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Health Differences Across the Lifespan 2 Study Guide the symptoms identical for each person. People with schizophrenia have a chemical imbalance of brain chemicals (serotonin and dopamine) which are neurotransmitters. These neurotransmitters allow nerve cells in the brain to send messages to each other. The imbalance of these chemicals affects the way a person’s brain reacts to stimuli, which explains why a person with schizophrenia may be overwhelmed by sensory information (loud music or bright lights), which other people can easily handle. This problem in processing different sounds, sights, smells, and tastes can also lead to hallucinations or delusions. Schizophrenic disorders are characterized by disturbances for at least 6 months in thought content and form, perception, affect, sense of self, volition (self-initiated behaviors), interpersonal relationships, and psychomotor behavior. Signs and symptoms include auditory hallucinations, disorganized thinking, or looseness of association. Negative behaviors include the absence of healthy behaviors including flat affect, apathy, anhedonia (inability to experience pleasure), avolition (inability to pursue goal directed behavior), alogia (poverty of speech), minimal self-care, ineffective social skills, and social withdrawal and isolation from concrete thinking. Positive symptoms focus on a distortion of normal functions and include delusions, hallucinations, disorganized speech, and grossly disorganized pacing, touching objects, or catatonic behavior. Types of schizophrenia include catatonic (least common), disorganized, and paranoid. Catatonia is a state of neurogenic motor immobility and behavioral abnormality manifested by stupor. It is associated with psychiatric conditions such as schizophrenia (catatonic type), bipolar disorder, post- traumatic stress disorder, depression, and other mental disorders, as well as drug abuse or overdose (or both). It may also be seen in many medical disorders including infections (such as encephalitis), autoimmune disorders, focal neurologic lesions (including strokes), metabolic disturbances, and abrupt or overly rapid benzodiazepine withdrawal. It can be an adverse reaction to prescribed medication. There are a variety of treatments available, but benzodiazepines are a first-line treatment strategy. Electro-convulsive therapy is also sometimes used. Antipsychotics are sometimes employed but require caution as they can worsen symptoms and have serious adverse effects. Disorganized schizophrenia is characterized by prominent disorganized behavior and speech and flat or inappropriate emotion and affect. Unlike the paranoid subtype of schizophrenia, delusions and hallucinations are not the most prominent feature, although fragmentary delusions and hallucinations may be present. A person with disorganized schizophrenia may also experience behavioral disorganization, which may impair his/her ability to carry out activities of daily living, such as showering or eating. The emotional responses of patients diagnosed with this subtype can often seem strange or inappropriate to the situation. Inappropriate facial responses may be common and behavior is sometimes described as silly, such as inappropriate laughter. The patient may also display complete lack of expressions and avolition (a lack of motivation). The major needs of schizophrenic patients are structure, diversion to distract them from disturbing thoughts, and stress reduction to minimize the severity of the disorder. Do not argue with or support a psychotic patient’s delusions. Paranoid schizophrenia patients believe others are out to get him or her. Patients may be hostile, suspicious, and aggressive. The patient has excessive feelings of importance and power over others. The patient may also have delusions that focus on religious content. The somatic type is when the

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