Schizophrenia

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What can Schizophrenia not be?
cured
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Since when has biological treatments been based on?
1950s, antipsychotic drugs
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What have they become?
available to tackle the imbalance of dopamine associated with the positive symptoms of S
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What are these positive symptoms?
hallucinaions, delusions and word salad
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What treatment was available before the 1950s?
A cold bath and shock treatment
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What was the first generation of drugs called?
typical antipsychotics
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Such as what?
Chloropromazine
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What symptoms did they combat?
the positive symptoms by reducing levels of dopamine
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What do these dopamine antagonists do?
bind to D2 receptors
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How?
blocking their action and letting less dopamine into the post synaptic membrane
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What are the new drugs called?
atypical antipsychotics
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such as?
Clozapine
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What do they combat?
positive and negative symptoms
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What are they associated with?
loss of normal function- a lack of emotion/disinterest in life)
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What do these drugs also act on?
D2 receptors
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but what do they do?
only block them temporarily
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leading to what?
fewer side effects
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What else do they work on?
serotonin systems as well
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What does research suggest?
the success rate for anti-psychotic drugs is somewhere between 70-80%
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what is a strength of these anti-psychotic drug treatments?
comes in supporting evidence
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from whom?
Davis
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How many results did he analyse?
29 studies
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How many pps?
3519 pps
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How many pps did he find relapse into Schizophrenia?
55% of patients who drugs were replaced by a placeo, bu
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What was relapse for pateints who remained on the drug?
19%
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What does this suggest about drug treatments?
they are an effective way of treating s
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What do they improve?
the quality of people's loves
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In methodological terms,Why should the background research which underpins these treatments be applauded?
it is objective, scientific and thus reliable.
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For example, what was the use of the placebo?
the placebo groups enable comparisons and predictions to be made
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However, what would critics question?
some details of the research,
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for example?
there may be individual differences between the pps with
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In what?
the drug and the placebo groups that affect the outcome of the drug treatment
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What is the weakness of the first type of treatment?
many anti-psychotic drugs have side effects
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For example?
30% of paitents taking typical drugs develop tardive dyskinesia
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What does this led to?
uncontrollable movements of the face, hands and feet
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What does this occur less with?
newer drugs such as clozapine (5%)
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However how early do patients tend to die?
20 years early
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due to what?
medication
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What does this suggest?
delicate ethical balance to be maintained between the positive effects of the drugs a
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and the ?
negative side effects
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Talking treatments for S are based on what?
Nurture
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What is the aim of talking treamtents?
To change the mind, not the brain
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What is one of the key talking therapies?
Cognitive behavioural therapy
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What is the aim of CBT?
to challenge the mistaken beliefs and thought disturbances associated with S
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What does it give clinets?
strategies to deal with them
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Where the recent research completed?
Manchester
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What was involved in this study?
randomised control trials of the effects of CBT treatment when NO drugs were given given alongside CBT
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What did the results suggest about the risk of developing a full blown psychotic illness?
It was more than halved for young people receiving CBT for at least 6 months least 6 months
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What was Dr Paul Hutton's proposal?
young people who are at risk of developing psychosis should now be offered care which includes at least six months of CBT
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How often does CBT treatment take place? and how long does it last?
weekly and lasts between 5 and 20 weeks
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what will the client be encouraged to do first?
understand and challenge their delusions and hallucinations
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What will they be taught?
coping strategies
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such as what?
distracting themselves or shouting when the voices are talking to them
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Lastly, what would they be encouraged to do?
accept their voices and to engage with them rather than o try and make them go away
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What did Rehospitilisations decrease by?
50%
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What did Linda hart call herself?
Voice hearer
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What did she use?
several non-drug strategies to cope with her S
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What did she find helped?
writing prevented her hearing dead father's voice telling her to kill herself
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Where is the supporting evidence for the strength of CBT come from?
Drury
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What did she find out about patients who receive CBT?
experience fewer symptoms of S
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How much faster do patients who have CBT recover?
25%-50%
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When was this case?
patients who are on anti-psychotic drugs
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What do the drugs allow?
access to the benefits of the CBT
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What does this suggest?
CBT can improve the quality of life for many people with Schizophrenia
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Particularly when?
if it is used in conjunction with anti-psychotic drugs
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How many people with S are offered CBT?
51%
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What do others have to manage with?
just drugs
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In methodological terms, talking treatments are to be applauded for what?
the same reasons as drug treatments
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What about the the ackground research?
which underpins CBT is scientific and high on reliability
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What was the Manchester CBT study based on?
RCTs
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which is what?
the gold standard for clinical research
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What is the difference between the control group and the CBT group?
CBT
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What do critics point out?
hello-goodbye effect
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What do people with S often do?
overestimate their symptoms at the start
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why?
in order to get care
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What do they do at the end?
underestimate their symptoms
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why?
show appreciation for the help
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What does overestimation of the effectiveness of treatments for S make?
the validity look higher than it is
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What is one weakness of talking treatments and drug treatments?
publication bias
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What is not published?
negative or neutral results of research into both treatments for Schizophrenia
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What do researchers suppress?
damaging findings making it scientifically impossible to assess the value of the treatment
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What did Radio 4 recently compare this bias too?
allowing Alex ferguson to referee a Manchester United match.
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What does this suggest?
research which underpins both treatments can be one sided
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What did the rethink report say about the treatment of people with S announce?
treatment fell 'catastrophically short'
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What does this suggest?
more research into the value of CBt opposed to drugs is needed
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Card 2

Front

Since when has biological treatments been based on?

Back

1950s, antipsychotic drugs

Card 3

Front

What have they become?

Back

Preview of the front of card 3

Card 4

Front

What are these positive symptoms?

Back

Preview of the front of card 4

Card 5

Front

What treatment was available before the 1950s?

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