As someone else said in another thread about sitting with patients who are on 1:1 precautions, it can be reaaaaaaally boring. I would much rather be up, making rounds and providing care for patients than sit and watch a patient sleep. I feel more worn out after a night of sitting with a 1:1 patient than I do being up & about on a busy night.
I was sitting with Bob, a patient diagnosed with schizophrenia who is psychotic and can be a behavior problem, on one particular night. Bob was awake, yet resting quietly in bed when I took over the 1:1.
Bob acknowledged me when I came into the room: "Daaaaaave!", I smiled and nodded to him and said nothing more. So I sat there, feeling sleep-deprived, ready to hit the wall, when Bob again said "Daaaaaave!" So I said, "Boooooob!" and Bob repeated, "Boooooob!" I said, "No, you're Boooooob, and I'm Daaaaaave!" Bob repeated, "No, you're Boooooob, and I'm Daaaaaave!"
I soon found out that Bob would repeat anything I said, indicating he was manifesting a symptom of psychosis called echolalia.
So, from memory, I began reciting The Berenstains B Book, a book I had read perhaps a hundred times to Head Start children when I worked as a teacher's aid back in 1981. Bob repeated each portion:
"Big Brown Bear" "Big Brown Bear"... "Blue Bull" "Blue Bull" .... "Beauuuuuutiful Baboon" "Beauuuuuutiful Baboon"... "Blowing Bubbles"... all the way through the the Berenstain Bears "biking backwards, bumping Black Bugs banna boxes, Billy Bunny's bread baskets, Brother Bob's baseball bus, and Buster Beagle's Bagpipe bugle band (which) busted Baby Bird's balloon"!
For 45 minutes we repeated The Berenstains B Book, sometimes backwards, starting with Baby Bird's busted balloon and ending with Big Brown Bear. Bob seemed to enjoy echoing each portion, but he could not echo more than three words at a time. So, for example, I broke down Buster Beagle's bagpipe.... bugle band into two portions.
I mentioned that Bob was my echo and Bob said, "Bob is my echo", which eventually went to a "mellow echo" and then to a "cello echo".
I wondered aloud if a cello said "celllllo!" instead of "helllllo!" and kept repeating it, if that cello wasn't also manifesting a specialized symptom of psychosis:
Being sleep-deprived and sitting with a 1:1 psych patient on a MN shift will cause one to do and think such things.
Specializes in Psych (25 years), Medical (15 years).
18 minutes ago, amoLucia said:
perseveration? My brain is foggy now but I'm thinking something along this line when pts repeat & repeat.
Repetition is a symptom of both depression and psychosis, Amolucia. Typically, in thought, repetition is a symptom of depression, in word, psychosis.
Typical and atypical dopamine antagonists, antipsychotics, help with both cases. I've seen low doses of atypical antipsychotics along with an SSRI antidepressant work wonders on patients diagnosed with MDD, with or without psychotic features. The spectrum of psychosis associated with repetition, treated with both typical and atypical antipsychotics, also have some really good results.
18 minutes ago, amoLucia said:
Hammy died over last summer if I remember right. Was kind of the group's collective pet.
Uh, is echolalia the real term? I'm too lazy to look it up. Bad me!
I had to look it up too. Then i saw DaveyDo's other thread (sesrunlla) and thought wow another medical term i have never heard, DaveyDo sure is smart!!
Having sat with many patients myself I think I would rather have a patient with Echolalia than some of the ones I have had. I worked neuro for awhile and had a pt with TBI who kept getting out of his restraints and was constantly walking into walls etc, the guy was like Houdini, even got out of a posey with 4 soft restraints, very long 12hrs!
Davey Do
10,666 Posts
Repetition is a symptom of both depression and psychosis, Amolucia. Typically, in thought, repetition is a symptom of depression, in word, psychosis.
Typical and atypical dopamine antagonists, antipsychotics, help with both cases. I've seen low doses of atypical antipsychotics along with an SSRI antidepressant work wonders on patients diagnosed with MDD, with or without psychotic features. The spectrum of psychosis associated with repetition, treated with both typical and atypical antipsychotics, also have some really good results.
My condolences.