables Mindy to find solutions for living
well.

17. Schizoaffective
• Is a major psychiatric disorder similar to
schizophrenia
• Is a biological disorder which likely results
from an imbalance in brain chemicals
• Develops in about 1 in 200 people (.05%)
• Affects all aspects of daily living, including
work, social relationships and self-care

18. Positive Symptoms of Schizoaffective
• Hallucinations
• Delusions
• Thinking Disturbances

19. Negative Symptoms of Schizophrenia
• Affective Blunting
• Anhedonia (Decrease in ability to experience
pleasure)
• Apathy
• Poverty of Speech or Content of Speech
• Inattention

20. Bipolar Disorder

21. Type I
• Manic phase: (Required)
– Disturbed sleep pattern
– Sleep deprivation
– Imbalanced nutrition
– Hypothermia
– Deficient fluid volume
– Noncompliance

22. Type II
• Hypomanic:
– Inflated self-esteem
– Decreased need for sleep
– More talkative or pressured to keep talking
– Flight of ideas
– Increase in goal-directed activity

23. Type II cont’d
• Depressive phase:
– Disturbed sleep pattern
– Imbalanced nutrition
– Fatigue
– Self-care deficit
– Nausea
– Disturbed thought processes
– Sexual dysfunction
• -Self-injury

24. Signs and Symptoms
• Manic episode: an abnormally and persistently elevated,
expansive, or irritable mood for a duration of at least 1 week
• Three (or four if the mood is irritable) of seven additional
symptoms:
– Inflated self-esteem or grandiosity
– Decreased need for sleep
– Being more talkative or having pressured speech
– Flight of ideas or racing thoughts
– Distractibility
– Increase in goal-directed activity or psychomotor agitation
– Excessive involvement in pleasurable activities that have a
high potential for painful consequences
– https://www.youtube.com/watch?v=oUI5xS_IH24

26. Community Activity
• This is Sam….

27. Community Activity
Veteran
Immediate
Family
Nurse
Spouse/Children
Police Officer
District Attorney
JudgeHospital
Friend
Co-Worker
County Worker
Doctor Office

28. QUESTIONS ???

29. VA RESOURCES
• Madison VA System (608) 256-1901
William S. Middleton Memorial Veterans,
2500 Overlook Terrace, Madison, WI 53705
• Milwaukee VA System (414) 384-2000
Clement J. Zablocki VA Medical Center
5000 W National Ave., Milwaukee, WI
• Tomah VA System (608) 372-3971
Tomah VA Medical Center
500 E. Veterans Street, Tomah, WI 54660
2500 Overlook Terrace2500 Overlook Terrace

30. Community Resources
• SAMHSA: Substance Abuse and Mental Health
Services Administration - http://www.samhsa.gov/
• NIMH: National Institute of Mental Heath
https://www.nimh.nih.gov/index.shtml
• NAMIWisconsin: http://www.namiwisconsin.org/
• Make the Connections:
http://maketheconnection.net/