9990 · 1.1.3
Treatment and management of schizophrenia flashcards
Revision flashcards for Cambridge 9990 Treatment and management of schizophrenia (syllabus 1.1.3). Flip, recall, then mark a real past-paper question.
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Typical vs atypical antipsychotics?
Typical (e.g. haloperidol) block D2 strongly — extrapyramidal side effects. Atypical (e.g. risperidone) affect serotonin too — fewer motor side effects, metabolic risks.
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CBT for psychosis (CBTp)?
Collaborative therapy challenging delusions/hallucinations — patients learn to reappraise beliefs, reduce distress, improve functioning; does not deny experiences.
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Family intervention aim?
Reduce **expressed emotion** (criticism, hostility) through psychoeducation and communication training — lowers relapse rates.
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Token economy?
Operant conditioning in institutional settings — tokens earned for adaptive behaviour, exchanged for privileges; ethical concerns about control and generalisation.
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Community care advantages?
Normalisation, social integration, reduced institutional stigma — but requires adequate funding and crisis support to avoid 'revolving door' readmissions.
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Ethical issue with antipsychotics?
Side effects (tardive dyskinesia, weight gain), **coercive** community treatment orders — balance autonomy vs preventing harm.
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What is the primary mechanism of action for typical antipsychotics?
They act as dopamine antagonists, primarily by blocking D2 receptors in the mesolimbic pathway. This reduces dopamine activity, which is thought to alleviate positive symptoms like hallucinations and delusions.
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Define 'Expressed Emotion' (EE) in the context of family therapy for schizophrenia.
A family communication style characterised by high levels of criticism, hostility, and emotional over-involvement directed at the person with schizophrenia. High EE is a strong predictor of relapse.
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What is the main goal of CBT for psychosis (CBTp)?
To help patients identify, challenge, and modify their irrational or delusional beliefs and develop effective coping strategies for symptoms like auditory hallucinations, thereby reducing distress and improving functioning.
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What is 'tardive dyskinesia'?
A serious side effect associated mainly with long-term use of typical antipsychotics. It involves involuntary, repetitive body movements, such as grimacing, tongue protrusion, and rapid blinking.
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What is an Assertive Community Treatment (ACT) team?
A multidisciplinary team (e.g., psychiatrists, nurses, social workers) that provides intensive, comprehensive support to people with severe mental illnesses like schizophrenia within their own community, aiming to prevent hospitalisation.
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What is 'metabolic syndrome' as a side effect of atypical antipsychotics?
A cluster of conditions including increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels. It increases the risk of heart disease, stroke, and type 2 diabetes.
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What is 'reality testing' in the context of CBTp?
A cognitive technique where the patient and therapist collaboratively examine the evidence for and against a specific delusional belief, helping the patient to consider alternative, less distressing explanations for their experiences.
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What is a key limitation of token economies?
Lack of generalisation. Behaviours learned in the institutional setting may not transfer to the outside world where rewards (tokens) are not provided for the same behaviours. It also raises ethical concerns about patient rights.