Summary Psychotherapies (first year)

CHAPTER MENTAL HEALTH
25 Psychotherapies
Schizoaffective – DE/ME occur with active phase schizo symptoms.

Psychotic episode – only schizo if not influenced by substances



Engagement between 2 individuals (therapist & client)

History
• Asylums
->Trephination – back to stone age
- boring hole in skull – release pressure/ demons.
-> Bethlehem (1st mental hospital) – ppl would come watch for entertainment
(‘insanity’ & ‘lunacy’ treated inhumanely)
- Belgian cage, rotary chair, bloodletting & ice baths
-> Philippe Pinel – improved conditions in 1860’s (treated w/kindness &
consideration)
- Hospitals built

• Moral therapy
-> 19th cent – led by Philippe Pinel & Jean Baptiste Pussin
-> Institutionalised pateints treated normally
-> inhumane treatments eliminate, social interaction encouraged
-> + consequences


• Medical Model
-> General paresis (physical cause & psychological symptoms)
-> Somatogenic Hypothesis – biological causes
-> Term ‘mental illness’ arose

Biomedical treatments
-> Medical techniques used
-> Affect biological functioning
-> Meds & therapy combined


1) Psychopharmacology – medication/drugs
-> Anti-anxiety drugs:
-Benzodiazepines – sedative effect (relieves symptoms)
-Beta Blockers – social anxiety disorder

, -Side effects = drowsiness, light-headedness, confusion, dry mouth, nausea,
vomiting, constipation, insomnia, blurred vison, addiction


->Antipsychotic drugs:


1st gen/ Typical 2nd gen/ Atypical
-> +symptoms -> -/+symptoms
- Chlorpromazine & haloperidol - Risperidone, clozapine, Seroquel
- Blocks dopamine receptors – reduces - Supresses release of dop in 1
effect of dop in ST pathway (causes psychosis) & blocks
- Side effects: movement disorders, serotonin receptors
tardive dyskinesia, reduced -Side effects: weight gain, diabetes,
emotionality drowsiness, blood lipid level changes
- LT effects = decreased cognitive in elec rhythms of heart.
functioning

->Mood-Stabilising
-Bipolar disorder
- Lithium
- Side effects: weight gain, lowered Na levels, toxic lithium build up
- Anticonvulsant drugs (seizures & mania) – Carbamazepine, lamotrigine
→As effective, less side effects
-Combines with atypical psycho drugs


->Antidepressants
1) Monoamine oxidase inhibitors (MAOIs)
2) Tricyclics – side effects decrease overtime
3) Selective serotonin reuptake inhibitors (SSRIs) – fewer & less severe side
effects. (SE= nausea, dry mouth, drowsiness, insomnia, decreased sexual
responses, suicide risk)


->Electroconvulsive Therapy (ECT)
- Mood disorders that haven’t RESPONDED to drug therapy (High risk of
suicide)
- 70-130 volts of current passed through head ½ sec – seizure & release of
Neurotrans.
- Given muscle relaxants & short-term anaesthetic
- 4 weeks relief
- Side effects: retrograde amnesia & anterograde amnesia, confusion,
headaches & nausea