treatments

Question 1

what are the two types of antipsychotics?

Answer 1

Typical and Atypical

Question 2

what do typical antipsychotics aim to do?

Answer 2

bind but dont stimulate dopamine recptors by reducing stimulation of the dopamine system. meaning hallucinations and delusions are eliminated.

Question 3

evaluate typical drugs

Answer 3

+they are successful. + Leucht’s study- meta analysis of 65 studies with 6,000 patients where some are given medicine and some are given a placebo and assessed after 12 months. 64% relapsed on the placebo and 27% on the treatment.
- extrapyramidal side effects- parkinsonism, dystonia, akathisia and tardive dyskinesia.

Question 4

what do atypical antipsychotics aim to do?

Answer 4

block dopamine and serotonin receptors.

Question 5

evaluate atypical drugs

Answer 5

+ fewer extrapyramidal side effects. + patients are more likely to stick with them as it is more suitable. + long term alleviation of symptoms.
- possible weight gain and increase in diabetes/blood clots and strokes.

Question 6

atypical vs typical

Answer 6

Crossely Study- meta analysis of 15 studies, where he examined efficacy and side effects in early phase of treatment. he found no difference in efficacy however, there was a huge difference in side effects.

Question 7

what is token economy?

Answer 7

therapy which is mainly used on patients who are institutionalised and is a method of helping them to manage and control impulses in behaviour. patients are given coloured counters which can get them privileges like cigs and tv time.

Question 8

what is the process of token economy?

Answer 8

1. identify desirable behaviours- getting dressed
2. tokens offered immediately when patient engages
3. where tokens can be exchanged for a variety of preferred items rather than one item, rates of response tend to be higher

Question 9

what studies of token economy?

Answer 9

Allyon and Azrin (1968) female patients with schiz had been hospitalised for an average of 16 years and were rewarded for actions like making their bed and brushing their hair. on average the number of ‘good acts’ increased from 5 to over 40 with the introduction of token based rewards such as tv and extra canteen trips.

Question 10

evaluation of token economy

Answer 10

+ one of thee first therapies for schiz showing positive effects which has no side effects.
- non-transferable ways of treating schiz outside an institutional setting.
- doesnt treat positive symptoms.
- deterministic- individual differences.
are they actually learning anything or just trying to minimise for a reward.

Question 11

what is family therapy?

Answer 11

a range of interventions aimed at the family of the schiz patient. NICE recommends that all schiz patients should be offered family therapy.

Question 12

how is family therapy conducted?

Answer 12

10 sessions which can last up to a year. aims to reduce the level of expressed emotion. psychoeducates the the family by letting them know negative symptoms are part of the disorder, aswell as it being episodic and symptoms can happen at any time.

Question 13

studies of family therapy

Answer 13

Leff- families with expressed emotion. compared family therapy with routine outpatient care, at 9 months 50% relapse rate for routine care and 8% for family therapy patients. after 2 years, 75% for outpatient care and 50% family therapy. suggesting family therapy is an improvement for symptoms for short and long term.

Question 14

evaluate family therapy

Answer 14

+research support Leff’s study
+ decrease relapse rates
+ good for younger patients
- appropriateness- motivation as the whole family has to be up for it. articulation as they will have to talk and some may not get involved and its very time consuming if no progress is made.