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SCHIZOPHRENIA - Coggle Diagram
SCHIZOPHRENIA
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DRUG THERAPY
ANTIPSYCHOTICS - these drugs are used in the most psychotic forms of schizophrenia, it helps the person with the disorder function better as well as increasing their subjective well being. they are usually recommended after therapy. ALL antipsychotics work by reducing dopaminergic transmision
TYPICAL ANTIPSYCHOTICS = the basic function of a typical antipsychotic drug is to reduce the affects of dopamine, they are dopamine antagonists in that they bind to receptors but do not stimulate the dopamine recpetors thus blocking their action - by reducing the stimulation of dopamine system in the metabolic pathway they eliminate hallucinations and delusions - they diminish within a few days, but there symptoms may take weeks - drugs such as chloropromezine (400-800mg) has a sedative effect
ATYPICAL ANTIPSYCHOTICS = carry low risks of extrapyridimanl side effects, have a benificial effect of negative symptoms and cognitive impairment and are suitable for treatment resistant patients - little effect on the dopamine system that controls movement - targets dopamine and other neurotransmitters such as sertonon - dopamine antagonist but dopamine agonist meaning it mimics its effects. clozapine and respiridone 300-450 mg and 4-8mg - has a mood boosting effect which is perfect for suicidal schizophrenics
A03 =
- side effects = tardivdisconesia and less sevre
- not a permanent sollution
- meltzer = clozapine is the most effective out of them all
- Forley = placebo vs drug
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FAMILY THERAPY
range of interventions done with the family of the patient, NICE recommend family therapy to be offered to schizophrenic patients
family therapy can help the family of the patient understand schizophrenia better and the difficulties the patient may face, provides explanations for some behaviours. typically offered between a 3-12 month period and reccomened 10 sessions by NICE, family therapies aim is to reduce EE in the climate of the patient,
`key study = Pharoa - review 53 studies published between 2002-2010 to investigate effectiveness of FT to DT and found that there were mixed mental respond rates but increased compliance with medication, improvements in social functioning and reduction of relapse rates
A03 =
- does Ft help or is it the medication, the study suggests FT increases the likelihood an individual will take medication but do they improve social functionality and other aspects because pf FT or because they take their meds
- impact on family - Lobbann suggests FT has an impact on family members, analysed 50 family therapies and concluded a 60^ positive impact on family
- high costs to Ft but lower than hospitalisation
TOKEN ECONOMY
form of behavioural therapy where patients are ecnouraged to achieve taks daily in rewards of tokens.
tokens are rewarded for patients when they complete a taks which could be as simple as brushing their hair, the idea is that individuals will complete more day to day tasks in order to revive more tokens, these behaviours will consequently be seen as desirvble and rewarding
value is given to the token as they can exchange it for something this could be something small like watching a movie or snacks - they need to be presented alongside each other as it works as a reinforcing stimuli - token is used as a generalised reinforcer as it can be exchanged fo something positive - Borreo suggests people want more small than less big - effectiveness of the token decrease the more time passes between receiving and exchanging
A03
- ethical concerns - food is a basic human right but its reinforcing the idea that something good must be done in order to receive it and reinforces its position as a reqward
- isnt useful for patients in the community, which is the majority of schizophrenics then again its argued that this doesnt need to be implicated on people within the community as its just a drasticc management strategy
- research support from Dickerson, studied 13 trials of token economy and found 11 out of 13 were effective