Revision session 2: treatments for Schizophrenia

1. Revision session 2: treatments for Schizophrenia • 1 9 Briefly discuss two limitations of community care in the treatment of schizophrenia. (4 marks)

2. Mark scheme • 1 9 Briefly discuss two limitations of community care in the treatment of schizophrenia. • (4 marks) • [AO2 = 4] • Up to two marks for each limitation briefly discussed. In each case award one mark for a brief explanation and two marks for an expanded or elaborated discussion point. • Likely answers: lack of consistent monitoring by medical professionals leading to lapses in medication and thence to relapse; inadequate funding – community care as a poor substitute for high quality professional care in hospitals; over-reliance on family and charity organisations who are not always equipped to care for patients with severe psychiatric disorders; normal but not normal – ostensibly a more normal environment but a small group living together is still an enclave; social isolation still possible – patients in community care may be ostracised by the local community because of fear/lack of understanding. Accept other valid answers.

3. Treatments essays • Came up in January examination • Biological (drug therapy), Psychotherapy (cognitive behavioural and cognitive) and Community Care (referred to as a ‘care option’ rather than a treatment)

4. (c) Discuss the use of anti-psychotic drugs to treat schizophrenia. (12 marks) • [AO1 = 4, AO2 = 8] • AO1 • Up to 4 marks for knowledge of the use of anti-psychotic drugs in the treatment of schizophrenia. Credit the following: description of specific medication (eg conventional anti-psychotics - haloperidol, newer anti-psychotics - risperidone); mode of action (eg blocking of dopamine activity, affecting levels of serotonin); description of the process of chemical transmission; description of relevant evidence. Credit evidence up to 2 marks. • AO2 • Up to 8 marks for discussion. Likely discussion points: effectiveness ( both positive and negative symptoms); side-effects, especially long-term effects (motor disturbances); possible dependency; does not address social factors; improvement in day to day functioning for sufferer; improvements for family/society; revolving door effect; need for close supervision; comparison of traditional and newer generation antipsychotics;comparison with other treatments eg psychotherapy; issues for health professionals; history of the use ( or overuse) of anti-psychotics when first introduced.Credit use of relevant evidence. • Maximum 8 marks if no alternative approach presented You can produce an essay plan for any of the potential treatments which come up. Decide what your A01 and A02 points will be and where the similarities and differences appear between the treatments in order to prepare you for any question!

5. January 2012 question: • ‘The most suitable treatment for schizophrenia is medication and this treatment should take place in an institution.’ Discuss this view. (12 marks) What could you write about for this question?

6. January 2012 – mark scheme • Question 21. • There are a number of different routes to answering this question. Candidates may focus • solely on the effectiveness, strengths and limitations of medication or may take the • opportunity to consider medication in relation to alternatives. They may also/alternatively • focus on the issue of care context. • AO1 Award up to 4 marks for knowledge of treatments for schizophrenia and/or care • options: traditional anti-psychotic dopamine blockers eg chlorpromazine: atypical antipsychotics • eg clozapine and risperidone; alternatives eg psychotherapies; community • care as an alternative care option to hospitalisation. Credit descriptions of relevant • evidence – 2 marks. • AO2 Award up to 8 marks for discussion of the views expressed in the statement. • Candidates are expected to evaluate the use of medication and/or compare • medication with alternative treatments. For full engagement with the question • candidates should also consider the point about the need for treatment to take place • in a controlled environment such as a hospital. Possible content: use of studies • showing relative effectiveness; issue of side effects; patient as passive or active; • need for combined approach ie drugs alongside other treatment; ethical issues; role • of the family v role of institution; problems of institutionalisation; strengths/limitations • of community care; issue of normalisation. Credit use of relevant evidence. Credit • evaluation of evidence where relevant to discussion.