Treatments of schizophrenia

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Introductions and ECT

  • Schizophrenia is a mental dosorder with positive and negative symptoms including hallucinations, delusion and blunted or flat effect.
  • ECT - first developed by Certelli and Bini (1938) whi noticed that schizophrenia was rare in people with epilepsy. They believed by inducing a siezure in a schizophrenic, they would reduce or eliminate symptoms.
  • ECT passes an electrical current of 0.6 amps through electrodes placed either side of the head for 0.5 seconds. Modern ECT patients are unconscious to paralyse the muscles so no brokemn bones occur. Pateints usually need between 3 and 15 treatments of the therapy.
  • Bennet (2003) reserached pateints experiences of ECT and many described it as a terrifying experience. 
  • Health issues involved with ECT, e.g distruption to the pateints memory and leave pateints feeling distressed and disorientated. However Royal College of Psychiatrists (1997) claim that ECT does not have any long term effects on memory or intelligence. Reliable study to use as it is the examining body and well-know society.
  • Benton (1981) explained that pateints see ECT as a punishment for thier behaviour. It cannot be a good punishment as to be effetcive punishments need to be aversive, immediate and consistant. ECT is not neither immediate or consistant.
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ECT (continued)

  • Sarita et al (1998) found no difference between 36 schizophrenic pateints treatedwith ECT or stimulated ECT in symptom reduction. However, small sample so may not be reliable.
  • APA listed 19 studies that compared ECT with stimulated ECT. Found that ECT was no better or worse compared to stimulated ECT. Meta-analysis so reliable.
  • Tharyan and Adams (2005) found when ECT compared to a placebo, more people improved with ECT howveer, this was not long term adn was more effective when combined with medication.
  • Alll studies may nto be valid as difficult to give placebo ECT.
  • Many ethical issues involed with ECT including the right to withdraw and not in the right state of mind ot give infomred consent.
  • ECT ignores psychological and social factors - shows why it is more effecitve when combined with medication.
  • However, it is less invasive and expensive compared to psychosugery.
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CBT and conclusion

  • CBT is the therapy given to schizophrenics to change their thinking and learn new behaviours. It gives psychological explanations for hallucinations and hearing vioces to reduce anxiety in pateints. Most pateints have between 5 and 20 sessions.
  • Drury et al (1996) found a reduction in postive symptoms and 25-50% less reconvery time with schizophrenics given a combination of antipsychotic drugs and CBT.
  • Kulpers (1997) noted that is is difficult to find how effective CBT is because is it usually combined with medication to deal with any physiological causes of schizophrenia.
  • Kingdon and Kirchen (2006) found that many pateints (paticualrly older ones) were seen as unsuitable for CBT as psychiatrists believed that they would not fully engage in the therapy. Thus means al studies for CBT only involve younger patients - age bias - not generalisable.
  • Conclision - ECT and CBT are more effective when combined with medication because treating both psychological and biological symptoms. Indicates more than one cause of schizophrenia.
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