This document defines schizophrenia as a mental disorder characterized by disordered thoughts, hallucinations, and delusions. It lists the main etiological factors as biological, psychological, environmental, and social. The main subtypes are described as paranoid, disorganized, catatonic, undifferentiated, and residual. Positive symptoms include delusions and hallucinations while negative symptoms involve restrictions in emotional expression and interests. Nursing interventions focus on safety, establishing trust, addressing delusions and hallucinations, and teaching coping skills and social support.

1. B Y
MUHAMMAD BAQAR
D I P : C H N , P O S T R N B S C N , M S P H
Schizophrenia

2. Objectives
At the end of this lesson you will be able to:
 define schizophrenia
 Describe the etiological Factors of schizophrenia
 list the types of schizophrenia
 State the clinical features of schizophrenia
 Explain the nursing interventions of schizophrenia

3. Schizophrenia
 is defined as a mental disorder characterized by
disordered thoughts, hallucination, and delusions.
 is a form of psychosis involving disorders of
perception, language, thought, emotion, and
behavior.

4. Etiological Factors
• Biological factors:
• age, virus, Chemical imbalance & physical
abnormalities-neurotransmitters, brain structures
Dopamine activity is excessive in the schizophrenic brain
 Psychological factors: Traumatic experiences: Abuse
Damage to body image , Fear of death, Frustration with
memory loss , Role transitions
• Environmental factors: Life stressors, changes
• Social factors: Loneliness, isolation ,Recent sadness
,Lack of a supportive social network , Decreased mobility
Due to illness or loss of driving privileges

5. Subtype of Schizophrenia
 Paranoid
 Disorganized
 Catatonic
 Undifferentiated
 Residual

6. Subtype of Schizophrenia
 Paranoid: Preoccupation with delusion or
hallucinations, often with themes of persecution or
grandiosity.
 Disorganized: Disorganized speech or behavior, flat or
inappropriate emotion.
 Catatonic: Immobility ( or excessive , purposeless
movement) extreme negativism and /or parrot like
repeating of another’s speech or movements.
 Undifferentiated: Many and varied symptoms.
 Residual: Withdrawal, after hallucination and
delusions have disappeared.

7. Symptoms
 Symptoms are divided into Positive and Negative
symptoms.
 Positive Symptoms: Positive symptoms are
characterized by abnormal thoughts, perceptions,
language and behavior
 Negative Symptoms: Negative symptoms are
characterized by restrictions in range and intensity
of emotional expression, communication, body
language and interest in normal activities.

8. Positive symptoms
 Delusions
 Hallucinations
 Associative looseness
 Ideas of reference
 Flight of ideas
 Echopraxia

9. Negative symptoms
 Blunted (or flat) Affect
 Alogia
 Lack of volition
 Anhedonia
 Catatonia

10. Schizophrenia treatment
 Psychosocial
 Clinical and family support services
 rehabilitation
 Pharmacological and physical treatments
 Neuroleptic medications

11. PRIORITIZED NURSING DIAGNOSES
FOR ALL TYPES OF SCHIZOPHRENIA
 Risk for violence: Directed toward self or other
(priority!!!)
 Self-care deficit
 Thought process, altered
 Sensory/perceptual alterations (related to illusion,
delusion & hallucination)
 Social isolation

12. NURSING INTERVENTIONS
 Promoting safety of client and others and right to Privacy and
dignity
 Establishing therapeutic relationship by establishing trust
 Using therapeutic communication (clarifying feelings and
statements when speech and thoughts are disorganized or
confused)
Interventions for delusions:
 Do not openly confront the delusion or argue with the client.
 Establish and maintain reality for the client.
 Teach the client positive self-talk, positive thinking,
 and to ignore delusional beliefs.

13. NURSING INTERVENTIONS
Interventions for hallucinations:
 Help present and maintain reality by frequent contact and
communication with client.
 Engage client in reality-based activities such as card playing,
occupational therapy, or listening to music.
Coping with socially inappropriate behaviors
 Redirect client away from problem situations
 Reassure others that the client’s inappropriate
 behaviors or comments are not his or her fault (without violating
client confidentiality).
 Do not make the client feel punished or shunned for inappropriate
behaviors
 Teach social skills through education, role modeling, and practice.
 Client and family teaching
 Establishing community support systems and care