Schizophrenia - Treatments Flashcards

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1
Q
A
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2
Q

what drugs are used to treat schizophrenia?

A

antipsychotics

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3
Q

what are the 2 types of antipsychotics?

A

typical and atypical

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4
Q

how do typical antipsychotics treat schizophrenia?

A

stop hallucinations and delusions by blocking D2 receptors

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5
Q

what are the side effects of typical antipsychotics?

A

anhedonia, weight gain, tardive dyskinesia (muscle spasms)

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6
Q

what is an example of a typical antipsychotic?

A

chlorpromazine

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7
Q

how do atypical antipsychotics treat schizophrenia?

A

act on D2 receptors by rapid dissociation but for a shorter amount of time than typical

act on serotonin to reduce anxiety/depression

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8
Q

what are the side effects of atypical antipsychotics?

A

lowers white blood cells (agranulocytosis)

headaches

weight gain

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9
Q

when are typical antipsychotics usually taken?

A

all of the time

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10
Q

when are atypical antipsychotics usually taken?

A

during episodes only

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11
Q

what are the issues with typical antipsychotics compared to atypical?

A

taken all the time - side effects all the time

severe side effects

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12
Q

what are the issues with atypical antipsychotics compared to typical?

A

immunocompromised patients cannot take them as side effects lowers white blood cells

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13
Q

what are the advantages of atypical antipsychotics over typical?

A

reduces anxiety and depression - good as 30-50% of SZ patients attempt suicide

works on ‘hard to treat’ patients

can take during episodes only - side effects only during episodes

less severe side effects

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14
Q

what are the advantages of typical antispychotics compared to atypical?

A

can be taken by immunocompromised

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15
Q

what are the advantages of drug therapies to treat SZ?

A

supporting evidence - study compared with placebo and antipsychotic significantly more effective

enhance quality of life for patients - can live outside inpatient facilities - ecological validity

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16
Q

what are the issues with drug therapies?

A

consent - patients in psychotic episodes may not be able to consent to drugs, especially with severe side effects

severe side effects

biased research - a lot of research into antipsychotics funded by drug companies - biased results to sell more

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17
Q

what is CBTp?

A

CBT but modified for psychosis

18
Q

what is the main difference between CBT for depression and CBT for psychosis?

A

depression - try to change behaviours to solve issues

psychosis - try to change behaviours to cope with the problem

19
Q

how long does CBTp usually run for?

A

5-20 sessions

20
Q

what are the key componenets of CBTp?

A

critical collaborative analysis

normalisation of the symptoms

behavioural assignments

uses Ellis’ ABCDE model

21
Q

what is critical collaborative analysis?

A

prompting the patient with logic to challenge illogical conclusions or thoughts the patient has

22
Q

how does normalisation in CBTp help schizophrenic patients?

A

helps them feel less alienated and isolated from the general population

makes possibility of recovery seem more likely

23
Q

why are behavioural assignments used in CBTp?

A

to improve the general level of functioning

24
Q

what are the advantages of using CBTp to treat schizophrenia?

A

when compared to standard care (antipsychotics only) it is effective

found to reduce hospitalisation rates up to 18 months following treatment

25
Q

what are the disadvantages of using CBTp to treat schizophrenia?

A

most studies on effectiveness had patients on antipsychotics as well - doesn’t show effect of CBTp on own

not widely available - low ecological validity

research consistently shown individuals with more experience of their disorder benefit more - doesn’t help all patients

found that the better study conducted into CBTp, the weaker the findings for its effectiveness

26
Q

what is the aim of family therapy to treat schizophrenia?

A

educate family members about schizophrenia so they can support the patient better

family learns how to spot and discuss problems with the patient positively

27
Q

what finding is family therapy based on?

A

hostile/overly expressive families lead to more relapses

28
Q

what % does family therapy reduce relapse by?

A

up to 50%

29
Q

what is often used in conjunction with family therapy?

A

antipsychotics

outpatient care

30
Q

how long does family therapy tend to last?

A

3-12 months

at least 10 sessions

31
Q

how does family therapy improve relationships?

A

patient encouraged to talk to family about what support is and isn’t helpful

family members encouraged to listen to each other, discuss problems and negotiate solutions together

32
Q

what are the key strategies used in family therapy?

A

forming a theraputic alliance with all family members

maintaining reasonable expectations amongst family members towards the patient’s performence

33
Q

what are the advantages of using family therapy to treat schizophrenia?

A

strong research support - Pharoah et al meta analysis

economic validity - cheaper than a lot of other treatment options eg hospitalisation

found to be good for family members health - 60% reported positive impact

34
Q

what are the disadvantages of using family therapy to treat schizophrenia?

A

issues with the pharoah study - said it used random allocation, in reality didn’t, observer bias as ‘raters’ knew who had SZ and who didn’t

if family already good, doesn’t help patient

35
Q

what were the findings from the Pharoah et al meta analysis?

A

reduction in relapse and reduction in hospital readmission during treatment and in the 24 months after

Some studies reported an improvement in the overall mental state of patients, others didn’t

increased compliance with medication.

not much of an effect on more concrete outcomes eg living independently or employment.

36
Q

what is token economy?

A

form of behavioural therapy where target behaviours are rewarded with tokens that can be exchanged for rewards/privaleges at a later time

37
Q

why is token economy effective?

A

patients are learning to associate positive behaviours with positive outcomes

38
Q

draw the cyclic process of token economy

A
39
Q

what are the advantages of token economy?

A

research support showing it is effective in psychiatric settings

40
Q

what are the disadvantages of using token economy to treat schizophrenia?

A

works in psychiatric settings - but not in the community

unethical - human rights (eg food) can be used as rewards

manages schizophrenia however does not cure/treat it

tend to not have a control group to be compared to so unsure of effectiveness

41
Q
A