LESSON PLAN

ON
SCHIZPHRENIA
NAME Taranjeet Kaur

COLLEGE Sidhu College of Nursing

SUBJECT Mental Health Nursing

TOPIC Schizophrenia

DATE 11 MAY 2023

METHOD OF TEACHING Lecture cum Discussion

AV AIDS Black Board

General objectives: - At the end class students will have brief and detailed knowledge on the schizophrenia.

Specific objectives:-

 Introduction about schizophrenia

 What is the definition of schizophrenia?
 What are the Classification of schizophrenia under ICD 10 ?
 Specify the epidemiological factors of schizophrenia?
 What are Types of schizophrenia?
 Describe about clinical features of schizophrenia?
 List of assessment tools for schizophrenia?
 What are the treatment and psychotherapy used for schizophrenia?
Sr Time Specific object Content matter AV.AIDS Teaching Evaluation
matter learning
no.
method
1. 2 min Introduction The word ‘Schizophrenia’ was coined by the - Verbally Introduction
about Swiss psychiatrist Eugene Bleuler in 1908. It about
schizophrenia is derived from Greek words skhizo (split) and schizophren
phren (mind). ia

2. 3 min Definition of Schizophrenia is a psychotic condition - lecture cum

Definition of
schizophrenia characterized by a disturbance in thinking, discussion
schizophrenia?
emotions, volitions, which usually leads to
social withdrawal.
3. 3min Classification F20-F29 Schizophrenia Black Verbally Classify
of F20.0 – Paranoid Board about
schizophrenia F20.1—Hebephrenic schizophreni
under ICD 10 F20.2—Catatonic a under ICD
F20.3—Undifferentiated 10?
F20.4—Post Schizophrenic
F20.5—Residual
F20.6-- Simple
F21- Schizotypal Disorder

4 2 min Specify the Schizophrenia is the most common psychiatric Verbally Explain about
epidemiological disorder. About 15% of new admissions in hospitals epidemiological
factors of are schizophrenic patients. factors of
schizophrenia schizophrenia?
 Peak ages of onset are –

a) Men – 15 to 25 years

b) Women – 25 to 35 years
 3min Explain the 1. Genetic Factors -- Verbally List out the
5.
causes of  The disease is more common among causes of

schizophrenia schizophrenia ?
people born of consanguineous marriages.

2. Biochemical Factors

 Dopamine hypotheses: excess of

dopamine-Dependent neuronal activity in
the brain may cause schizophrenia.

3. Neurostructural Theories

 Prefrontal cortex and limbic cortex may

never fully develop in the brains if persons
with schizophrenia.

4. Family Theories

 Mother – child relationship

 Family dysfunction

5. Perinatal Risk factors

 Complications of pregnancy particularly

during labor and delivery.

 Maternal influenza
5 15min What are the Schizophrenia can be classified into the following - Verbally Describe about
types of subtypes; the types of
schizophrenia schizophrenia?
1. Paranoid

2. Hebephrenic ( Disorganized )

3. Catatonic

4. Residual

5. Undifferentiated

6. Simple

1. Paranoid schizophrenia – The word

‘paranoid’ means ‘delusion’. Paranoid
schizophrenia is the most common type of
schizophrenia.

 Delusion of persecution- In persecutory

delusion, individual believe that they are
malevolently treated in some way. Like
cheated, spied upon, poisoned, harassed.

 Delusion of reference – In this delusion, the

individual believes that behavior of others
have got an unusual significance for one self.
The individual may falsely believe that
 others are talking about him.

 Delusion of jealousy- The content of jealous

delusion centers around that the person’s
sexual partner is unfaithful. The idea is held
on inadequate grounds and unaffected by
rational judgement.

 Delusion of grandiosity- individual with

grandiose delusion have irrational ideas
regarding their own worth, talent, power.
They may believe that they have a special
relationship with famous persons.

 Hallucinatory voices- These voices

threaten the or command the patient, or
auditory hallucinations without verbal form,
such as whistling, laughing.

2. Hebephrenic schizophrenia- Is usually

before age 25 and the course is commonly
chronic.

 Behavior is regressive and primitive.

 Contact with reality is extremely poor.

 Facial grimaces and bizarre mannerisms are

 common and communication is consistently
incoherent.

3. Catatonic schizophrenia- catatonic

schizophrenia is characterized by marked
abnormalities in motor behavior and may be
manifested in the form of Stupor or
excitement.

 Catatonic stupor is characterized by

extreme psychomotor retardation.

 Catatonic excitement is characterized by a

state of extreme psychomotor agitation.

4. Residual schizophrenia- Symptoms of

residual schizophrenia include emotional
blunting, eccentric behavior, illogical
thinking, social withdrawal. This category
should be used when there has been at least
one episode of schizophrenia in the past.

5. Undifferentiated schizophrenia- In this

type of schizophrenia no subtype are fully
present or they may meet the criteria for
more than one subtype.
6. Simple schizophrenia- In this presence of
negative symptoms, hypochondrial features,
aimless activity.
6. 5min Describe about the CLINICAL FEATURES - lecture cum Elaborate
clinical features Bleuler’s 4 A’s discussion about clinical
about features of
 Affective disturbance:
schizophrenia schizophreni
Inability to show appropriate
a?
emotional response.

 Autistic thinking: It is the

thought process in which
individual is unable to relate
to others or to the
environment.

 Ambivalence: It refers to
contraindicatory or opposing
emotions, attitudes, ideas for
the same person.

 Associative looseness:
Inability to think logically.
Kurt Schneider proposed the first rank
symptoms of schizophrenia in 1959. The presence
of even one of these symptoms is considered to be
strongly suggestive schizophrenia. These
symptoms include: -
 Hearing one’s thought spoken aloud.
 Hallucinatory voices
 Thought withdrawal
  Thought insertion
 Thought broadcasting

THOUGHT AND SPEECH DISORDER

 Autistic thinking
 Thought blocking
 Poverty of speech
 Poverty of ideation
 Echolalia
DISORDERS OF PERCEPTION
 Auditory hallucination
 Visual hallucination
7. 2min List the assessment DIAGNOSTIC EVALUATION Black board Elaborate about

tools for  History collection clinical features

schizophrenia  Mental status examination of schizophrenia?

 Blood test
 CT Scan and MRI

8 5min Mention the TREAMENT Black Board Explain

treatment and About

1. PHARMACOLOGICAL
psychotherapy treatment and
MANAGEMENT
used for psychotherap
a) Conventional (Typical) Antipsychotics
schizophrenia y for
The typical antipsychotics work by schizophreni
blocking postsynaptic dopamine receptors a?
in basal ganglia, brainstem, and medulla.

E.g:

 Chlorpromazine: 300-1500mg/day

IM- 50-100mg/day

 Haloperidol: 5-100mg/day

IM- 5-20mg/day

 Trifluoperazine: 15-60mg/day

IM- 1-5mg/day

b) Atypical antipsychotics
 The atypical antipsychotics are weaker
dopamine receptor antagonists than the
conventional antipsychotics.

E.g.

 Clozapine: 25to 450mg/day

 Risperidone: 2 to 10 mg/day

 Olanzapine: 10 to 20mg/day

 Quetiapine: 150 to 750 mg/day

2. PSYCHOLOGICAL
TREATMENTS

 Individual Psychotherapy

 Group Therapy

 Behavior Therapy

3. SOCiAL TREATMENT

 Milieu Therapy

 Family Therapy

4. ECT

 Catatonic stupor

 Severe side effects of drugs

 Usually 8 to 12 ECT’ are needed

 5. NURSING MANAGEMENT
a. ASSESSMENT
 In the first step of the nursing process,
the nurse gathers a database from which
nursing diagnoses are derived and a plan
of care is formulated.
 This first step of the nursing process is
extremely important because without an
accurate assessment, problem
identification, objectives of care, and
outcome criteria cannot be accurately
determined.
 Data may be obtained from family
members, if possible; from old records,
if available; or from other individuals
who have been in a position to report on
the progression of the client’s behavior.

THE ASSESSMENT MAINLY INCLUDES

 Observe behavior pattern
 Assess speech pattern
 Assess self-care activity
 Encourage the patient to express their
feelings
 Note the any recent suicide attempts
SUMMARY:
Till now I have discussed about the definition, criteria, types, epidemiology, causes, clinical
features, assessment
methods, treatment and psychotherapy used for schizophrenia.

CONCLUSION:
I hope that you all understand about definition, ICD 10 criteria, types, epidemiology, causes,
clinical features,
assessment methods, treatment and psychotherapy used for Schizophrenia.

POST EVALUATION:
1. What is schizophrenia?
2. Identify the schizophrenia under ICD 10
3. What are the types of schizophrenia?
4. What are the epidemiological factors of schizophrenia?
5. What are the causes of schizophrenia?
6. Explain about clinical features of schizophrenia?
7. What are the assessment tools for used for schizophrenia?

BIBLIOGRAPHY:

1. Sreevani, R. A Guide to Mental Health and Psychiatric Nursing. 4th ed. Jaypee Brothers
Medical Publishers. New Delhi. 2016
2. K. Lalitha (2007),”Mental health and psychiatric nursing and Indian perspective” 1st edition,
Bangalore, VMG book house.
3. Niraj Ahuja, A short textbook of psychiatry, Jaypee brothers, New delhi, 2002.
4. Bimla Kapoor, Textbook of Psychiatric Nursing, Vol. I & II Kumar publishing house Delhi,
2001