Psychosis -272.pdf

Psychosis (Māuiui Ahotea)  What is Psychosis? § Psychosis is an umbrella term for several specific disorders, such as schizophrenia. However, the general term psychosis will be used rather than having a focus on any one disorder. § Psychosis is about problems with interpretation and perceptio...

Psychosis (Māuiui Ahotea)  What is Psychosis? § Psychosis is an umbrella term for several specific disorders, such as schizophrenia. However, the general term psychosis will be used rather than having a focus on any one disorder. § Psychosis is about problems with interpretation and perception. Some medical conditions can also cause psychosis such as brain tumors, head injuries, dementia, delirium and epilepsy. § It is important to rule out physical conditions first before diagnosing with a Mental health condition. § Psycho active substances should also be considered as a provisional diagnosis and screening should also be made to rule out drug induced, intoxication or withdrawal.  § Heterogeneous § 3 in 100 suffer from psychosis § Genetic Causes § Environment § Illicit substance abuse § Medical conditions ie Brain tumours, dementia Depression Positive symptoms- Symptoms that would not normally be present ie extra or added. Delusions (a fixed false belief) Hallucinations (an experience/ perception associated with the senses of something not actually present) Disorganised responses Disorganised speech Aggressive, agitated responses Negative symptoms-Symptoms that would normally be present ie Symptoms taken away. Flat/inappropriate affect Poor eye contact Avolition (motivation) Withdrawal Poverty of speech Poor Activities of daily living Severely disturbed relationships with family/friends/peers  § Hallucinations can include: § Seeing things that other people don't Hallucinations (for example people's faces, animals or religious figures). Visual § Experiencing tastes, smells and sensations that have no apparent cause (for example feeling insects crawling on your skin). Gustatory, olfactory & tactile § Hearing voices that other people don't (these could be positive and helpful or hostile and derogatory) Auditory.  § In groups research “hearing voices” from different cultural world view perspectives and examine how hearing voices are viewed and treated. § Be prepared to discuss your findings in Group Activity the class and compare them to NZ current treatments and views. § Māori views of Mental health and hearing voices video https://www.newshub.co.nz/home/shows/2019/09/m-ori-experiences-of-nz-s- mental-health-services.html  Schizophrenia § Abrupt onset § Absence of premorbid disturbance § Onset in mid-life § Presence of acute and resolvable life stressor § Family history of affective disturbance § Presence of florid symptoms § Early intervention § Non-critical attitude from family § Absence of blunted affect § Social inclusion principles present  Schizoaffective disorder Acute and transient psychotic disorder Related disorders that get confused Schizotypal personality disorder Persistent delusional disorder  9 Medication Talking therapy Family/Whanau support Support and ‘treatment’ Practical support Making sense of experiences Community resources  Typical Atypical Haloperidol Rispiridone Medications Chlorpromazine Olanzapine There are two classes of Stelazine Quetiapine antipsychotics: Typical or First generation Thioridazine Clozapine (Older versions) Fluphenazine Aripiprazole Atypical or Second generation (Newer Versions) Monitor effectiveness of antipsychotics and their side effects, especially for metabolic syndrome and neuroleptic malignant syndrome. Ensure baseline vital signs including height and weight and ECGs and blood tests are completed on a regular basis  11 § Violence - less than 5% due to mental health challenges. § More frequently aggression/violence due to substance use. § Aggression or violence with psychosis, mostly associated with: Facts about § fear aggressive § § belief of acting in self-defense delusions of persecution behaviour § command hallucinations § directed towards a family member or friend than a stranger. DISCUSSION -What do you do if a person appears threatening?  12 Speak slowly and confidently Use a gentle, caring tone of voice Do not argue with or threaten Negative words may cause overreaction De-escalation Avoid nervous behaviour techniques Do not restrict their movement Take a break from the conversation. Invite them to sit down. Revise week 1 labs Continually assess your approach, be flexible.  Sensory modulation § Whakaāio ā-rongo or sensory modulation is an evidence based tool that supports people to use their senses to learn self-soothing techniques and change their current emotional and behavioural responses to a stressful situation. § In groups what kinds of things do you do to self-sooth in response to stressful situations?