WJEC A2 Psychology PY4 - Two Treatments of Schizophrenia
Two Treatments of Schizophrenia
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- Created by: Zoey Jowett
- Created on: 23-10-12 14:13
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
EVALUATION (Atypical)
(+) 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
EVALUATION
(+) 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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