Treatments for schizophrenia

Biological and psychological treatments for schizophrenia

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  • Treatments for schizophrenia
    • Biological
      • Antipsychotics
        • First line of treatment
        • Can be taken orally or via injection.
        • Take until episodes cease however long term is recomened.
        • Reduces anxiety and aggression. And later reduces other symptoms such as hallucinations and delusions
        • Conventional
          • 1st generation - 1950's
          • Reduce dopamine - blocks receptors
          • Only eliminates positive effects
          • AO2/AO3
            • Relapse rate - significantly less relapse rate between treatment and placebo groups.
            • Need to consider other factors those who went back to a hostile environment had a relapse rate of 53% but those who went back to a supportive environment had a relapse rate of 12%
            • Tardive dyskinesia - side effect of the drugs. about 30% of patients get it and in 75% its irreversible.
        • Atypical
          • Newer generation developed in the 1990's.
          • Blocks dopamine and serotonin recpetors
          • Reduces positive and negative symptoms
          • AO2/AO3
            • meta-analysis - only marginally better than conventional.
            • improvements of negative symptoms. 2 drugs slightly more effective, one as effective and one slightly worse.
            • Lower likelihood of tardive dyskenisia with only 5% of patients getting it.
            • Less side effects so patients want to continue their treatments and therefore see more benefits.
      • Electro-convulsive therapy
        • Inducing a seizure to reduce symptoms.
        • AO2/AO3
          • Meta-analysis - 1/2 of pp's showed short term benefits but did last as long as the control group.
          • 19 ECT studies were compared with simulated ECT, found that it was no different than anti-psychotics
          • Significant risk: brain damage permanent memory loss even death.
    • Psychological
      • Cognitive behavioural therapy (CBT)
        • AO2/AO3
          • CBT doesnt always address the negative symptoms.
          • Most patients are treated with drugs alongside cbt so we dont know which one is having the effect
          • Not all benefit from CBT and younger patients benefitted more than older ones.
          • Gould et al - meta analysis - significant decrease in the positive symptoms after treatment.
        • Reattribtuion therapy - look at previous maladaptive responses to things that have happened in their lives.
        • adjusts thinking patterns and alters irrational beliefs
        • Encourages patients to think back and try to find out hoe the symptoms may have come about.
        • Based on irrational + unrealistic thoughts.
        • Belief modification - patients are encouraged to evaluate the content of their halluciations and delusions.
      • Psychoanalysis
        • Freud saw schizophrenia as an organic problem rather than a psychological one.
          • He renounced the idea of using psychoanalysis with psychotics
        • AO2/AO3
          • American medical boards say that the therapy should only be used along side drug therapy
          • It is very expensive and long term and doesn't appear to be any more effective than the cheaper drug therapies.
          • It is argued that it is impossible to say for whether psychoanalysis is beneficial and some can even be harmful. however a meta-analysis that is was an effective trwatment
        • Harry stack sulivan - pioneered the use of psychoanalysis with schizophrenic patients.
          • Schizophrenics reflect a return to early childhood forms of communication.
          • The individual has a fragile ego + unable to cope with stress and so regreses
        • The therapy requires the patient to learn adult forms of communication and understand the role of the past in their problems.

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