SCHIZOPHRENIA ( DRUG THERAPY , CBT)

Question 1

Define Drug therapy

Answer 1

Drug therapy in schizophrenia is based on the biological approach , which assumes schizophrenia is caused by neurochemical imbalances , particularly involving dopamine.

Question 2

Antipsychotics are the primary treatment for schizophrenia . These are divided into typical and atypical antipsychotics outline the role of both

Answer 2

Typical antipsychotics : eg. chlorpromazine acts as a dopamine antagonist , they block dopamine transmission and reduce positive symptoms ( hallucinations , delusions ) . It also has sedative properties , used to calm agitated patients .

Atypical antipsychotics : eg. clozapine also act as dopamine receptors , but more selectively , block serotonin and glutamate receptors they target both positive and negative symptoms eg. improving motivation , reducing social withdrawal

Question 3

Evaluate the effectiveness of Drug therapy

Answer 3

STRNGTHS:

Supporting evidence : Numerous studies support the effectiveness of antipsychotics
Leucht et al : Meta analysis of 65 studies with nearly 6,000 participants. Found antipsychotics were significantly more effective than placebos in reducing relapse rates and symptom severity over a 12 - month period

Thornley et al ( 2003 ) : Found patients treated with chlorpromazine had improved functioning and fewer hospitalisations compared to placebo groups

Practical advantages : Cost effective ( cheaper than long - term hospitalisation ) , accessible , rapid acting

However most of these studies are short term and focus on symptom reduction , not long -term recovery or quality of life.

LIMITATIONS :

Side effects : Typical antipsychotics can cause tremors , stiffness , weight gin

atypical antipsychotics : have fewer side effects but can cause a fatal drop in white blood cells , require blood monitoring which affects patient compliance . This may lead to patients discontinuing medication leading to high relapse rates .

Drug therapy treats symptoms not the cause : drug therapy targets positive symptoms , but does not address underlying psychological or social causes of schizophrenia . Does not address negative symptoms like avolition , flat effect.

Leads to biological reductionism : reduces schizophrenia to a chemical imbalance , ignoring chemical imbalances , ignoring environmental , cognitive and trauma - related factors ( eg. family dysfunction , stress , abuse )

Question 4

Outline CBT’s role in treating Schizophrenia symptoms

Answer 4

CBT - a psychological treatment that helps individuals identify , challenge , and modify distorted or irrational beliefs , for schizophrenia the goal is not to eliminate symptoms ( hallucinations) , but to help the patient cope with and manage them.

Question 5

Outline the core techniques in CBT such as cognitive restructuring , behavioural experiments , symptom management strategies , normalisation , developing alternative explanations

Answer 5

Cognitive restructuring - encouraging patients to challenge delusional beliefs ( eg. questioning the evidence for persecutory delusions)

Behavioural experiments - patients test the reality of their beliefs in a safe environment

Symptom management strategies - Teaching coping strategies for auditory hallucinations (eg. distraction , or relaxation techniques )

Normalisation - helping the patient realis that experiencing unusual thoughts is not uncommon and can reduce feelings of isolation

Developing alternative explanations - patients are encouraged to generate less distressing interpretations of their experiences

Question 6

Evaluate the role of CBT as treatment for Schizophrenia symptoms

Answer 6

STRENGTHS :

Effective in reducing symptoms : NICE (2014) found CBT to be moderately effective in reducing positive symptoms like delusions and hallucinations. Meta - analyses show consistent benefits when CBT is used alongside medication

Improves functioning and insight : Helps patients understand and manage their condition , improving long-term outcomes like social functioning and treatment compliance

Empowering for patients : Encourages active participation and gives patients tools to manage their condition , enhancing self-esteem and independence

Limitations :

Does not eliminate symptoms : CBT helps manage rather than eradicate psychotic symptoms , which may limit its appeal to patients expecting symptom removal

Not suitable for all patients : Requires engagement , insight and verbal communication - patients in acute psychotic states or with severe cognitive impairments may not benefit. May be less effective for those with negative symptoms eg. avolition or alogia

Cost and accessibility : CBT is time - intensive and requires trained professionals , making it less available than drug treatments , particularly in underfunded healthcare systems