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Treatments of Schizophrenia
- Electroconvulsive Therapy (ECT)
- ECT works by using electricity
to induce an epileptic-like
seizure in the patient
- we know this as chimps
became less aggressive
when their frontal lobe
was removed
- ethical issues with using chimps
- ethical issues with using chimps
- we know this as chimps
became less aggressive
when their frontal lobe
was removed
- first developed by Cerletti and Bini (1938)
under the belief that by inducing a seizure
in a schizophrenic patient, they should
reduce/eliminate the symptoms
- Side effects
- the general anaesthetic
carries its own risk
- makes the
mortality rate for
ECT look quite low
- makes the
mortality rate for
ECT look quite low
- physical harm could come from the effects of an
epileptic seizure; reported that patients have suffered
broken bones and bruising due to restraints
- however, without it, more harm could've been caused
- however, without it, more harm could've been caused
- disruption to memory; patient is
often confused and disorientated
for about 40 minutes after the
treatment; could be distressing
- however, recall gradually returns
- however, recall gradually returns
- Royal College of Psychiatrists (1997) - ECT
does not have any long term effects on
memory / intelligence
- however, critics have said that ECT
also caused mental / emotional
dysfunction, as well as memory loss
- however, critics have said that ECT
also caused mental / emotional
dysfunction, as well as memory loss
- the general anaesthetic
carries its own risk
- How does ECT work?
- although it's not clear how it
works, Benton (1981) identified
3 possible explanations:
- patients come to see
ECT as a punishment
for their behaviour
- the memory loss caused
allows the restructuring of
the patient's view of life
- however, unilateral ECT
causes less memory
loss and is effective
- however, unilateral ECT
causes less memory
loss and is effective
- the shock produces a range of
changes in the brain. Lilienfield
(1995) - neurotransmitters are
particularly stimulated
- however, in some cases the
effects of ECT are permanent;
would be temporary if due to
neurotransmitters
- however, in some cases the
effects of ECT are permanent;
would be temporary if due to
neurotransmitters
- patients come to see
ECT as a punishment
for their behaviour
- although it's not clear how it
works, Benton (1981) identified
3 possible explanations:
- Effectiveness
- an American Psychiatric Association (APA) review in
2001 listed 19 studies that had compared ECT with
'simulated ECT' (patients are given general
anaestesia but no ECT - a form of placebo)
- the review concluded that ECT produced
results that were no different from or
worse than anti-psychotic medication
- the review concluded that ECT produced
results that were no different from or
worse than anti-psychotic medication
- however, some evidence that ECT
combined with anti-psychotic medication
may be more effective than either alone
(Tharyan and Adams, 2005)
- an American Psychiatric Association (APA) review in
2001 listed 19 studies that had compared ECT with
'simulated ECT' (patients are given general
anaestesia but no ECT - a form of placebo)
- ECT works by using electricity
to induce an epileptic-like
seizure in the patient
- Cognitive Behavioural Therapy (CBT)
- aim - challenge maladaptive thoughts
and replace them with constructive
thinking leading to healthy behaviour
- therapist will try to make these
maladaptive thoughts conscious,
and the patient will see that there
is no basis for these thoughts
- therapist will try to make these
maladaptive thoughts conscious,
and the patient will see that there
is no basis for these thoughts
- CBT techniques
- understanding where
symptoms originate
can be crucial for
some patients
- EG. patient hears
voices and believes they
are demons; they are
naturally afraid
- offering a range of
psychological
explanations for the
existence of hallucinations
can help reduce anxiety
- offering a range of
psychological
explanations for the
existence of hallucinations
can help reduce anxiety
- EG. patient hears
voices and believes they
are demons; they are
naturally afraid
- patients are encouraged to evaluate the content of
their delusions/hallucinations and to consider ways in
which they can test the validity of their faulty beliefs
- the therapist may draw diagrams to
show patients the links between their
thinking, behaviour and emotion
- understanding where
symptoms originate
can be crucial for
some patients
- Drury (1996) found benefits in
terms of a reduction of
symptoms and a 25-50%
reduction in recovery time with
patients given a combination of
anti-psychotic medication and
CBT; medication allows
access to the benefits of CBT
- CBT cannot completely
eliminate the symptoms
- CBT cannot completely
eliminate the symptoms
- Kulpers (1997) - CBT
seems to be effective
- however, Kingdon &
Kirschen (2006) found that
CBT wasn't for everyone, as
it will not benefit people
who don't fully engage
- however, Kingdon &
Kirschen (2006) found that
CBT wasn't for everyone, as
it will not benefit people
who don't fully engage
- patients are taught strategies to protect
them against the wishes of the voices; EG.
relaxation, choosing to pay attention to the
voices at particular times of day
- however, focussing on
voices can be damaging as
you're not fixing it; listening to
the voices can enforce them
- however, Romme & Escher (2000) -
focussing on the voices reduces the
likelihood of harm to others or yourself
- however, Romme & Escher (2000) -
focussing on the voices reduces the
likelihood of harm to others or yourself
- however, focussing on
voices can be damaging as
you're not fixing it; listening to
the voices can enforce them
- CBT ignores the role of family and
society in both the cause and the
maintenance of schizophrenia
- aim - challenge maladaptive thoughts
and replace them with constructive
thinking leading to healthy behaviour
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