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5202 Essay Plan Relationships, conflict, complimentary patterns // own…
5202 Essay Plan
Relationships, conflict, complimentary patterns // own ideas, evidence to back up //
Who? What? When? How? So what? What if? What next?
1. Introduction
What is health/mental health? What is ill mental health?
WHO - Complete positive physical, mental and social wellbeing and not merely the absence of disease
What is schizophrenia? (Various definitions)
(Yr2 textbook)
Kraeplin (1883) chemical imbalance
dementia praecox 'precocious madness'
cognitive and emotional impairments
(Yr2 textbook)
Bleuler, 1950 termed SCZ
Syndrome of disorders including hallucinations, delusions, etc
(Year 2 text book)
Psychotic disorder, thought disorder
well known, poorly understood
Greek - split brain
lifetime prevalence of 1%
varies across time, culture, gender (Mcgrath, 2006)
Influencing factors in schizophrenia (three perspectives)
NTs, brain structure, environment, abuse, genetics, epigenetics, substance abuse, coping mechanisms (defense mechs), personality traits (some more susceptible), socio-economic status
Potential causes of ill health
Why is it important to study schizophrenia? (stats on hospitalisations / cost to health service and economy / level of distress caused / reduce stigma...
1/3 require institution, worst prognosis of ill MH (Jobe & Harrow, 2010)
This essay will look at three perspectives and how they each have a role in a complex interplay between bio-psycho-social experiences of an individual
e.g. correlation between CSA and SCZ but why? what is the cause? Is it environment, stress? why some people and not others? Is it individual optimal arousal levels / coping mechs?
Likelihood that not one cause but a not yet understood interaction between many factors
With up to 50% of literature ghost-written by pharma, what to believe? (Healy, 2003)
Imbalance in what UK psychiatrists believe as cause;
0.4% social, 46.1% bio, 53.5% both; ratio 1:115 believe bio
but maybe outdated :warning:
Kingdon et al, 2004
X. Conclusion
(NHS FYFV) Integrated treatment plans;
personalised care at point of access
NICE Guidelines; therapy + medications :!:
Individual differences must be taken into account
Rarely anything disputing the role of dopamine in SCZ, but no conclusive evidence as to whether this is cause or symptom - and if cause, what has contributed to this overabundance?
SU experience and preferences must be taken into account
No. of those who believe social cause vs biological cause
Personal accounts of recovery
Twin studies show high correlation for role of genetics, but also studies finding that deprived children with no family history at all are much more likely to be Dx with SCZ (Harrison et al, 2001)
No one approach alone is conclusive in evidencing direct causation to SCZ - must be concluded that there is complex interaction between genes, environment, experiences and adversity, cultural norms which are brought up in and personal innate and learned capacity to cope with adverse experiences
Chicken and egg - cause or symptom, which came first, likely treating symptoms, but they may then have knock on effect on cause e.g. moving household environment could lower dopamine, less stress, restore 'normal' function in frontal cortex?
X. Summary/Discussion
Evidence that SCZ is brain disease is similar to that for CSA factors, but not all CSA survivors dev SCZ, and not all Dx with SCZ have exp CSA; WHY?
Reaction to threat, betrayal, distortion - could distort brain?
Vulnerability to stress due to trauma, family situation etc. IDs?
Alone each approach is reductionist;
Bio - nerves and cells
Social - 'abnormal' criteria social constructions
ID - individual themselves
Nature Vs Nurture
Treatment
:
Prodromal phase where symptoms build gradually, what is the trigger? What if MHS could intervene before trigger?
Early intervention psychosis teams :!:
Meds work for large percentage, but not everybody
Bio approach doesn't explain relapse / remission: must be influenced by environment / individual experiences
Personality itself is likely genetics + environment + learning + social experiences
Mental illness changes over time and culture - DSM is changing to reflect dimensions of condition, symptoms and severity - not sane / insane. Defining and categorising may not always be helpful
Although focus of DA in this essay, as this is where the majority of the research lies to date - more recent studies are starting to implicate other NTs such as serotonin and GABA.