AQA PSYB3 Psychology - Schizophrenia treatment notes

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Treatments for Schizophrenia
The most effective treatment is a combination of drug therapy, psychotherapy and social or community
Antipsychotic drugs
1. Conventional antipsychotic drugs
also called neuroleptic drugs because they often cause unwanted side effects of
physical movements e.g. muscle tremors similar to those in Parkinson's
Phenothiazines were the first antipsychotic drug to be used for schizophrenia in the
1950s. These are a type of antihistamine and the name of the drug used to treat the
disorder is Chlorpromazine. This reduces frequency and strength of positive symptoms
by blocking dopamine receptors and hence reducing dopamine
Chlorpromazine must be taken regularly and all the time even if no symptoms are
present otherwise the symptoms will return, often with great severity
Since this has been introduced the need for hospitalization has been reduced
Cole et al (1964) found that after just 6 weeks of treatment people showed significant
improvement compared to those given a placebo
Side effects:-
o Severe muscle tremors known as extrapyramidal effects because the drugs
affect these parts of the brain
o Shuffling of feet when walking, moving slow and rigid facial expression
o Restlessness and limb discomfort with bizarre face and tongue movements
o Tardive dyskinesia; jerky movements of the face, tongue or whole body
including involuntary chewing (difficult to eliminate)
These can be reduced or eliminated by also using anti-Parkinsonian drug
2. Atypical antipsychotic drugs
New generation of drugs which can reduce positive and negative
Most effective and commonly used are clozapine and risperidone. The former is
effective with schizophrenics who have not responded to conventional drugs
They are `atypical' because they work differently to conventional drugs; they change the
levels of serotonin
They have different side-effects to the conventional drugs including nausea, weight
gain, irregular heartbeat and excessive salivation. A few patients also develop a
possibly life-threatening disorder in which the levels of white blood cells drops
dramatically ­ agranulocytosis. There is also the occasional reporting of akathisia
(extreme restlessness and agitation)
Evaluation of drug treatments
Both types reduce the positive symptoms of schizophrenia, so that a person a live a relatively
normal life and not require hospitalisation
Atypical also reduce negative and so help even more with everyday life

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Both cause undesirable bizarre and significant side effects
Clozapine is associated with potentially fatal lowering of white blood cells and its use requires
regular blood monitoring
Newer drugs such as Risperidone do not cause distressing side effects but is expensive so
not widely used
About 2% of sufferers do not respond to the conventional antipsychotic drugs.…read more

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Used in psychiatric hospitals where patients receive rewards for behaving
appropriately and punishment or no reward for behaving inappropriate or disruptively
o If taken to the extreme, where basics such as food and water are used as rewards they
are shown to be effective but are sometimes regarded as inappropriate now and a
breach of basic human rights
Evaluation of behavioural treatments
SST is effective in increasing patients ability, comfort and assertiveness in social situations
(Birchwood and Spencer 1999)
It does not always generalise to…read more

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Assess the form and content of psychotic experience
2. Asses the emotional response
3. Asses the persons thoughts that accompany the emotion
4. Assess and prior warning or stimulus
5. Assess the individuals coping strategy in terms of its effectiveness
The therapy then progresses using two components;
1. Education and rapport training:- involves creating an ambience and
shared understanding between therapist and client
2.…read more

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CSE therapy is most effective on those suffering less severe symptoms or those already
receiving antipsychotic medication to control hallucinations and delusions
Research trials using cognitive therapy for delusions have demonstrated 40% reduction in the
severity of psychotic symptoms (Kuipers et al 1997)
During a period of acute psychosis, cognitive therapy led to a faster response to treatment in a
group of patients with schizophrenia compared with drugs alone (Drury et al 1996)
Community care
There has been a move away from hospitalisation and towards…read more


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