Treatments of Schizophrenia

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first developed by Cerletti and Bini (1938)- thought that ECT could be stopped by inducing seizures in the patient because not many people with epilepsy get schizophrenia- just a relationship, no cause and effect

side effects?- memory loss, broken bones, confusion and disorientation Bennet (2003) found patients described it as terrifying, abusive invasion, repeat of early traumas (e.g. sexual abuse) and said that it reduced their trust in mental health professionals. Royal College of Psychiatrists (1997) said that it doesn't cause any long term damage to memory or intelligence but can cause mental and emotional dysfunction

how does it work?- Benton (1981) says it works in three ways, operant conditioning- acts as a punishment for hallucinations etc. but this wouldn't work because it wouldn't be consistent and probable as a patient wouldn't recieve ECT everytime they hallucinate, suggesting change in voluntary, also memory loss means that thinking can be reconstructed- howevever unilateral ECT doesn't cause memory loss but is still effective & biochemical changes in the brain involving neurotransmitters. Abrams (1997) modern ECT researchers don't have more of a clue than when it first came out

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Evaluation of ECT

difficult to measure results unlike with chemotherapy

Tharyan and Adams (2005) found that when ECT was compared with a placebo, more people imporved in the real ECT situation however Sarita et al (1998) found that there was no difference in 36 schizophrenic patients given either ECT or stimulated ECT

ignores the role of psychological and social factors 

mixed evidence so we can't be sure whether it does work

seems to work well when combined with chemotherapy

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Ethical Issues of ECT

ethics- consent? right to withdraw? protection from harm?

advantage of psychosurgery as there is less damage caused and it's less invasive 

use of ECT has declined rapidly over the past few decades 59% in UK 1979-1999

if we are unsure of how it works there may be long term effects that we don't know about, surely we should understand how it works fully before using it on patients

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challenges maladaptive thoughts and replaced them with constructive thinking

how effective is it for schizophrenia?- Drury (1996) found that it reduces positive symptoms and recovery time especially when combined with chemotherapy, however it's uncertain how successful CBT is because it's almost always combined with chemotherapy. Kingdon and Kerscher (2006) not suitable for everyone e.g. people who have been suffering with schizophrenia for a longer period of time because it's harder to show them that what they are thinking is not real such as hallucinations

for patients that hear voices?- cognitive, faulty information processing Frith (1992) says that the voices they are here are actually their own being misinterpreted- CBT can help patients control the voices and recognise them as being part of their own mind. Bentall et al (1994) argues however that emphasis should be on controlling thought processes rather than understanding the unconscious thoughts and feelings behind them

this could limit the effectiveness of CBT because the maladaptive thoughts are still there, and patients are being taught to only pay attention to them sometimes

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Evaluation of CBT

ignores the role of family and society in the cause and maintenance of schizophrenia

doesn't fix the biological causes such as genetics and neurotransmitters 

Bentall et al (1994) CBT may be good for patients suffering their first episode of schizophrenia as it is easier to challenge their thoughts because they can remember a time when the didn't have them 

costly and time consuming compared with ECT 

CBT is most effective when combined with chemotherapy because it acknowledges more of the factors that cause schziphrenia- diathesis stress model, environmental and biological

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