Treatments of schizophrenia

Schizophrenia identified by the profound disruption of cognition and emotion which effects thought, perception and sense of self

Positive symtpoms of the disorder include delusions, experiences of control and hallucinations

Negative symtpoms - effective flattening and loss of interest

Two common treatments - use of drugs and cognitive-behavioural therapy

Chemotherapy - use of antipsychotic drugs to treat schizophrenia 

Conventional antischotics - combat positive symptoms which are due to an overactive dopamine system

Drugs reduce dopamine levels - they are dopamine antagonists -bind to receptors without stimulating them - block their action

Atypical antipsychotics also help treat positive symptoms however also help negative symptoms

Said to act on both dopamine and serotonin levels but no universal agreement on this 

Kapur & Remington (2001) - atypical act on dopamine receptors alone - it only occupies receptors for short time before normal transmission continues - advantageous as it means atypical drugs have a lot fewer side effects thn conventional drugs

Wealth of evidence to support the use of drugs in treatment - Davis et al (1980) analysed results from 29 studies and found relapse occurs in 55% of patients whose medication was replaced with placebo but was significantly less in those who remained on drug

Ross & Read (2004) - these results show 45% of those given placebo had no relapse and did well without drugs, suggesting they weren't needed - also argued that being given drugs reinforced that there is "something wrong with you" - prevents individuals looking for causes that can be fixed and thinking medication is only option

Also, despite some people seeing bigger benefits using atypical antipsychotics compared to conventional, a meta-analysis of studies revealed that the superiority of the drugs was only moderate - however atypical drugs still have less risk of side effects

Conventional anrtipsychotics - uncontrollable movements in 30% of ases, 75% are irreversable according to Hill (1986) - effects are lower in atypical

Jeste et al (1999) found movements happen in 30% taking conventional drugs and just 5% taking atypical - fewer side effects means patients more likely to take medication and help schizophrenia

Basic assumption is mentally-disordered behaviour is caused by distored beliefs which influence behaviour 

Maladaptive responses to problems is due to faulty thinking by the schizophrenic

During CBT patient develops alternatives to thoughts by looking at coping strategies alreadt present in their mind but they're unable to implement 

Usually takes place in weekly sessions for 5-20 sessions - patients trace back causes of their symptoms to get idea of when schizophrenia developed - crucial for patients and offering range of explanations for certain symptoms can reduce anxiety

Also encouraged to analyse content of their delusions and consider how they can test the validity of them 

May be given behavioural assignments - aim to improve general level of functioning

CBT can't completely elimate symptoms but allows patients to cope better with thoughts 

Outcome studied look at how well patient does after treatmnet - suggest people who underwent CBT experienced fewer hallucinations and delusions than those who recieved anytipsychotic medication alone

Dury et al (1996) - benefits in terms of reducing symptoms and 20-50% reduction in recovery time in patients given combination of medicaton and CBT

Kulpers (1997) supported this - found lower patient drop out raters and greater satisfaction when CBT & drugs combined 

As most studied involve patients on medication, difficult to asses effects of CBT alone 

However, commonly believed not everyone would benefit from CBT - in study of 142 patients, Kingdon and Kirschen (2006) found that many patients weren't deemed suitable for CBT as it was believed that they wouldnt fully engage with therapy - in particular older patients deemed unsuitable