4.3 Biological and Psychological Therapy for Schizophrenia Flashcards
What are antipsychotics?
Drugs used to reduce the intensity of symptoms (in particular positive symptoms) of psychotic disorders
What are the 2 types of antipsychotic?
- Typical
- Atypical
Name a typical antipsychotic, how it is taken and its dosage
- Chlorpromazine
- Can be taken as tablets, syrup or injection
- 400-800mg per day
How is chlorpromazine a dopamine antagonist?
- Has an inhibitory effect
- Block dopamine receptors in the synapses of the brain
What is a secondary effect of chlorpromazne and how is this useful?
- Sedation effect
- Often given to anxious patients admitted to the hospital, in order to claim/manage mood
What are 2 atypical antipsychotics?
- Clozapine
- RIsperidone
How does clozapine work?
- Similar to chlorpromazine (antagonist which binds to receptors)
- Also acts on serotonin and glutamate receptors
- This improves mood and reduces anxiety/depression (can also improve cognitive functioning)
What is a side effect of clozapine?
- Agranulocytosis (low white blood cell count)
What is the dosage and how is it administered of risperidone?
- 4-8mg per day
- Tablets, syrup or injection
Why is risperidone more effective than clozapine?
- Binds more strongly to dopamine receptors
- This means it is more effective in smaller doses
- Leads to fewer side effects
One strength for the biological therapy for schizophrenia
Evidence for effectiveness:
- Thornley et al: reviewed studies comparing effects of chlorpromazine to control
- Data from 13 trials showed chlorpromazine effective compared to placebo
- Associated with better overall functioning and reduced symptom severity
- Meltzer: clozapine more effective than typical and other atypical drugs
- Effective in 30-50% of treatment-resistant cases (where antipsychotics fail)
Two limitations for the biological therapy for schizophrenia
What is cognitive behaviour therapy?
A method for treating mental disorders based on both cognitive and behavioral techniques
What is the duration of CBT?
Over a period of 5-20 sessions
How does CBT help?
Helps make sense of how irrational cognitions (e.g delusions/hallucinations) impact feelings and behaviour
How does CBT work to help with hallucinations?
- Therapist can convince patient that hallucinations e.g hearing voices come from malfunctioning speech centre in brain
- Reduces distress and allows patient to cope with symptoms
- Normalisation: voice-hearing is an extension of the ordinary experience of thinking
What is family therapy?
A psychological therapy carried out with some or all members of a family with the aim of improving communications within the family
What did Pharoah et al identify about the strategies used to improve family functioning?
- Reduces negative emotions: reduce levels of expressed emotion e.g anger/guilt which create stress (reduces likelihood of relapse)
- Improves the family’s ability to help: improves family’s beliefs/behaviour towards those with schizophrenia, balance between caring for schizophrenic individual and own life
Describe Burbach’s model of practice (7 phases)
- Sharing basic information + providing emotional/practical support
- Identifying the resources different family members can offer
- Encourage mutual understanding
- Identifying unhelpful patterns of interaction
- Skill training (e.g stress management techniques)
- Relapse prevention techniques
- Maintenance for the future
Two strengths of family therapy for schizophrenia
One strength and one limitation of CBT for schizophrenia
What are typical antipsychotics?
The first generation of drugs for schizophrenia/psychotic disorders, that have been used since the 1950s (work as dopamine anatongists)
What are atypical antipsychotics?
Drugs for schiophrenia developed after typical antipsychotics (typically target a range of neurotransmitters e.g dopamine/serotonin)
What symptoms does chlorpromazine reduce?
Positive symptoms e.g hallucinations
How does chlorpromazine work?
- Initially, dopamine levels build up, but then production is reduced
- Neurotransmission in key areas of the brain is normalised
- This reduces symptoms
What is the typical dosage of clozapine?
300-450mg per day
Why are the effects of clozapine useful?
- Has mood-enhancing effects
- Can be prescribed to individuals at high risk of suicide
- (30-50% people with schizophrenia attempt suicide)
How can CBT help with delusions?
- Patient and therapist can jointly examine the likelihood that beliefs are true (test reality)
What is the identified patient?
Member of a dysfunctional family who expresses the family’s conflicts
