Schizophrenia overview
- Created by: molliegeorgiou
- Created on: 21-09-15 21:08
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- Schizophrenia Unit 4
- Symptoms
- Positive
- Delusions
- Grandeur
- Persecution
- Hallucinations (auditory/visual)
- Experiences of external control
- Disordered thinking
- Delusions
- Negative
- Affective flattening
- Alogia - poverty of speech
- Avolition - inability to persist in goal-directed behaviour
- Alogia - poverty of speech
- Lack of motivation/interest
- Affective flattening
- Positive
- Subtypes
- Disorganised
- Inappropriate emotions/behaviour
- Paranoid
- Delusions and mostly auditory hallucinations
- Residual
- Minor
- Undifferentiated
- Catatonic
- Stupor/excitement
- Disorganised
- Biological
- Genetics
- Twin/family/adoption studies
- Concordance
- Diathesis stress model - genetic predisposition triggered by environment.
- 'Schizophrenia spectrum disorders'
- Cardno et al (1999) - 40% MZ but 5.3% DZ
- Tosato et al - gene mapping - no singular gene
- Dopamine Hypothesis
- Snyder ... Davis
- Abnormal D2 receptors
- Developed after effects of L-dopa
- Healy - pharmaceutical companies
- Cause or effect?
- L-dopa
- Davis et al - relapse 55% placebo but 19% drug
- Lloyd et al - if factor is indirect, caused by family circumstances
- Neuroanatomy
- Differences in size of ventricles.
- Lambert and Kinsey - due to space left by smaller frontal and temporal lobes OR abnormal blood flow to parts of brain
- Cause or effect? MRI usually AFTER symptoms
- Many perspective studies use animals
- Genetics
- Psychological
- Psychodynamic
- Pre-ego state
- Harsh upbringing
- Unable to distinguish between imagination and reality
- Oltmanns et al - parents DO behave differently
- BUT is this cause or effect?
- Explanatory power - e.g. loss of reality
- However, no other childlike behaviour?
- Abstract
- Cognitive
- Hemsley (1993)
- Schemas
- Sensory overload
- Schemas
- Frith (1992)
- Meta-representation problems - positive symptoms
- Central control problems - negative symptoms
- Conscious vs preconscious processing
- Central control problems - negative symptoms
- Meta-representation problems - positive symptoms
- Bentall et al
- Not universal
- Doesn't explain why voices are abusive - British Journal of Psychiatry study
- Hemsley (1993)
- Socio-cultural
- Labelling theory
- Rosenhan
- Child of its time? MacLeod
- Expressed emotion
- Cause or effect?
- Hogarty et al (1991) - therapy reduced relapse rates
- Double-Bind Theory
- Berger (1965)
- Liem (1974)
- Labelling theory
- Psychodynamic
- Treatments
- Biological
- ECT
- Side effects
- BUT death rate of 1 in 10,000
- Sarita et al - no difference between real and fake ECT
- Side effects
- Drug therapy
- Less than 3% in hospital
- Davis et al - relapse 19% vs 55% placebo
- Side effects (e.g. 30% TD)
- However, atypical less severe
- Revolving door syndrome
- ECT
- Psychological
- Psychoanalysis
- Eysenck - control group 66% recovered - more than psychoanalysis
- Bergin - patients in one of the control groups were in fact hospitalised
- YAVIS effect
- Smith et al (1980) - those receiving psychodynamic therapies scored higher for improvement
- BUT 50% students - not representative
- Eysenck - control group 66% recovered - more than psychoanalysis
- CBT
- Kuipers - reduction in symptoms and lower drop-out rates when used with antipsychotics
- BUT study didn't use control or blind trial
- Older patients found to be less suitable than younger
- Kuipers - reduction in symptoms and lower drop-out rates when used with antipsychotics
- Family Intervention
- NICE (2009) - reduction in relapse compared to standard
- NICE review - saves money as reduces hospitalisation
- Pharoah et al - complying with treatment - biological
- Psychoanalysis
- Biological
- Symptoms
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