clinical key question

Question 1

what is schizophrenia (AO1)?

Answer 1

• a mental disorder that can affect how someone thinks, speaks and feels to a degree that the may lose focus on reality

Question 2

what are the symptoms of Sz that psychologists aim to treat (AO1)?

Answer 2

• positive symptoms = hearing voices and ideas about being guided by others
• negative symptoms = disorganised thoughts and flattened emotions

Question 3

what are the two current treatments for Sz (AO1)?

Answer 3

• ACT = used to help patients who have frequently relapsed and had bouts of hospitalisation
• drug treatment with antipsychotics e.g. FGA’s and SGA’s

Question 4

why is this an important question to answer (AO1)?

Answer 4

• only 13% of the NHS budget goes to mental illness
• Sz costs society £11.8 billion a year

Question 5

who benefits if treatments are successful (AO1)?

Answer 5

• both patients being treated and those in need of treatment will benefit as resources will be freed up for the NHS and patients are given more independence

Question 6

what are the implications if treatments are found to be ineffective (AO1)?

Answer 6

• may revert back to original treatment e.g. institutionalisation

Question 7

what are FGA’s and how do they work (AO2)?

Answer 7

• target excess dopamine by blocking D2 receptors which reduces the activity of dopamine
• reduces positive symptoms
• e.g. chloropromazine

Question 8

what are SGA’s and how do they work (AO2)?

Answer 8

• targets dopamine, serotonin and glutamate
• block some receptors by temporarily binding and then disappear to allow for normal functioning
• e.g. clozapine

Question 9

what does ACT involve (AO2)?

Answer 9

• caring for the schizophrenic patient in their own home
• individualised plan involving a multidisciplinary team
• wide range of activities and everyday chores e.g. securing housing and meeting appointments
• lifelong service with no automatic termination
• available 24/7, 365 days a year

Question 10

what is evidence for drugs being an effective treatment (AO3)?

Answer 10

• meltzer carried out studies to look at the effectiveness of drug treatments
• found that haloperidrol gave improvements in all aspects of functioning tested

Question 11

what is an opposing study of the effectiveness of drug treatments (AO3)?

Answer 11

• patel found that 20% of people with Sz showed negligible improvements after multiple FGA trials
• 45% experience partial improvement

Question 12

what is an issue with other recreational substances being used (AO3)?

Answer 12

• recreational drugs, alcohol and nicotine can have an effect on how well antipsychotics work and so they may need additional help through these issues

Question 13

what is an issue with drug therapies only masking symptoms (AO3)?

Answer 13

• it doesn’t take into account the root cause of the disorder
• if you stopped taking the medication then the symptoms will likely return

Question 14

what does carlsson suggest that needs to be done to improve drug treatments (AO3)?

Answer 14

• suggests that further research is needed into glutamate e.g. needs drugs that target glutamatergic Sz

Question 15

what is some evidence for ACT being an effective treatment (AO3)?

Answer 15

• found to reduce re-hospitalisations by 85%, this benefits the patient to spend less time in hospital

Question 16

what is a problem with the effectiveness of ACT (AO3)?

Answer 16

• only works in conjunction with drug treatments
• not proven to be effective long term

Question 17

what is the opposing study of McGrew et al (AO3)?

Answer 17

• found that there was poor understanding of which of the described components actually matters
• treatment may not be effective as we don’t know what to focus on

Question 18

what is a strength of ACT being an individualised treatment (AO3)?

Answer 18

• it is an individualised and effective therapy which is therefore more likely to work for the individual
• accounts for individual differences such as culture and gender

Question 19

what is a weakness of cost and time for ACT (AO3)?

Answer 19

• very expensive treatment costing 6000-12000
• treatment for life, staff available 24/7, 365 days a year

Question 20

conclusion - which is a more effective treatment?

Answer 20

• ACT provides a more holistic overview working in conjunction with other therapies such as drug treatments as well as giving you the skills to work independently

Question 21

what is the key question?

Answer 21

how effective are the current clinical treatments for treating Sz?