Chapter 15 - Treatments for Schizophrenia and other Severe Mental disorders

Question 1

How was schizophrenia treated in the past?

Answer 1

Institutionalized in a public mental hospital, the primary goals were to restrain them, and give them food, shelter and clothing

Question 2

What is social breakdown syndrome?

Answer 2

Extreme withdrawal, anger, physical aggressiveness, and loss of interest in personal appearance and functioning. As a result of institutionalization

Question 3

What is milieu therapy (social climate)?Developed by Maxwell Jones

Answer 3

Creating a climate that promotes self-respect, individual responsible behaviour, and meaningful productive activity (otherwise they deteriorate)

Question 4

What is the token economy program?

Answer 4

A behaviour-focused program in which persons desirable behaviours are systematically reinforced by the awarding of tokens that can be exchanged for goods or privileges (operant conditioning techniques)

Question 5

What is custodial care?

Answer 5

Non-medical care that helps individuals with their daily basic care, such as eating and bathing

Question 6

What are antipsychotic drugs

Answer 6

Drugs that help correct grossly confused or distorted thinking

Question 7

What are first-generation drugs? (conventional antipsychotic drugs)

Answer 7

Neuroleptic drugs, producer undesired movement effects. Reduce more of the positive symptoms of schizophrenia

Question 8

How effective are antipsychotic drugs?

Answer 8

Reduce symptoms in around 70 percent of patients, maximum improvement within six months

Question 9

What are extrapyramidal effects?

Answer 9

Affect areas of the brain that help control motor activity. Result in unwanted movements

Question 10

What is Parkinsonian symptoms?

Answer 10

Reactions that closely resemble the features of Parkinson’s disease. Result of the medication-induced reductions of dopamine activity

Question 11

What is neuroleptic malignant syndrome?

Answer 11

A severe, potentially fatal reaction consisting of muscle rigidity, fever, altered consciousness and improper functioning of the autonomic nervous system. Largely affects elderly people. Stop treatment of antipsychotic drugs when this occurs

Question 12

What is tar dive dyskinesia (late-appearing movement disorder)?

Answer 12

Extrapyramidal effects involving involuntary movements that some patients have after they have taken antipsychotic drugs for an extended time (at least 6 months)

Question 13

What is the theory behind the tar dive dyskinesia?

Answer 13

Occurs as a result of the drug’s effect on dopamine receptors in the straitum. If discovered early, can be cured. Often times it is discovered late and is permanent

Question 14

What do clinicians do today when a drug does not improve the patient?

Answer 14

Used to increase the dose, now the clinician will add an additional drug to achieve a synergistic effect (polypharmacy), or stop the drug and try an alternative or stop all medications.

Question 15

Which generation of drug is found to be more effective?

Answer 15

Second-generation drugs

Question 16

Benefits of second-generation antipsychotic drugs? most commonly used

Answer 16

Not only reduces positive symptoms but negative ones as well, cause fewer extrapyramidal symptoms and less likely to produce tar dive dyskinesia

Question 17

What is agranulocytosis?

Answer 17

A life-threatening drop in white blood cells

Question 18

What are the side effects of second-generation drugs?

Answer 18

Weight gain, dizziness, metabolic problems, sexual dysfunctions, cardiovascular changes, significant elevations in blood sugar

Question 19

Overall effect of antipsychotics drugs?

Answer 19

Produce only modest changes in overall life satisfaction among those who have chronic schizophrenia

Question 20

What would Frieda Fromm-Reichmann say to patients?

Answer 20

They could continue to exclude her from their private world and hold onto their disorder as long as they wished

Question 21

How has psychotherapy developed?

Answer 21

Help relieve thought and perceptual disturbances. make changes in their behaviour, and cope with stressors

Question 22

What is cognitive behavioural therapy?

Answer 22

Two kinds of therapy: Cognitive remediation and hallucination reinterpretation and acceptance

Question 23

What is cognitive remediation therapy?

Answer 23

A treatment that focuses on the cognitive impairments including difficulties in attention, planning, memory and problem solving

Question 24

What is hallucination reinterpretation and acceptance therapy?

Answer 24

Help change how people view and react to their hallucinations, control over their hallucinations and reduce delusional thinking

Question 25

What is the 1st step in hallucination reinterpretation and acceptance therapy?

Answer 25

Provide education and evidence about the biological causes of hallucinations

Question 26

What is the 2nd step in hallucination reinterpretation and acceptance therapy?

Answer 26

Help to learn more about the “comings and goings” of their hallucinations and delusions

Question 27

What is the 3rd step in hallucination reinterpretation and acceptance therapy?

Answer 27

challenge the patients inaccurate ideas about the power of their hallucinations

Question 28

What is the 4th step in hallucination reinterpretation and acceptance therapy?

Answer 28

Teach to reattribute and more accurately interpret their hallucinations

Question 29

What is the 5th step in hallucination reinterpretation and acceptance therapy?

Answer 29

Teach techniques for coping with their hallucinations

Question 30

What is new-wave cognitive behavioural therapy for schizophrenia?

Answer 30

Acceptance and commitment therapy, help patients accept their streams of problematic thought, rather than judge, act on or try to change them. Be mindful

Question 31

What is family therapy?

Answer 31

overall helping the person with schizophrenia cope with the pressures of family life

Question 32

What is social therapy (personal therapy)?

Answer 32

Provide techniques that address social and personal difficulties in the clients life. Offer practical advice, work on problem solving, memory enhancement, decision making and social skills.

Question 33

What is a community mental health centre? (coordinated services)

Answer 33

A treatment facility that provides medication, psychotherapy, and emergency care for psychological problems

Question 34

What is a day centre (day hospital)?

Answer 34

A program that offers hospital-like treatment during the day only

Question 35

What is short-term hospitalization?

Answer 35

If first approach fails, will place the patient in a mental hospital for a few weeks. After improvement, patients are released to aftercare

Question 36

What are semihospitals/ residential crisis centres?

Answer 36

provide 24-hour nursing care for people with severe mental disorders

Question 37

What is a sheltered workshop?

Answer 37

Occupational training, that is a supervise workplace for people who are not yet ready for completive jobs. Replicates a typical work environment, paid according to perform

Question 38

What is supported employment?

Answer 38

Vocational agencies and counsellors help clients find competitive jobs in the community and provide psychologist support while the clients are employed

Question 39

How has community treatment failed?

Answer 39

poor coordination of services and shortage of services