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Treatments of Schizophrenia - Coggle Diagram
Treatments of Schizophrenia
Biochemical
1st and 2nd generation antipsychotics block dopamine and serotonin receptors to reduce levels of dopamine in the brain
1st generation antipsychotic drugs (eg: chlorpromazine) tested through RCT - Randomised Control Trials
Each participant was randomly allocated to the control or experimental group
Double blind placebo controlled (neither groups, nor the researchers know who got the treatment and who got the placebo)
Results
50% of patients showed signs of significant improvement
30-40% show partial improvement
Minority show no improvement
They both reduce agitation and hostility in the patient
Side effects
1st generation antipsychotics are more likely to produce EPS and Tardive dyskinesia
2nd generation atypical antipsychotics are less likely to produce EPS and TD, but instead cause increase risk of weight gain and obesity.
Usually high relapse rates as patients stop taking medication once their symptoms decrease in order to reduce side effects
Electro-convulsive Therapy
Electrodes are placed on the scalp and a finely controlled electric current is passed through the head for no longer than 1 second
Can be done unilaterally or bilaterally.
The patient is anathesaised and the electrodes are attached to the skull at the non-dominant hemisphere.
The pulses of electricity which induces seizures to treat schizophrenia.
Token Economy (Paul and Lentz 1977)
It aims to reinforce appropriate behaviour in schizophrenic patients because behaviourists believe that some symptoms of schizophrenia are learnt, and can be treated by unlearning them with operant conditioning
Patients were given tokens as a reward when they behaved appropriately
Could be exchanged for luxury items like snacks, TV, etc.
Results
For the patients that underwent token economy treatment, positive and negative symptoms were significantly reduced and only 11% of patients needed drug treatment
100% needed drug treatment in control group
Cognitive Behavioural Therapy (Sensky 2000)
A randomised controlled design
Patients were put into cognitive behavioural therapy group or 'befriending' group
Sample
90 patients. 57 from clinics in Newcastle, Cleveland and Durham and 33 from London
Aged 16 - 60
They were treatment resistant scizophrenics
Both groups were delivered by two experienced nurses who received regular supervision.
'Befriending' group discussed hobbies, sports or current affairs. CBT group identified the emergence of the disorder before tackling symptoms. They kept voice diaries as a coping strategy
Patients were assessed by blind raters at baseline, after treatment (lasting up to 9 months) and at a 9-month follow-up evaluation.
Comprehensive Psychiatric Rating Scale, the Scale for Assessment of Negative Symptoms, plus a depression rating scale.
Results
Both interventions resulted in significant reductions in positive and negative symptoms and depression. (no significant difference)
At the nine-month follow-up evaluation, patients who had received cognitive therapy showed greater improvements on all measures.
It is a talking therapy used by the patient to recognise their faulty mental processing and tackle symptoms by generating coping mechanisms (eg: voice diaries)