Schizophrenia

I thought I ‘d trial a new idea on the MN site based on the precept that several student (and pre-student) nurses visit this site. I’ll open up a forum discussion for feedback on the idea in general but leave this thread for responses to the vignette.

The idea is to set a scenario and debate the issues it throws up - I explicitly invite “service users” to also jump in and stir the ethical stew-pot as well as our regular contributors.

#1 is around confidentiality (and risk).

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Since I lost the previous post, I will provide the abridged version:

Estradiol is good for reducing symptoms of schizophrenia in women. A study of 102 female patients in a RCT (not sure single or double blind) published in the Archives of General Psychiatry showed clinically significant reduction in PANSS measurements.

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Surfing the net; an interesting article on yet another theory on the aetiology of mental disorder.

This one suggests that the culprit may be nothing more than the common ‘flu’.

Doctors have known for many years that microbes such as syphilis and Streptococcus can, if left untreated, lead to serious psychiatric problems. Now a growing number of scientists are proposing that microbes are to blame for several mental illnesses once thought to have neurological or psychological defects at their roots. The strongest evidence pertains to schizophrenia, but autism, bipolar disorder and obsessive-compulsive disorder have also been linked to bacterial, viral or parasitic infections in utero, in childhood or in maturity. Some of these infections can directly affect the brain, whereas others might trigger immune reactions that interfere with brain development or perhaps even attack our own brain cells in an autoimmune mistake.

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So, if positive symptoms cause violence, why aren’t there as many violent incidents to reflect this linearly?

As pointed out by beakie, not all hallucinatory experiences are bad ones. But is it the bad ones that cause violence in mental illness?

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Mental health and violence has long been given an erroneously represented causal link. Indeed, it has long been the promulgation of sensationalist reporting of ‘mental patient does harm’ that has sustained this misconception. For some time there has been a post on Mr Man’s Wife’s blog on just this topic.

I decided to bring some of the thinking over to here and add to previous discussions on the topic.

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Following on from the myth of the antipsychotic and the research apparently showing that antidepressants don’t work either, here, comes this.

“New schizophrenia drugs no better, Dutch team find”

The research apparently shows that the new generation of atypical antipsychotic drugs are no more effective than the older first generation of antipsychotic medication. Seroquel, Zyprexia, Geodon (available in the US), and Solian were compared with Haloperidol. Although the newer drugs were not found to be any more effective in treating psychotic symptoms the compliance rate was significantly better.

Over the following 12 months, 63 patients on Halopreidol stopped treatment compared to 51 on Seroquel, 32 on Solian, 31 on Geodon and 30 on Zyprexia

I was asked the question recently as to what i thought about the idea of the label ’schizophrenia’ being abolished. There is no getting away from the fact that the label ’schizophrenia’ inherently carries a poor image and stigma. This has ultimately been brought about through the negative and unbalanced portrayal of ’schizophrenics’ in the media. The image that they are all unstable murderers and attackers.

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I noted from an ancient posting of Mental Nurse the suggestion of a posting something on “Insight”. I have not seen one yet within these pages and wasn’t sure in what direction Mental muight have been thinking of going but I thought I’d begin one anyhow (as I’ve had two recent dealings of suitable dispute to comment on).

Before you read on, I would note I tend to write in an academic style, not a ‘blog’ writing style. Sorry about that!

This opener looks at my own recent dealings into the “insight” of two distinctly different people.To clarify, my understanding of ‘insight’ isn’t “How well do they understand what I tell them about themselves and how to be better”; it’s more “How well do they know themselves and the effect they have on themselves.”
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