Schizophrenia simplex diagnosis is difficult because it depends decisively to consolidate progress walked slowly and progressively from a typical negative symptoms of schizophrenia, without a preceded by a history of hallucinations, suspicion, or other manifestations of psychotic episodes. Accompanied by changes in individualized behavior meaningful, manifest as a noticeable loss of interest, do not do something, without the purpose of life and social withdrawal. (PPDGJ – 3.2001)

Schizophrenia simplex is less clear psychotic sub-type compared with other types of schizophrenia. Causes of Schizophrenia simplex is generally the same as schizophrenia, which includes several factors:
1. Heredity
2. Endocrine System
3. Metabolic system
4. Central nervous
5. Theory of Adolf Meyer
6. Theory Sigmund Freud
7. Eugen Bleuler.
8. Schizophrenia as a syndrome
9. Schizophrenia is a psychosomatic disorder.

Symptoms – symptoms
Schizophrenia symptoms typical simplex is the emotional shallowness and setbacks will. Interference in the process of thinking hard. Supposition and hallucinations are rare, the emergence of very slowly.

Prognosis
Prognosis is generally considered matters as follows:
1. Pre psychotic personality
2. Schizophrenia incidence of attacks, acute better.
3. Type: Schizophrenia simplex type as hebefrenik and ugly, patients toward mental decline.
4. age: the younger the beginning, the ugly.
5. Treatment: the sooner the better.
6. Trigger: the trigger better.
7. Heredity: Some people in the family worse.

Medical
Schizophrenia treatment principle refers simplex pengebotan Schizophrenia disease, which include:
1. Psikofarmaka
2. Electro therapy convulsions
3. Insulin coma therapy
4. Psychotherapy and rehabilitation
5. Prefrontal lobotomies

IP II
1. Evaluating the regular schedule of patients
2. Train patients to control hallucinations in a way converse with other people
3. Advise patients included in the regular activity schedule

IP III
1. Evaluating the regular schedule of patients
2. Train patients to control hallucinations by doing activities (the usual activities of patients at home)
3. Advise patients included in the regular activity schedule

IP IV
1. Evaluating the regular schedule of patients
2. Provide health education about drug use on a regular basis
3. Advise patients included in the regular activity schedule

In Family Clients
IP I
1. Discuss the perceived problems in caring for the patient’s family
2. Explaining terms, signs and symptoms of hallucinations, and the types of hallucinations experienced by patients with the occurrence
3. Explaining the ways to care for patients hallucinations

IP II
1. How to train family practice treating patients with Hallucinations
2. Coaching families to how to care directly to patients Hallucinations

IP III
1. Helping families make the activity schedule at home, including taking medication (discharge planning)
2. Explain follow-up of patients after

1. Rowdy restless catatonic:
There hiperaktifitas motor but not accompanied with the proper emotion and not influenced by external stimuli. Clients continue to talk or move and steroitipi show, manerisme, grimas, Mologisme, can not sleep, not intake and drinking, so maybe there dehydration or collapse or occasionally death (drained and especially if there are bodily disease: heart, lungs, lung and so on). A mortal who is starting to improve the noise shizofrenia catatonic agitated repeatedly asked discharged from hospital. This thought of them through a variety of ways, so it is perceivable.
2. Stupor catatonic:
In catatonic stupor the patient showed no concern at all for the environment. Emotions such as shallow. Important symptoms are psychomotor symptoms such as:
a. Mutisme sometimes with eyes closed.
b. Face without expression like a mask.
c. Stupor, the patient does not move at all for a long time, a few days, sometimes up to several months.
d. When the patient changed his position challenged: negativism.
e. Denied food, saliva is not swallowed, so that accumulated in the mouth and melts out, urine and dejection were arrested.
f. There grimas and katalepsi. Suddenly or slowly the patient out of this stupor say and began to talk and move.

Same etiology as Shizofrenia catatonic shizofrenia general symptoms are:
1. Heredity
2. Endocrine System
3. Metabolic system
4. Central nervous
5. Theory of Adolf Meyer
6. Theory Sigmund Freud
7. Eugen Bleuler
8. Shizofrenia as a syndrome
9. Shizofrenia a psychosomatic disorder

Prognosis, generally think about the following matters:
1. Pre psychotic personality
2. Incidence of acute attacks superior shizofrenia
3. Shizofrenia Types: hebefrenik and simplex type as bad, patients towards mental decline.
4. Age: young growing increasingly bad prognosis
5. Treatment the sooner the better
6. Fakktor impetus: a superior trigger factor
7. Heredity: Some people in the family worse.

Treatment:
The principle of equal treatment of schizophrenia catatonic schizophrenia treatment in general are:
1. Farmakoterapi
2. Elektorkonvulsi Therapy
3. Psychotherapy and rehabilitation
4. Pre-frontal Hobotomi.

Predisposing factors
Various experiences of apiece mortal might be a predisposing bourgeois that might / might not occur if the following factors experienced by the individual:
Psychological; experienced unfortunate which can cause frustration can Arise aggressive or Berserk.
Behavior, reinforcement of diteima as violence, violence is often observed, is an aspect of violent behavior stimulates adopt
Socio-cultural; shut culture, social control would not create violent behavior as if the violent behavior acceptable
Bioneurologis; dilapidated limbic system, frontal lobe / temporal and imbalances neurotransmiser

Precipitation factor
Sourced from the client (physical weakness, despair, demand empowerment, self-confident or less), environment (noisy, crowded, critics pointed humiliation, loss of a loved one / employment and violence) and interaction with others (provocative and conflict).

To confirm the above information, the client’s mental illness, violent behavior can be caused by the interference of self-esteem: low self-esteem. Self-esteem is an individual assessment of the accomplishment of self by examining how much behavior in accordance with the saint self. Where disturbance of self-esteem can be described as negative feelings about yourself, lose confidence, sense of unfortunate to reach the desire.

Clients with violent behavior can perform hazardous acts for himself, others or the environment, such as attacking other people, breaking furniture, etc. to burn the house.

The second phase / condeming (severe anxiety)
- Increased anxiety associated with interpersonal and external experience, daydreaming, thinking himself to be a guide.
- Begin troubled by vague whispers
- Clients do not want others to know and he still can control

The third phase / controlling (severe anxiety)
- Whisper voice: The contents of the more prominent hallucinations, dominate and control the client,
- Clients to be used and become not believe the hallucinations

The fourth phase / Conquering (panic)
- Hallucinations turned into threats, and affect the client’s rule
- Client was afraid, do not believe it, lost control and can not significantly associated with others in the neighborhood.

Cause:
1. Predisposing factors
- Genetic: inherited, the development of the nervous system abnormalities associated with biologic response maladaptif.
- Neurobiological: a disturbance in the context of the pre-frontal and limbic cortex.
- Neurotransmitters: abnormalities in the dopamine, serotonin, and glutamate.
- Viruses: influenza virus exposure in trimester III
- Psychological: mom anxious, overprotective, dad did not care.
2. Precipitation Factor
- The process of processing information overload
- Mechanism of abnormal electrical conductivity
- A trigger symptoms

The characteristics of suspicion:
- Not realistic
- No logical
- Living
- Egocentric
- It is believed the truth of the patient
- There can be corrected
- Internalized by the patient as a real thing
- Say or believed it was not a part of local sociocultural.

Various kinds of supposition
- Supposition control thought (thought of being controlled). The patient believes that thoughts, feelings or behavior is controlled by outside forces.
- Supposition greatness (Delusion of grandiosty). Patients have the confidence that he is an important and influential people, might have hidden advantages power, or really a powerful figure in the history of man (eg General Sudirman, Napoleon, Hitler, etc.).
- Supposition caught. patients believe that each event in the surroundings have a individualized relationship such as orders or special message. Patients believed that foreigners around watching him, TV and broadcasting broadcasters to send a message with the language of your password.
- Supposition bizarre, is an odd supposition. Included in the bizarre supposition, among other things: suspicion parenthesis think / thought of insertion (to believe that someone has inserted his mind to the patient’s head); supposition Broadcast think / thought of broadcasting (the patient believes that thoughts can be known by others, other people seemed to be read the mind of the patient); supposition lipo think / thought of withdrawal (to believe that someone has taken out of his mind); supposition control thought; hipokondri supposition.
- Hipokondri supposition. Patients believed that in itself is the goal that must be removed because it can endanger themselves.
- Jealous suspicion. Jealous here is a pathological jealousy
- Suspicious supposition. Pathological suspicion that suspicion is excessive
- Threatened supposition. Trust or confidence that he always followed, threatened, harassed or there is a group of people who fill them.
- Pursue supposition. Believing that he was always being chased people
- Guilty supposition. Believing that he is the guilty
- Sinners supposition. Believing that he was innocent so it is always moody
- Supposition Not Useful. Believing that he was not worth it anymore, so often thought it was superior to die (suicide)
- Kiskin supposition. Believing that he is a poor man.

The family does not mean that should help all the regular needs of elderly people, so that the elderly tend to be silent and depend on the environment. All members are expected keluargapun active in helping elderly people in order to optimally perform their regular activities independently safely. Perform apiece day activities on a regular basis as most elderly people without dementia can reduce depression experienced by elderly people with dementia.

Patience is a demand of caring for family members who suffer from dementia. Mutually reinforce apiece other’s family members and always take time for yourself to rest and socialize with other friends can refrain the stress that can be experienced by family members who care for elderly people with dementia.

Elderly with dementia do something that they themselves sometimes do not comprehend it. This behavior can be hazardous to himself or others.

Reference
1. Grayson, C. (2004). All about Alzheimer’s. Retrieved on October 2006 from

2. Harvey, R. J., Robinson, M. S. & Rossor, M. N. (2003). The prevalence and causes of dementia in people under the age of 65 years. Journal Neurosurg Psychiatry, 74: 1206-1209.

3. Mace, N. L. & Rabins, P. V. (2006). The 36-hour day: a family guide to caring for people with Alzheimer’s disease, other dementias, and memory loss in later life (4th Ed.) Baltimore, USA: The Johns Hopkins University Press.

4. Volicer, L., Hurley, A.C., Mahoney, E. (1998). Behavioral symptoms of dementia. In Volicer, L., Hurley, A.C. (Eds), Hospice care for patients with advanced progressive dementia. New York: Springer Publishing Company.

Most researchers in the research concurred that the main cause of the symptoms of dementia is Alzheimer’s disease, vascular disease (blood vessels), Lewy body dementia, frontotemporal dementia and ten percent of them caused by other diseases. Fifty to sixty percent of the causes of dementia is Alzheimer’s disease. Alzhaimer is a condition in which nerve cells die in the brain that makes signals from the brain can not transmit properly (Grayson, C. 2004). Alzheimer’s memory impaired, the capability to make decisions and also decrease the thinking process.

The interesting thing is the symptoms of dementia sufferers adannya changes in personality and behavior that affect their regular activities. Patients are referred to in this paper is the Elderly by age sixty-five years old and above. Elderly people with dementia do not show a prominent symptom in the primeval stages, they are as old people in general experience of aging and degenerative process. Initial awkwardness felt by the sufferers themselves, they are hard to remember the obloquy of their grandchildren or forget putting an item.

Symptoms of dementia that comes next is usually a depression in elderly people, they kept their distance with the environment and more sensitive. Such conditions might be followed by the emergence of other diseases and usually will worsen the condition of elderly people. At this time might be very frightened elderly people even hallucinate. This is where families Elderly patients with dementia to the hospital where dementia is not the main focus of this investigation.

Dementia often escapes examination and not terkaji by health teams. Not all health workers have the capability to assess and recognize the symptoms of dementia. Assess and diagnose dementia is not an simple and fast, needs a long time before to ensure a positive mortal suffering from dementia. At least five types of critical tests to be done, starting from the individual background studies, physical examination, neurological examination, assessment of mental position and the necessary supporting work tests.

In advanced stages of dementia led to changes in behavior are increasingly worried about, so it was important for families to comprehend well behavior changes experienced by elderly people with dementia. Understanding changes in behavior can result in dementia empathy that is needed by the family members who must care for them patiently. Changes in behavior (behavioral symptoms) that might occur in elderly people with dementia include delusions, hallucinations, depression, alteration to body functions, anxiety, spatial disorientation, inability to conduct meaningful action, can not perform regular activities independently, against, anger, agitation, apathy, and fled from their homes.

Various conditions or illnesses (ranging from mild dehydration to drug toxicity or infection can be fatal), can cause delirium.

Causes of delirium:
# Alcohol, drugs and toxic substances
# Toxic effects of treatment
# Levels of electrolytes, salts and minerals (eg calcium, sodium or magnesium) is not normal due to medication, dehydration or certain diseases
# Acute infections with fever
# Hydrocephalus normal pressure, ie a say where the pillow brain fluid is not absorbed properly and near the brain
# Hematoma subdural, videlicet the collection of blood under the skull that can suppress the brain.
# Meningitis, encephalitis, syphilis (infectious disease that attacks the brain)
# Lack of thiamine and vitamin B12
# Hypothyroidism and hypothyroidism
# Tumors of the brain (some of them dazed and sometimes cause memory problems)
# Hip fracture and the long bones
# Function of the heart or lungs causing bad and low oxygen levels or high levels of carbon dioxide in the blood
# Stroke.

The main characteristic of delirium is not healthy to focus.
The patient can not concentrate, so they have difficulty in processing new information and can not remember the events that had just happened.

Almost all patients experienced disorientation of time and confusion with the place where they are.
Their minds confused, delirious, and there inkoherensia.

In severe cases, patients do not know themselves.
Some people experience paranoia and delusions (believing that was going on the things that strange).

Patient’s response to the difficulties it faces different; there is a very quiet and withdrawn, while others become hyperactive and tried to fight hallucinations and delusions experienced.

If the cause is drugs, then often behavioral changes. Drug toxicity causing the patient to sleep very quiet and withdrawn, whereas amphetamine poisoning causes sufferers to be aggressive and hyperactive.

Delirium can last for hours, days or even longer, depending on the weight of symptoms and patient medical environment.Delirium is often worse at night (a phenomenon known as the sun sets). In the end, the patient will sleep restless and might develop into coma (depending on the cause).

Diagnosis based on symptoms and determined the cause as soon as possible. A complete physical examination and focused on patient neurological response. Another Examination is usually conducted blood tests, X-rays and lumbar pungsi.

Treatment depends on the cause;
- Infection treated with antibiotics
- Fever lowering drugs overcome by heat
- Disorders of salt and mineral levels in the blood overcome by setting fluid and salt levels in the blood.

To alleviate the agitation given drugs benzodiazepines (eg diazepam, triazolam and temazepam).
Anti-psychosis (eg haloperidol, tioridazin and klorpromazin) is usually given only to patients who experienced paranoid or scared or patients who can not be comforted by benzodiazepines.
If the cause is alcohol, benzodiazepines given until the patient lost agitation.

In the lay people who deal with patients having delusions would look real, this is caused by facial expressions so convincing that people will believe in what is being stated by individuals with delusional disorders are. Patients will be seen as normal as anyone else during the last episode theme. Known as delusional disorder delusional if appearance is not caused by a medical condition.

Type of delusion
There are several types of delusions among others;
• Delusion of erotomanic; individuals or patients to trust a mortal has an important position and involved romance with him.
• Delusion of grandiose; patients believe that he has more knowledge, talent, insight, strength, trust people, or have special relationships with famous people and even God.
• Delusion of jealous; patients believe that their partner was having an affair or can not be trusted.
• Delusion of persecutory; patients believe that he cheated, spied on, followed, slandered and do not trust other people.
• Delusion of somatic; patients believe that her body felt the sensation of something or feel any of the internal organs are not functioning properly.
• Type mixture; have more than one delusional theme
• Type is not defined; if not included in existing categories above, or other types related to local culture

Several other types of delusions in psychotic disorders;
• Delusion of control; supposition which the individual assumes that she controlled from outside, or someone else
• Delusion of influence, the patient felt himself influenced by something outside himself the power of
• Delusion of passivity, where the individual in ketidaberdayaan, felt himself the most miserable people
• Delusion of perception, sensory experience that is amusing to the mystical or miraculous
• Type mixture; have more delusional than one theme or another type related to the local culture