Exam 1 Study Guide 220
🧠 Development & Progression of Schizophrenia
1️ Early / Premorbid Phase
Subtle, slow changes (often in adolescence).
Personality traits: shy, withdrawn, poor peer relationships, academic underachievement.
These are early warning signs, not yet psychosis.
2️.Prodromal Phase
Gradual deterioration in functioning (weeks–years).
May see:
o Social withdrawal
o Neglect of hygiene
o Unusual behavior/thoughts
o Depressed mood
This is when negative symptoms (like lack of motivation, flat affect) often start
showing.
3️.Active / Acute Psychotic Phase
This is when positive symptoms appear:
o Delusions (fixed false beliefs)
o Hallucinations (auditory most common)
o Disorganized speech/behavior
o Catatonia (rare, but possible)
Often requires hospitalization.
4️.Residual Phase
After acute episode subsides (often with meds).
Positive symptoms may lessen.
Negative symptoms (avolition, flat affect, anhedonia, social withdrawal) persist and
worsen with repeated episodes.
, Positive vs. Negative Symptoms
Positive Symptoms = “added on” experiences not seen in healthy people
o Hallucinations
o Delusions
o Disorganized speech/behavior
Negative Symptoms = “loss” of normal characteristics
o Avolition (lack of motivation)
o Anhedonia (lack of pleasure)
o Alogia (poverty of speech)
o Flat or blunted affect
o Social withdrawal
💊 Nursing/Exam Pearls
Positive symptoms respond well to typical antipsychotics.
Negative symptoms are harder to treat, but atypical antipsychotics (e.g., risperidone,
clozapine) can help.
Long-term outcome is often tied more to negative symptoms, because they impair daily
functioning.
✅ So you’re absolutely right:
Schizophrenia starts subtly (shy, poor socialization, isolation) → progresses slowly →
leads to acute positive symptoms → stabilizes into a phase dominated by negative
symptoms.
💊 Antipsychotics in Schizophrenia
1️. Typical (First-Generation) Antipsychotics
Examples:
Haloperidol (Haldol)
Chlorpromazine (Thorazine)
Mechanism: Strong dopamine D2 receptor blockade
❌
↓ Positive symptoms (delusions, hallucinations)
Little effect on negative symptoms
🧠 Development & Progression of Schizophrenia
1️ Early / Premorbid Phase
Subtle, slow changes (often in adolescence).
Personality traits: shy, withdrawn, poor peer relationships, academic underachievement.
These are early warning signs, not yet psychosis.
2️.Prodromal Phase
Gradual deterioration in functioning (weeks–years).
May see:
o Social withdrawal
o Neglect of hygiene
o Unusual behavior/thoughts
o Depressed mood
This is when negative symptoms (like lack of motivation, flat affect) often start
showing.
3️.Active / Acute Psychotic Phase
This is when positive symptoms appear:
o Delusions (fixed false beliefs)
o Hallucinations (auditory most common)
o Disorganized speech/behavior
o Catatonia (rare, but possible)
Often requires hospitalization.
4️.Residual Phase
After acute episode subsides (often with meds).
Positive symptoms may lessen.
Negative symptoms (avolition, flat affect, anhedonia, social withdrawal) persist and
worsen with repeated episodes.
, Positive vs. Negative Symptoms
Positive Symptoms = “added on” experiences not seen in healthy people
o Hallucinations
o Delusions
o Disorganized speech/behavior
Negative Symptoms = “loss” of normal characteristics
o Avolition (lack of motivation)
o Anhedonia (lack of pleasure)
o Alogia (poverty of speech)
o Flat or blunted affect
o Social withdrawal
💊 Nursing/Exam Pearls
Positive symptoms respond well to typical antipsychotics.
Negative symptoms are harder to treat, but atypical antipsychotics (e.g., risperidone,
clozapine) can help.
Long-term outcome is often tied more to negative symptoms, because they impair daily
functioning.
✅ So you’re absolutely right:
Schizophrenia starts subtly (shy, poor socialization, isolation) → progresses slowly →
leads to acute positive symptoms → stabilizes into a phase dominated by negative
symptoms.
💊 Antipsychotics in Schizophrenia
1️. Typical (First-Generation) Antipsychotics
Examples:
Haloperidol (Haldol)
Chlorpromazine (Thorazine)
Mechanism: Strong dopamine D2 receptor blockade
❌
↓ Positive symptoms (delusions, hallucinations)
Little effect on negative symptoms
