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Concept Map for Schizophrenia

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Concept Map for Schizophrenia

Pathophysiology

· Schizophrenia is characterized by abnormalities in the neurotransmitter systems, particularly dopamine and glutamate. An excess of dopamine activity in certain brain areas is linked to psychotic symptoms (Kahn, 2020).

· Abnormalities in the structure and function of the brain are evident, including reduced gray matter and impaired connectivity between different brain regions.

· Glutamate dysfunction contributes to cognitive deficits and negative symptoms by affecting the neural circuitry (McCutcheon et al., 2023).

· Neurodevelopmental disturbances possibly related to prenatal exposure to infections, malnutrition, or stress may disrupt brain development, leading to susceptibility to schizophrenia (Goff, 2021).

Medical Diagnosis

Diagnosis is primarily clinical, based on patient history and symptoms, following DSM-5 criteria. Symptoms must include delusions, hallucinations, or disorganized speech (Kahn, 2020).

Clinical Manifestations

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Subjective Data (reported by the patient): Delusions, hallucinations (auditory most common), disorganized thinking, feelings of being controlled (McCutcheon et al., 2023).

· Objective Data (observed): Disorganized behavior, negative symptoms like reduced emotional expression, lack of motivation.

· Labs and Radiology: MRI may show ventricular enlargement or reduced cortical thickness. EEG might show nonspecific abnormalities (McCutcheon et al., 2023).

Complications

· Increased risk of suicide and self-injury.

· Co-occurring conditions such as depression, anxiety disorders, and substance abuse (Goff, 2021).

· Social and occupational dysfunction due to symptoms.

Treatment

· Medical: Comprehensive assessment and management of comorbidities, including substance use disorders and mood disturbances.

· Medications: Antipsychotic medications (typical and atypical) to alleviate psychotic symptoms, adjunctive agents for mood stabilization and cognitive enhancement (McCutcheon et al., 2023).

· Intervention: Individualized psychotherapy (cognitive-behavioral therapy, family therapy) to address specific symptomatology and functional impairments.

· Supportive: Psychosocial interventions, vocational rehabilitation, housing assistance, and peer support programs to enhance social integration and quality of life (Goff, 2021).

Risk Factors

· Chemical: Imbalance of neurotransmitters, especially dopamine and glutamate (Goff, 2021).

· Environmental: Urban upbringing, migration, and cannabis use can increase risk.

· Psychological: Stressful life events and trauma are significant risk factors (Kahn, 2020).

· Physiological: Advanced paternal age, prenatal nutritional deficiencies, and prenatal exposure to toxins or infections.

· Genetic: Strong genetic component with heritability estimated at around 80%. Multiple genes involved, but none are solely responsible (Kahn, 2020).

Nursing Diagnosis

Problem statement (NANDA diagnosis): Disturbed sensory perception related to schizophrenia.

Related to (What is happening in the body to cause the issue?): Neurochemical imbalances and disrupted perceptual experiences.

As evidenced by (Specific symptoms): Reported hallucinations, delusional thoughts, disorganized speech, and altered cognitive functions.

References

Goff, D. C. (2021). The pharmacologic treatment of schizophrenia—2021. Jama, 325(2), 175-176. doi:10.1001/jama.2020.19048

Kahn, R. S. (2020). On the origins of schizophrenia. 
American Journal of Psychiatry, 
177(4), 291-297.

McCutcheon, R. A., Keefe, R. S., & McGuire, P. K. (2023). Cognitive impairment in schizophrenia: aetiology, pathophysiology, and treatment. 
Molecular psychiatry, 
28(5), 1902-1918.

Nursing Care Plan 2