Schizophrenia Flashcards
Schizophrenia
Schizophrenia is a serious mental psychotic disorder characterised by a profound disruption of cognition and emotion. It is so severe, that it affects a person’s language, thought and perception, emotions and even their sense of self. It is suffered by approximately 1% of the population. The onset of the disorder is between 15 and 45 years of age. In the past, it was more commonly diagnosed in:
• Men more than women
• Cities rather than the countryside
• Working class than middle class people
More of a psychotic than neurotic disorder
Psychotic
the term psychotic refers to serious mental issues causing abnormal thinking and perceptions and also the fact that people lose touch with reality and even their sense of self. Many people who suffer from schizophrenia end up homeless or hospitalised. It is not uncommon for a person suffering with SZ to commit or attempt suicide.
Type 1 schizophrenia
characterised more by positive symptoms (those which are an addition to an individual’s behaviour) e.g. visual or auditory hallucinations or delusions of grandeur.
Generally with this type of SZ, there are better prospects for recovery.
Type 2 schizophrenia
characterised more by negative symptoms e.g. loss of appropriate emotion of poverty of speech. Generally with this type of SZ, there are poorer prospects for recovery.
Positive symptoms
Hallucinations- sensory experiences of a stimuli that have either no basis in reality or are distorted perception of things which are there
Delusions (paranoia)- irrational, bizarre beliefs that seem real to the person with schizophrenia
Disorganised speech- this is the result of abnormal thought processes, where the individual has problems organising his or her thoughts and this shows up in their speech, in form of derailment, word salad (speech so incoherent that it sounds like complete gibberish)
Catatonic behaviour- includes the inability or motivation to initiate or even complete a task, catatonia refers to adopting rigid postures or aimless repetitions of the same behaviour
Negative symptoms
Appear to reflect a reduction or loss of normal functions which often persist even during periods of low positive symptoms.
Speech poverty (alogia)
Avolition- finding it difficult to begin or keep up with a goal directed activity
Affective flattening- reduction in the range and intensity of emotional expression including facial expressions
Anhedonia- a loss of interest or pleasure in all or most activities, or a lack of reactivity to normally pleasurable stimuli
Classifying schizophrenia- DSM-v
Need 2 or more of the following criteria: delusions, hallucinations, disorganised speech, catatonic behaviour, avolition
Social/ occupational dysfunctions
Duration: for 6 months or more, symptoms from criteria A must be present for more than a month
ICD-11
Produced by the WHO, updated every few years, focuses on clusters of symptoms needed to classify a psychiatric illness, mainly used in Europe, focuses on subtypes of schizophrenia
DSM-V
200 mental disorder which are grouped together in terms of features, produced in the USA, updated every few years, used to have subtype of schizophrenia but removed from updated version
Issues In diagnosis of schizophrenia
Comobidity, symptom overlap, gender bias and culture bias
Comorbidity
This refers to the extent that two or more conditions occur simultaneously/coexist in the same individual at the same time (co-exist alongside each other.) Therefore a person with schizophrenia might also be suffering from another condition such as depression.
This is an important issue when considering the validity in diagnosing and classifying schizophrenia. Swets (2014)_stated that 1% of the population will suffer from schizophrenia and 2.5% from OCD. However, 12% of schizophrenic patients meet the diagnostic criteria to also be suffering from OCD (co-morbid). This causes the problem of classifying the illness as schizophrenia, and not OCD.
The boundaries between schizophrenia and mood disorders are blurred, and both types of illnesses share many symptoms.
There is the problem that depression (a mood disorder) is co-morbid (occurs alongside) schizophrenia. This means that full consultation using the DSM and ICD must be used in order to get the correct and valid diagnosis of the illness.
Comorbidity evaluation
- dms and icd can be seen as lacking validity, there is too much of an overlap between sz and depression, sometimes clinicians might classify the patient as having both to avoid making a decision, second opinion is important
-invalid and unreliable- 32% of 142 hospitalised schizophrenia patients had additional mental disorders - has been found through research that SZ patients before being diagnosed suffered from alcohol, cannabis, cocaine substance abuse, unreliable because some symptoms are from drug abuse
-schizophrenic patients with Comorbidity illness are often excluded from research when in reality majority suffer from this. Can not be generalised
Culture bias
Culture has an influence on the diagnosis and classification of schizophrenia. For example, “hearing voices” (auditory hallucinations) can be influenced by culture. Luhrmann (2015) interviewed 60 adults with schizophrenia, (20 from Ghana, 20 from India and 20 from USA), all of the patients reported that they heard voices, but the patients from the USA reported the most negative experiences associated with the voices, e.g. the voices were violent and hateful.
Therefore culture has an influence on the reliability of diagnosing schizophrenia.
b) Davison and Neale (1994) _explain that in Asian cultures, some people are praised if they do not show that they are suffering from an emotional/psychological problem, therefore people from Asian cultures might be unlikely to seek psychological help if they have schizophrenia (and therefore these people will not appear in any stats). In Arabic cultures, people are encouraged to show emotions, and therefore this culture might be more likely to seek help for schizophrenia if they have it and there might be more stats and data available for this group. Therefore there is a cultural bias.
Evaluation of culture bias
negative point about diagnosing and classifying schizophrenia is cultural relativism. The psychologist might not be able to understand the patient’s symptoms correctly due to not fully understanding the patient’s cultural background, and might misdiagnose schizophrenia. The psychologist might also wrongly label the patient as schizophrenic if the psychologist makes incorrect judgements about the patient in terms of their cultural background.Also some people from an African background might be wrongly diagnosed with schizophrenia due to the fact that they might claim that they can hear the voice of God (due to religion). In the African culture, these people would be seen as gifted; however in the western world this could be interpreted as a hallucination (auditory), and could be judged as being a symptom of schizophrenia, which could lead to an incorrect and invalid diagnosis. (-)
Afro Caribbean people have little immunity to file and children born to the mothers which had flu in the second trimester, have an 88% increase chance of developing schizophrenia
3) Barnes (2004) suggested there is supporting research evidence for cultural differences when diagnosing and classifying schizophrenia. The Ethnic Culture hypothesis predicts that ethnic minorities experience less distress if they suffer with the illness of schizophrenia, because they have protective characteristics and social structures that exist in their culture. 184 individuals with schizophrenia were investigated from African American, Latino or White American cultures. It was found that Americans had more symptoms than the other 2 cultures because they had less protective and supportive features in their culture (social support).
Gender bias
The accuracy of diagnosing schizophrenia can be dependent on the gender of the patient which leads to a gender bias occurring. Male sufferers of schizophrenia tend to show more negative symptoms than women, and also seem to suffer from more substance abuse. Males have an earlier onset (aged 18-25 years) of schizophrenia than females (25-35 years).
There seems to be great disagreement amongst clinicians when diagnosing schizophrenia, especially when the factor of gender is taken into account. The accuracy of diagnosis can vary due to clinicians having stereotypical beliefs about gender. Critics of the DSM argue that healthy adult behaviour is linked more to healthy males rather than healthy females. Therefore the DSM could be viewed as being gender biased, especially when trying to classify and diagnose the symptoms of schizophrenia, which might be invalid.
Evaluation of gender bias
There is a problem of gender bias occurring when diagnosing schizophrenia and research support comes from Loring
(1985). He gave 290 male and female psychologists case studies of patients to read (one male and one female).
Psychologists had to judge the patients using diagnostic criteria. When the patient was described as male, or no information was given about gender, 56% of psychologists diagnosed the patient as schizophrenic. When the patient was described as female, 20% of the psychologists diagnosed schizophrenia. Therefore there is a gender bias when diagnosing schizophrenia, and this was especially prominent when the psychologist was male. (-)
2) The validity of the diagnosis of schizophrenia can be questioned, especially as it seems that females develop schizophrenia 4-10 years later than males do. There are different types of schizophrenia that males and females are vulnerable to, so this must be taken into account when diagnosing and classifying the illness. (-)
3) Research evidence by Kulkarni (2001) has found supporting data to suggest that females might be less vulnerable than males to schizophrenia. He found the female sex hormone estradiol can help treat schizophrenia in females, especially when added to anti-psychotic drugs. It seems that estradiol might be a protective factor present in females that might lower their chances of getting schizophrenia compared to males. Clinicians must take this into account when diagnosing schizophrenia, especially in females, in order to ensure the diagnosis is valid. (+)
Symptoms overlap
The positive and negative symptoms of schizophrenia are a valid diagnosis of schizophrenia, however some of the symptoms of schizophrenia can also be found in the other disorders such as depression and bipolar disorder, and this is called symptom overlap which means that shared symptoms could lead to an incorrect and invalid of diagnosis.
Ross (1995) found that patients who had Dissociative Identity Disorder had many symptoms which overlapped with schizophrenia, so much so, that they could have been diagnosed with schizophrenia!
Other illnesses that seem to show symptom overlap with schizophrenia include:
• Bipolar depression (depressed mood, episodes of mania/energy, unpredictable, hallucinations delusions)
• Depression (hallucinations)
• Schizotypal personality disorder (similar symptoms of schizophrenia, but milder)
The person may exhibit a symptom typical of schizophrenia (e g. delusions) but they could instead have another condition with the same symptom (e.g. bipolar disorder).
Evaluation of bipolar depression
1) To support a correct diagnose of schizophrenia in a valid way, clinicians should conduct a brain scan or EEG. This can examine the brain in detail and especially check the grey matter in the brain (where intelligence is held). Schizophrenic patients tend to suffer from a deterioration of grey matter, and this can be checked by conducting a brain scan. Patients who have bipolar depression do not have a reduction in grey matter. (+)
2) A problem of symptom overlap is that it can cause misdiagnosis of schizophrenia. Ketter (2005) found evidence of schizophrenia being misdiagnosed as another illness, because of symptom overlap. This causes years of delays, whereby schizophrenia patients do not receive the necessary treatment that they actually need, and their illness gets worse. This can increase rates of suicide and deterioration. Therefore it is important than patients get a valid and accurate diagnosis in the first place. (-)
3) Research evidence has supported the idea that inter rater reliability is actually quite low, especially when asking psychologists to agree on diagnosing schizophrenia and not another illness. Beck (1961) studied 154 patients who met with two different psychiatrists. It was found that inter rater reliability was 54%, which means that there was 54% agreement between the two psychiatrists in terms of diagnosis of the illness schizophrenia. This therefore suggests that different psychiatrists might give different diagnosis to the same patient who display the same symptoms of schizophrenia (-)
Rosenham- study on validity of schizophrenia
Psychiatrist cannot reliably distinguish schizophrenics from non schizophrenics, he questioned the validity of classification and diagnosis of schizophrenia, he conducted a field experiment in the USA (8 sane patients sought admission to 12 separate hospitals ), they lied about having auditory hallucinations, all but one was given the diagnosis of schizophrenia, remained in hospital for 7-52 days, 35 out of 118 genuine patients suspected the pseudo patients to be sane.
Hospital staff were informed by rosenham that pseudo patients might see, admittance in the next 3 months, out of 193, 41 were confident, and 23 as suspect, no pseudo patients were sent at all
Evaluation of rosenham
- lacks temporal validity, now more procedures have been added like consulting a second psychiatrist before making decision
+ could we argue that the psychologists made correct decision to keep the patient in hospital for help, otherwise can be seen as negligence
-The study by Rosenhan raises many problems. If we accept the statement by Rosenhan that psychiatrists cannot detect the sane from the insane, then this means that psychiatrists cannot be trusted to accurately and reliably make a diagnosis about schizophrenia. If psychiatrists are in doubt when diagnosing the illness of schizophrenia, then they should seek a second opinion from a colleague, preferably a consultant who has more experience in the field. This would help increase the validity and reliability when diagnosing a patient with schizophrenia (-)
Genetic causes of schizophrenia
The mental disorder schizophrenia is inherited through generations and transmission of genes and DNA.
Schizophrenia runs in families/familial link and involves a combination genes (polygenic)
The gene NRG1 contributes to the genetics of schizophrenia.
NRG1 participates in glutamatergic signalling. It regulates the (NMDA) receptor which is a glutamate receptor (primary excitatory neurotransmitter in the brain).
NRG3 is another schizophrenia susceptibility gene
Ripke et al (2014)
• Ripke suggested that schizophrenia might be polygenic, whereby a number of candidate genes might be responsible for schizophrenia
• He did a meta-analysis of studies that looked at candidate genes and schizophrenia sufferers.
37,000 schizophrenia sufferers were investigated compared to 11,000 controls
He found that 108 separate genetic variations were associated with increased risk of getting schizophrenia.
These genes seemed to code for the functioning of the neurotransmitter dopamine.
: High levels of dopamine can cause schizophrenia
Evaluation of ripke
1) A disadvantage of genetics is that we must be cautious when looking at genetics alone as a cause for schizophrenia.
Other approaches need to be examined in terms of what could cause schizophrenia, for instance the behavioural model might suggest that children can learn abnormal behaviours via the environment (classical and operant conditioning and social learning theory), and therefore this could help develop schizophrenia rather than genetics. (-)
2) A problem with genetics is that is does not offer a full explanation as to how schizophrenia is transmitted. Just because someone has the gene for schizophrenia, it does not automatically mean that they will get the illness (due to the gene possibly being recessive). The diathesis stress model would advocate the idea that a person is more likely to get schizophrenia if they have the gene for the illness, and then a factor in the environment will trigger the illness (for example stress). Therefore the diathesis stress model highlights the importance of genetics, but also includes an environmental factor that helps trigger the illness (-)
3)
There is a great amount of research support from many psychologists that schizophrenia does seem to be caused by genetics. There is evidence from Gottesman and Kety which makes the evidence robust and strong. Therefore genetics cannot be ignored as a major cause for schizophrenia (+)
4)
To contradict the research conducted by Ripke, sometimes schizophrenia can occur in the absence of genetics or family history. There could be a mutation in parental DNA that causes schizophrenia in their future offspring, (such as a sperm cell might be damaged by radiation, poison or a viral infection). There is also a positive correlation between the paternal age of fathers and the risks of having a schizophrenic child. 0.7% if the father is under the age of 25, which increases to 2% if the father is over the age of 50. (-)
5)
The research conducted by Ripke can by supported by the dopamine hypothesis which states that high levels of dopamine in the D1 and D2 receptors in the brain can cause schizophrenia. Ripke’s work can be praised for linking together two biological mechanisms that could cause schizophrenia: genetics and the link to high dopamine production. (+)
Gottesman and shields
Gottesman and Shields investigated 224 sets of twins from 1948-1993 who appeared on the Maudsley twin register (106 sets of twins were MZ and 118 were DZ).
• 120 males and 104 females were studied
• The average sample age was 46 years and they came from a range of ethnic backgrounds.
• Conducted in a London hospital and was a longitudinal study over a period of 25 years.
• The study relied on the fact that one twin already had the illness of schizophrenia, and concordance rates were investigated (which examined the likelihood or the chances of the healthy twin becoming schizophrenic over time
• The methods that Gottesman and Shields used to diagnose schizophrenia included the following:
a) In depth interviews
b) Doctors case notes
c) The DSM
The result found that:
• 48% of MZ twins were both concordant for schizophrenia by the end of the study
• 17% of DZ twins were both concordant for schizophrenia by the end of the study
• This indicates that schizophrenia does have a genetic basis to some extent, especially for MZ twins.
• For DZ twins, genetics seems less prominent as a cause for schizophrenia (but the risk is still greater than for the general population which is 1%)
Evaluation of gottesman and shields
A strength of Gottesman and Shields study is that it was longitudinal. This means that the schizophrenic patients could be tracked over long periods of time in order to monitor the development of the illness schizophrenia. (+)
2) The research by Gottesman and Shields ignores the behavioural approach when examining the causes of schizophrenia. Identical twins often copy and model (social learning theory) each other’s behaviour, so it could be that the healthy twin has modelled or copied schizophrenic behaviour rather than getting the illness via genetics. (-
3) The research by Gottesman and Shields has the advantage of being both reliable and valid when investigating the genetic cause for schizophrenia. The research diagnosed schizophrenia using in depth interviews, doctor case notes and the DSM. Therefore there were three different methods that were used to diagnose the illness which means that there would have been more chance of inter-rater reliability and higher validity (+)
4) The research conducted by Gottesman and Shields could be criticised because it relied on interviews with patients. Schizophrenia patients often have difficulty with their speech and communication and therefore some patients might have found it difficult to communicate their symptoms effectively to the psychologists/psychiatrists.
Therefore this issue could have had a negative effect on the diagnosis and classification of schizophrenia. (-)
Psychological explanations for schizophrenia- family dysfunction/ double bind theory of communication (Bateson)
Bateson has proposed that disturbed patterns of communication and family dysfunction, might be a risk factor that can help cause the illness of schizophrenia. The double bind hypothesis means that children are given conflicting and mixed messages from parents and feel they cannot do the right thing. For instance parents might be caring some of the time and then critical at other times, or they might say positive comments in a cruel way, e.g. “I love you”.
This can create confusion, withdrawal and self doubt in children, and they cannot construct an internally coherent sense of reality. The child becomes trapped in situations whereby they fear doing the wrong thing and get mixed messages from parents. If they do something wrong parents might punish them by withdrawing their love.
Children see the world as confusing and dangerous.
They might start to develop some schizophrenic symptoms such
as withdrawal, disorganized thinking, paranoia and delusions.
A marital schism explains how family dysfunction can induce strange behaviour in their children. A marital schism is when parents may argue in front of their children and they might involve children into their argument. This can cause distress and confusion for children and they might then start developing some symptoms of schizophrenia.
Evaluation of the double bind theory
The double bind theory can be criticised because Bateson investigated his theory studying families retrospectively. This meant that families had to think back over a long period of time and identify traits of the double bind theory. Participants had to rely on their memories which could have been faulty and inaccurate.
(-)
2)
Bateson’s ideas can be criticised because he needs to investigate the element of cause and effect. Does family dysfunction cause schizophrenia to occur, or could it be that schizophrenia is caused by other factors which then cause the development of double bind? (-)
3)
Research conducted by Berger (1965) would support the double bind theory of schizophrenia. Berger founc that schizophrenic patients reported a higher recall of double bind statements by their mothers, than did non schizophrenic people. (+)
4) Ethical issues need to be taken into account when studying dysfunction in the family, and the research can be criticised for being unethical. It can cause a great deal of psychological harm if a family is told that their negative communication patterns have helped cause schizophrenia in a family member. Psychologists must also be aware of invading the family’s privacy, and they should also keep results confidential and anonymous
5)
Research evidence from the psychologist Read (2005) would support the double bind theory. He found that people who had difficult families in childhood had an increased risk of developing schizophrenia in adulthood.
From studies of child abuse and schizophrenia it was found that 69% of females and 59% of adult male schizophrenia patients had a history of physical or sexual abuse in childhood (+) |
6)
Support for family dysfunction comes from psychodynamic theorists who recognised a schizophrenogenic (schizophrenia-causing) mother who is typically cold, controlling and rejecting to her children which leads to excessive stress. This can be a main factor that helps develop schizophrenia. (+) |
Expressed emotions- kavanagh
Negative emotional interactions/climate in families might play a key role in helping to cause and maintain the symptoms of schizophrenia Expressed emotion can be regarded as a set of traits whereby family members talk about/to the schizophrenia patient in a critical and hostile manner. This might aid a relapse in a person who once had schizophrenia, but is now getting better. Traits include: criticism, hostility and emotional over involvement
Families with high EE talk more than they listened, causing the schizophrenia patient to have a low tolerance for emotional stimuli such as intense emotional comments and interactions in the family. This causes stress.
• There is evidence that schizophrenics living in families with high expressed emotion are X4 more likely to relapse than those families with low expressed emotion.
• Hooley (1998) found evidence to suggest that high EE families can help predict the relapse of not just schizophrenia, but other mental disorders such as depression and eating disorders.
• EE seems to be more typical in developed countries rather than developing ones, (even though developed countries have more access to resources and treatments).
Evaluation of EE
1)
Brown conducted research into expressed emotion and found results that agree and support that of Kavanagh, in terms of high EE causing schizophrenia/relapse. (+)
2) Support for expressed emotion was apparent in the 1990’s and became a well established maintenance model of schizophrenia. There was a large amount of evidence to suggest that EE can cause relapse in schizophrenia patients; this is true in many different cultures. This idea is so strong that families who show high EE are encouraged to undergo education and training to help reduce the amount of EE in the family. (+)
3) Critics of the EE model would state that schizophrenic patients have minimal contact with their families, possibly because the patient is institutionalised and the amount of familial contact is controlled, or because the family withdraw themselves. Therefore critics have argued that there is a minimal chance of expressed emotion being a causal factor for schizophrenia. (-)
4) Cause and effect needs to be established and is a major criticism of the EE model. Could it be that high EE can cause schizophrenia, or could it be that that the schizophrenia itself can cause the family members to have high EE? (-)
5) EE can be criticised because it ignores biological factors that might cause schizophrenia. When examining schizophrenia, we must remember that the main causes of the illness tend to be biological e.g. genetics, dopamine There is a great deal of research support for biological causes of schizophrenia that cannot be ignored e.g. Ripke, Gottesman and Shields (-)
Typical anti psychotic drugs - 1950s
Common examples of these drugs include: Chlorpromazine, Phenothiazines and Thorazine, These drugs are available as a tablet, syrup or injection.
• Chlorpromazine is a popular typical anti-psychotic drug and acts as a sedative.
Typical drugs are less popular than atypical drugs (see later on)
: Typlcal drugs aim to reduce the positive symptoms of schizophrenia such as delusions and hallucinations that
have been caused by high dopamine levels.
• These drugs reduce dopamine levels in the brain and act as dopamine antagonists. These drugs block dopamine receptors at the synapse.
• The drugs bind to dopamine receptors (D2) in the mesolimbic dopamine pathway in the brain and reduce the positive symptoms of schizophrenia such as delusions and hallucinations.
• The drugs must bind to 60-75% of the D2 receptors and block their activity in order to be effective
Evaluation of typical anti-psychotic drugs
1) There is supporting evidence from Thornley (2003) that typical anti-psychotic drugs are effective in tackling symptoms of schizophrenia. He compared Chlorpromazine to a placebo and found that schizophrenia patients had better functioning and reduced severity of symptoms when they took Chlorpromazine compared to a placebo, and the relapse rate was lower. (+)
2) A negative point about typical drugs is that they have terrible side effects which include dizziness, agitation, sleepiness, stiff jaw, weight gain, itchy skin and in the long term patients might develop, “tardive dyskinesia” (can be caused by dopamine super sensitivity) whereby mouth muscles and their chin make involuntary strange movement. (-)
3) A problem with typical anti-psychotic drugs has found that problems can occur when patients take the drug long term, for instance, 2% of schizophrenic patients’ develop the side effect of, “Neuroleptic malignant syndrome” which involves muscle rigidity, high temperature, delirium, altered consciousness, fever and a coma that can be fatal. (-)
4)
A strength of Typical anti-psychotic drugs is that they are effective in minimising symptoms of schizophrenia, they are cheap to produce and administer and help patients lead a relatively normal life outside of an institution. Around 97% of schizophrenia patients live at home, and this is because of the use of drug therapy
(+)
5) Supporting research from Marder (1996) has found that typical anti-psychotic drugs are good at reducing the positive symptoms of schizophrenia such as delusions and hallucinations. However they do not have any effect on the negative symptoms of schizophrenia such as apathy and speech poverty. (+) (-)
6) A negative point about typical drugs is that they can produce terrible side effects called, “extra pyramidal side effects” whereby dysfunction occurs in the nerve tracts from the brain and the spinal motor neurons. The schizophrenia patient might develop side effects that resemble Parkinson’s disease such as tremors in the fingers, drooling and muscular rigidity. (-)
Atypical antipsychotic drugs- 1980s
• There are alternative drugs available that seem to be better than neuroleptic drugs. Some examples of atypical anti psychotic drugs include Risperidone and Clozapine
• These drugs block the activity of dopamine receptors within the brain by acting on the D2 receptors (reduce dopamine). The drugs temporarily occupy the D2 receptors and then allow normal dopamine transmission.
• Atypical drugs also increase serotonin activity in the brain and bind to serotonin receptors (5-HT 2A) in order to improve mood
These drugs have fewer side effects than typical drugs
: Atypical drugs also seem to be able to reduce both the positive and negative symptoms of
schizophrenia, which is an improvement when comparing them to typical drugs
[Answer]
Clozapine: Atypical drug (AO1)
It is given when there is a high risk that the schizophrenic patient might commit suicide : tozaine bines thream hire restor cell stal arts in attent in and it smate receptors too. This
has the following effects on the schizophrenic patient:
• Improvement of mood
Reduction of anxiety and depression
• Can improve cognitive functioning
Evaluation of atypical drugs
1) Typical and atypical drugs have their strengths in that they have been proven to be the most effective treatment when compared to any other form of therapy available for treating schizophrenia (biological or psychological) (+)
Drug therapy has the disadvantage that it treats the symptoms of schizophrenia, but not the cause of it.
Symptoms might return if the patient stops taking the drugs and this leads to the, “Revolving door phenomenon” whereby patients leave hospital and then return because the drugs have failed to work (and this is a cycle). (-)
3) A problem with atypical drugs (and drugs in general), is that some schizophrenia patients are resistant to Clozapine and/or Risperidone as results from trials can sometimes be inconclusive about how effective they are. Some drugs will not be effective on some schizophrenic sufferers due to individual differences. (-)
4) Meltzer (2012) conducted research to support the idea that Clozapine is a more effective drug for treating schizophrenia than typical anti-psychotic drugs and alternative drugs. Clozapine was found to be 30-50% more effective in minimising schizophrenia symptoms compared to typical drugs. (+)
5) A problem with drug therapy in general is that there are ethical issues that can be raised. Drugs have been referred to as being, “A chemical strait jacket” whereby they do not help the schizophrenic patient, but just aims to control them, sedate them and make them easier to manage. (-)
6) Atypical drugs such as Clozapine have serious side effects, one of them is called, “Agranulocytosis” which is a blood condition whereby the bone marrow is affected and less white blood cells are produced, which can affect immunity to illness. (-)
NICE
National Institute for Health Care Excellence
CBT- cognitive behavioural therapy
NICE recommended that all schizophrenic patients have CbT, even if they are taking medication. This can help the patient to identify their irrational thought and change them it involves discussion between patient and therapist, about how likely the schizophrenic patients beliefs are true, they are then helped to make sense of delusions and hallucinations and the impact this has on their feelings and behaviour. CBTp doesn’t get rid of schizophrenia but helps to manage the symptoms, it allows the patients to evaluate the content of their hallucinations, and the patients are set homework assignments to improve their functioning. Positive self talks are encouraged
