Case Study: Brain Changes in Schizophrenia (Nursing)

by Brenda Marshall, EdD, MSN, RN

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    00:00 So, what are some of the cognitive signs of schizophrenia? Let's take a look at Pat. Pat is a 17-year-old highschool senior and Pat arrives in the emergency room and has been complaining about hearing voices. Pat states repeatedly "the grodimeres are coming for me." Well, if you hear someone say the grodimeres are coming for you, what are grodimeres? Right? Pat's parents explained that recently Pat has been refusing to go to school or even take a bath, saying that the grodimeres are going to kill him. According to Pat's parents, the first signs, he's always been a little bit eccentric when they talk about him as a little child, but recently these symptoms of hearing voices and thinking of new words, they were really brait and they wanted to know what the problem was. Well, one of the things I want you to think about is grodimeres. Well, what would we call that? What would we call making up new words? We think back to Latin, we're going to think neo which means new, logism which are words. Grodimeres would be considered a neologism and a neologism is one of the symptoms that we look for when a person has schizophrenia. The hearing of voices, we are going to call that a positive symptom. So, what do we mean by positive symptom? We're going to get much deeper into positive and negative symptoms, but positive symptoms is one that is like visual hallucinations, delusions, very active parts of the brain that are causing the person to react to stimuli that is not necessarily factual or there. Keep that in mind for positive symptoms. Mom and dad are also saying that he's withdrawing from school, doesn't want to go to school, staying in his room. So now I want you to start thinking about negative symptoms. That's normally what we're going to see first, not the positive symptoms. And because negative symptoms are saddle, very frequently especially parents and loved ones, they don't really think about the person who is just not seeing their friends so much or not talking so much or seems a little off, a little sad. These are our first chronic negative symptoms that we are going to start seeing that sometimes are misdiagnosed as maybe a little depressive, but they are actually the prodromal symptoms so as negative symptoms of schizophrenia. So, if we're thinking about these positive symptoms of hallucinations, what part of the brain does this come from? Do you recall? Well, let's think about it. If we are thinking about that he's hearing voices that are not there, we're thinking auditory.

    03:30 Now, we just went over all of these different sites of the brain. Why do we know it's not hippocampus? Because the hippocampus is memory and learning. Why do we know it's not frontal? Because frontal is executive functioning. Why do we know it's not occipital? Because that's vision. So when we're thinking about auditory hallucinations, we're thinking about the auditory system. If that's what you chose, C was the correct answer. So, our summary for now is to just remember that schizophrenia is a chronic mental illness, and it's characterized by disordered thinking. There are multiple theories about what causes schizophrenia and diagnosis is lately made between the late teens and the mid 20s for men and for women. It's also important to remember that 50% of persons who are diagnosed with schizophrenia may develop that chronic long-term life, but the sooner we intervene with any person with a mental illness, the better the prognosis is going to be. So it's critical for us to be able to get some help to that young man, young woman who is beginning to feel some of these symptoms of schizophrenia.

    About the Lecture

    The lecture Case Study: Brain Changes in Schizophrenia (Nursing) by Brenda Marshall, EdD, MSN, RN is from the course Schizophrenia (Nursing).

    Included Quiz Questions

    1. Neologism
    2. Idea of reference
    3. Visual hallucination
    4. Flight of ideas

    Author of lecture Case Study: Brain Changes in Schizophrenia (Nursing)

     Brenda Marshall, EdD, MSN, RN

    Brenda Marshall, EdD, MSN, RN

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