Schizophrenia is a serious mental disorder characterized by distortions in thinking, perception, emotions, language, sense of self and behavior. It is classified into different types based on symptoms such as paranoid, disorganized and catatonic schizophrenia. Treatment involves medication, therapy and lifestyle management to control symptoms and enable functioning. Nurses play an important role in safety, rehabilitation and health education for patients and their families.

1. PRESENTATED TO PRESENTED BY
MADAM MRS AARTI
CHANDRAVANSHI
LECTURER
CNC BHILAI
MISS NIKITA MASIH
BSC NURSING 3RD
YEAR
10TH BATCH
CNC BHILAI
CHHATTISGARH NURSING COLLEGE
DHANORA, BHILAI
SUBJECT - MENTAL HEALTH NURSING
TOPIC - SCHIZOPHRENIA
Seminar on

3. INTRODUCTION
The world schizophrenia was coined by swiss
psychiatrist Eugen Bleuler in 1908. The Word was
derived from Greek skhizo (split)and phren (mind). In
ICD-10 schizophrenia is classified under the code F2 .
It is a serious brain disorder that distorts the way
person thinks , act ,expresses emotions ,perceive reality
Etc. Often they have problems with functioning in
society, at work, at school, and in relationships. It is a
Common type of psychosis characterized by
hallucinations and delusions , thought disturbances.

4. DEFINITION
“According to LP shah & Hemashah 1997”
“ A group of mental illness characterized by specific
psychological symptoms leading to disorganization of
personality of an individual. The symptoms emotions
& behaviour in characteristics way.”
“ According to ICD 10 ”
“ A group of disorder that manifested by fundamental
disturbance or distortions in thinking mood &
behaviour. ”

5. INCIDENCE
THROUGH THE
BLACK
BOARD

6. CLASSIFICATION
According to ICD – 10 (F20 – F29)
• F20 - SCHIZOPHRENIA
• F20.0 - PARANOID SCHIZOPHRENIA
• F20.1 - HEBEPHRENIC SCHIZOPHRENIA
• F20.2 - CATATONIC SCHIZOPHRENIA
• F20.3 - UNDIFFERENTIATED SCHIZOPHRENIA
• F20.4 - POST- SCHIZOPHRENIA DEPRESSION
• F20.5 - RESIDUAL SCHIZOPHRENIA
• F20.6 - SIMPLE SCHIZOPHRENIA
• F20.8 - OTHER SCHIZOPHRENIA
• F20.9 - SCHIZOPHRENIA UNSPECIFIED
• F21 - SCHIOTYPAL DISORDER
• F22 - PERSISTENT DELUSIONAL DISORDER

7. According to DSM- IV
1) DELUSIONS
2) HALLUCINATIONS
3) DISORGANIZED SPEECH
4) GROSS DISORGANIZED/ CATATONIA BEHAVIOR
5) NEGATIVE SYMPTOMS SUCH AS FLAT , ALOGIA

8. F 20.0 PARANOID SCHIZOPHRENIA
 IT IS CHARACTERIZED MAINLY BY THE PRESENCE OF
DELUSIONS OF PERSECUTIONS OR GRANDEUR AND
AUDITARY HALLUCINATIONS RELATED TO A SINGLE THEME.
 THE INDIVIDUAL IS OFTEN TENSE , SUSPICIOUS AND MAYBE
ARGUMENTATIVE HOSTILE AND AGGRESSIVE.
 ONSET OF SYMPTOMS IS USUALLY LATER ( PERHAPS IN THE
20S OR10S)
 DISTURBANCE OF SPEECH , AND CATATONIC SYMPTOMS
ARE EITHER ABSENT OR RELATIVELY INCONSPIOUS.

9. F 20.1 HEBEPHRENIC SCHIZOPHRENIA
(DISORGANIZED)
 PEOPLE WITH THIS TYPE OFTEN ARE CONFUSED AND
HAVE JUMPED SPEECH
 THEIR OUTWARD BEHAVIOR MAYBE EMOTIONLESS , OR
INAPPROPRIATE , EVEN SILLY OR CHILDLIKE
 THEY HAVE DISORGANIZED BEHAVIOR THAT MAY DISRUPT
ABILITY TO PERFORM NORMAL DAILY ACTIVITIES SUCH AS
SHOWERING OR PREPARING MEALS.

10. F 20.2 CATATONIC SCHIZOPHRENIA
oCATA MEANS DISTURBED.
oCATATONIA SCHIZOPHRENIA IS A RARE MENTAL DISORDER.
oIT IS CHARACTERIZED BY MARKED PSYCHOMOTOR
DISTURBANCES / ABNORMALITIES IN MOTOR BEHAVIOR AND MAYBE
MANIFESTED IN THE FORM OF STUPOR OR EXCITEMENT.

11. CATATONIC STUPOR
IT IS CHARACTERIZED BY EXTREME PSYCHOMOTOR RETARDATION
MUTISM ( ABSENCE OF SPEECH ) IS COMMON AND NEGATIVISM
( AN APPARENTLY MOTIVELESS RESISTANCE TO ALL INSTRUCTIONS
OR ATTEMPT TO BE MOVED ) . WAXY FLEXIBILITY MAYBE EXHIBITED.

12. CATATONIC EXCITEMENT
 CLIENT WITH CATATONIC REQUIRE PHYSICAL AND MEDICAL
CONTROL BECAUSE THEY ARE OFTEN DESTRUCTIVE AND
VOILENT TO OTHERS , AND THEIR EXCITEMENT MAY CAUSE
THEM TO INJURE THEMSELVES OR TO COLLAPSE FROM
EXHAUSATIONS.

13. F20.3 UNDIFFERENTIATED SCHIZOPHRENIA
IT IS DIAGNOSED WHEN A PERSON MEETS THE CRITERIA FOR
DIAGNOSIS
OF SCHIZOPHRENIA .
PEOPLE WITH UNDIFFERENTIATED SCHIZOPHRENIA EXHIBIT
SYMPTOMS
OF MORE THAN ONE TYPE OF SCHIZOPHRENIA.

14. F20.4 POST SCHIZOPHRENIC DEPRESSION
DEPRESSIVE SYMPTOMS WILL DEVELOP IN ACUTE SCHIZOPHRENIA
AND ARE ASSOCIATED WITH SUICIDAL TENDENCY.

15. F20.5 RESIDUAL SCHIZOPHRENIA
CHRONIC FORM OF SCHIZOPHRENIA ,CLIENT CAN BE ABLE TO DO HIS ROUTINE
WORK NORMALLY AS THEY ATTAINED A SOCIAL RECOVERY BUT SYMPTOMS
MAY PERSIST LIKE BLUNTING OF EMOTIONS , ILLEGICAL THINKING , SOCIAL
WITHDRAWAL , LOOSENING OF ASSOCIATION , DISORGANIZED SPEECH.

16. F20.6 SIMPLE SCHIZOPHRENIA
SIMPLE SCHIZOPHRENIA IS CHARACTERIZED BY EARLY AND SLOWLY
DEVELOPING INITIAL STAGE WITH GROWING SOCIAL ISOLATION, SMALL
ACTIVITY , AVOLITION AND DEPENDENCE ON OTHERS.

17. F21 SCHIZOTYPAL DISORDER
ACCORDING TO ICD-10 THIS DISORDER IS CHARACTERIZED BY ECCENTRIC
BEHAVIOR AND BY DEVIATIONS OF THINKING AND AFFECTIVITY, WHICH ARE
SIMILAR TO THAT OCCURING IN SCHIZOPHRENIA , BUT WITHOUT PSYCHOTIC
FEATURES AND EXPRESSED SYMPTOMS OF SCHIZOPHRENIA OF ANY TYPE.

18. F22 PERSISTENT DELUSIONAL DISORDER
INCLUDES A VARIETY OF DISODERS IN WHICH LONGSTANDING DELUSIONS
CONSTITUTE THE ONLY .

19. DIAGNOSTIC CRITERIA
(1) MEDICAL
HISTORY :-
(2) PHYSICAL
EXAMININATION:-

20. (3) IMAGING TEST :-
 ct scan  mri

21. BLOOD , URINE AND CEREBROSPINAL FLUID ( spinal tap)
TESTS :-
This tests look for chemical changes in bodily fluids
That might explain changes in behavior .
BRAIN ACTIVITY TESTING :-
An EEG(electro – encephalogram ) detects and record
The electrical activity in brain.

22.  MENTAL STATUS EXAMINATION
 MINI MENTAL STATUS EXAMINATION
 NEUROLOGICAL TEST
 PHYSICAL THERAPY :- ECT ( ELECTRO
CONVULSIVE THERAPY)
 PSYCHOTHERAPY

23. SURGICAL MANAGEMENT
Lobotomy :- a lobotomy is a type
of brain surgery that became
Popular in the 1930s as a treatment
For mental health conditions. It is a
Neurosurgical operation that
Involves permanently damaging
Parts of the brains prefrontal lobe…
Deep brain stimulation:- it is a new
Treatment that uses electric pulses
To help part of brain to commu-
Nicate better. A surgeon places
Wires and electrodes in brain. This
Electricity in that current stimulate
The brain cells in that area…….

24. DIETARY MANAGEMENT
OMEGA-3 FATTY ACIDS AND VITAMINS HAVING
THE INFLAMMATORY PROPERTIES HAVE BEEN
SUGGESTED TO IMPROVE THE SYMPTOMS OF
SCHIZOPHRENIA.
 A KETOGENIC DIET, LOWER THE CARBOHYDRATES ,
PROTEINS.
 VITAMINS B6 ,B8 ,B12 CAN SIGNIFICANTLY REDUCED
SYMPTOMS OF SCHIZOPHRENIA.

25. NURSING MANAGEMENT
ASSESS THE PATIENTS ABILITY TO CARRY OUT THE ACTIVITIES TO DAILY
LIVING, PAYING SPECIAL
ATTENTION TO HIS NUTRITIONAL STATUS. MONITOR HIS WEIGHT IF HE IS NOT
EATING. IF HE
THINKS THAT HIS FOOD IS POISONED , OR OFFER HIM FOODS IN CLOSED
CONTAINERS THAT HE
CAN OPEN .
MAINTAIN A SAFE ENVIRONMENT , MINIMIZING STIMULI. USE PHYSICAL
RESTRAINTS ACCORDING
TO THE HOSPITALS POLICY TO ENSURE THE PATIENTS SAFETY AND OTHERS.
AVOID PROMOTING DEPENDENCE . MEET THE PATIENTS NEEDS BUT ONLY
DO TO FOR THE PATIENT
WHEN HE CANNOT DO FOR HIMSELF.
ENGAGE THE PATIENT IN REALITY- ORIENTED ACTIVITES THAT INVOLVE

26. IF THE PATIENT IS HALLUCINATING, EXPLORE THE CONTENT OF THE
HALLUCINATIONS.
AVOID ARGUING ABOUT THE HALLUCINATION; IF POSSIBLE , CHANGE
THE TOPIC.
DO NOT TEASE OR JOKE WITH THE PATIENT, CHOOSE WORDS THAT
ARE CLEARLY UNDERSTANDABLE.
DO NOT TOUCH THE CLIENT WITHOUT TELLING HIM FIRST EXACTLY
WHAT YOU ARE GOING TO DO.
DECREASE ENVIROMENTAL STIMULI SUCH AS LOUD MUSIC,
EXTREMELY BRIGHT COLORS .
DO NOT WHISPER OR LAUGH IN THE PRESENSE OF THE PATIENT.
DO NOT ARGUE WITH THE CLIENT .
MAINTAIN EYE CONTACT DURING INTERACTION WITH CLIENT.
IDENTIFY AND RESPOND TO THE EMOTIONAL NEEDS OF THE

27. NURSING DIAGNOSIS
1) DISTURBED THOUGHT PROCESS RELATED TO INABILITY TO TRUST
, PANIC ANXIETY,
POSSIBLE HEREDITORY FACTORS AS EVIDENCED BY DELUSIONAL
THINKING, INABILITY
TO CONCENTRATE , IMPAIRED VOLITION.
2) IMPAIRED VERBAL COMMUNICATION RELATED TO REGRESSION,
WITHDRAWAL AS
EVIDENCED BY LOOSE ASSOCISTION OD IDEAS, NEOLOGISMS,
POOR EYE CONTACT.
3) DISTURBED SENSORY PERCEPTION ,AUDITORY/VISUAL RELATED
TO , WITHDRAWAL INTO
THE SELF AS EVIDENCED BY INAPPROPRIATE RESPONSE , POOR
CONCENTRATION.
4) SOCIAL ISOLATION RELATED TO INABILITY TO TRUST , EGO

28. COMPLICATION
1) SEVERE EMOTIONAL , BEHAVIORAL AND HEALTH PROBLEMS AS WELL AS
LEGAL AND FINANCIAL PROBLEMS THAT AFFECT EVERY AREA OF LIFE.
2) SUICIDE
3) ANY TYPE OF SELF INJURY .
4) ANXIETY AND PHOBIAS
5) DEPRESSION
6) ABUSE OF ALCOHOL, DRUGS ETC
7) POVERTY
8) INABILITY TO WORK OR ATTEND SCHOOLS

29. PREVENTION
 IGNORE THE VOICES , BLOCK THEM OUT OR DISTRACT YOURSELF.
 SEEK EARLY TREATMENT.
 STICK TO THE TREATMENT PLAN.
 AVOID ILLEGAL DRUGS AND ALCOHOL USE.
 REDUCE STRESS.
 AVOID SOCIAL ISOLATION.
 EAT A HEALTHY DIET WITH A LOT OF
VEGETABLES, FISHES, WITH OMEGA3 FATTY ACIDS.
 AVOID HEAD INJURIES.
 TAKE VITAMIN D SUPPLEMENTS
 GET ENOUGH SLEEP.

30. HEALTH EDUCATION
THROUGH
THE CHART
PAPER

31. SUMMARY
SCHIZOPHRENIA IS A SERIOUS MENTAL DISORDER IN WHIC
INTERPRET REALITY ABNORMALLY. SCHIZOPHRENIA MAY R
SOME COMBINATION OF HALLUCINATION , DELUSIONS , AN
DISORDERED THINKING AND BEHAVIOR THAT IMPAIR DAILY
AND CAN BE DISABLING. PEOPLE WITH SCHIZOPHRENIA R
LONG TREATMENT, THIS CONSIST DRUG THERAPY AND CO