WJEC A2 Psychology PY4 - Two Treatments of Schizophrenia

Two Treatments of Schizophrenia

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Chemotherapy Treatment of Schizophrenia

1. Chemotherapy

  • people with Sz almost always treated with anti-psychotic medication
  • can be administered to stabilise patients during or after a psychotic episode, either in a psych ward or as patient within the community (self-administration)
  • two types of anti psychotics: typical (older) and atypical (newer)
  • both work by altering activity level of chemicals (neurotransmitters) in brain
  • Sz anti psychotics = dopamine antagonists = lessen activity of dopamine
  • anti psychotics work by blocking dopamine receptors in the post synaptic neuron, reduces influence of dopamine on thought, behaviour and emotion

EVALUATION (Typical anti psychotics)

(+) Cole et al (1964)

  • investigated effectiveness of drug treatments compared with placebos
  • patients given anti psychotics showed 75% improvement compared with 25% improvement if given placebos
  • suggests drug therapy is effective for treating psychotic illnesses
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Chemotherapy Treatment of Schizophrenia

(-) HOWEVER...

  • anti psychotics not effective for everyone as improvement rate not 100%
  • 25% of those given placebo showed improvement = suggests act of receiving treatment alone effective in reducing symptoms regardless of actual treatment

(-) Hello/Goodbye Effect

  • success of drug could be due to this effect = when patient overestimates symptoms at the onset of symptoms (to elicit help) and underestimates their symptoms at the end of treatment (to show appreciation for the help)

(+) Other treatments reduced

  • drug treatments drastically altered how Sz patients treated; lengthy hospital stays not necessary (reducing overcrowding and institutionalisation)
  • older, more barbaric treatments, like insulin shock treatment, reduced; eventually banned = more ethical and humane
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Chemotherapy Treatment of Schizophrenia

(-) Negative symptoms/side effects

  • typical anti psychotics effective in treating Sz positive symptoms (hallucinations, delusions), not nearly as effective at alleviating the negative symptoms (lack of emotion, social withdrawal)
  • muscle tremors, drowsiness and weight gain; about 1 in 20 experience permanent movement in the tongue and mouth called tardive dyskinesia

(-) Revolving Door Syndrome

  • drugs only treat symptoms, not a cure; patients often stop taking the drugs as feel better, cannot cope with side effects or just forget
  • leads to 'RD Syndrome' of continual discharge into the community and then readmission to hospital, due to medication non-compliance


(+) atypical drugs treat negative symptoms and produce less side effects than other anti psychotics (Gelder et al, 1999)

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Chemotherapy Treatment of Schizophrenia

(-) HOWEVER...

  • one side effect is possible development of fatal blood disorder - agranulocytosis = causes a depletion of white blood cells, can occur spontaneously at any stage in treatment, therefore monthly blood tests are vital if atypical anti psychotics used

(?) May (1968)

  • studied various treatments available to Sz and found most effective to be anti psychotics with psychotherapy, suggests drugs alone cannot provide complete treatment for the illness
  • May conducted follow up study in 1976, found very similar results, increases reliability of original findings
  • strengthens the view that there is a need for combination of treatment methods in order to effectively manage Sz
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Family Interventions (Reducing EE) Treatment

2. Family Interventions (Reducing EE)

  • Family Intervention target families where there are high levels of EE
  • Intervention programme should continue for at least 9 months with family sessions at least monthly
  • professional staff part should adopt a non-judgemental approach
  • aims of Family Intervention include reductions of relapse frequency into illness and hospital admissions, reduction in the burden of care on families/carers, and improvement in medication compliance
  • programme includes education prog; analysis of family relationships/functioning; family sessions to identify/address problems and relative support groups
  • help family cope with illness and not to allocate blame for relationship difficulties
  • the changes that are hoped for after the programme are: construction of an alliance with the family; improvement of adverse family atmosphere; enhancement of relatives' anticipating and solving problems; reduction of feelings of anger/guilt by the family; attainment of desirable change in relatives' behaviour and belief system
  • families may merit priority where patient relapses frequently or highly violent
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Family Interventions (Reducing EE) Treatment


(+) Brown, Briley + Wing (1972)

  • found that following admission to hospital, Sz patients discharged to environment with high EE are 3 or 4 times more likely to relapse than those moving to environment with low EE
  • suggests that if family intervention is successful in reducing EE, this should decrease chances of Sz patients relapsing

(+) Anderson and Adams (1996)

  • suggest family interventions have been formulated to reduce features of high EE, to lessen the burden on carers and reduce the frequency of relapse

(-) Research

  • no research into effectiveness of family intervention without medication, effectiveness in the absence of medication is not known, reduces the validity
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Family Interventions (Reducing EE)

(-) Measurement of EE

  • measurement not easily quantifiable, not necessarily objectively measured
  • difficult to have one family intervention programme for all families because no guarantee that EE has been measured correctly, even if prog tailored

(-) Intervention Strategy

  • most intervention strategies (IS) contain more than one technique (eg social skills training, vocational rehabilitation included in some studies)
  • separating and defining effects of individual components of an IS difficult

(+) HOWEVER...

  • practice guides have been published = give detailed descriptions of techniques

(-) Resistance from families

  • suggested those families who are more receptive to family intervention (and change) need it least; those who need it most are most resistant to having it
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Aarti Patel

heyyy how is 

Family Interventions (Reducing EE) a treatment for sZ ????im confused 

Zoey Jowett

hi, i'm sorry i haven't got back to you sooner!
because research has shown that high levels of expressed emotion (EE) can cause a relapse in schizophrenia and family intervention programmes are used to try and reduce the levels of EE in order to avoid any relapsing:)

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