The biological model of schizophrenia

The biological model views mental disorders, such as schizophrenia, as illnesses arising from underlying physical factors within the body. This approach assumes that symptoms result from issues like chemical imbalances or genetic influences. As a result, treatments focus on correcting these biological problems to reduce symptoms.

This model leads to interventions that target the body's systems directly. One common example is drug therapy, which aims to adjust brain chemistry. Biological treatments seek to manage symptoms by altering neurotransmitter activity in the brain.

Drug therapy for schizophrenia

Drug therapy is a primary biological treatment for schizophrenia, where medications are used to manage symptoms. Most individuals with schizophrenia receive some form of medication, often in tablet form or by injection. These drugs primarily target the neurotransmitter dopamine.

Antipsychotic drugs are the most common type used. They work by reducing dopamine's effects, either by decreasing its availability or by blocking receptor sites where dopamine binds. This helps alleviate positive symptoms like hallucinations and delusions. There is substantial evidence that these medications can lessen such symptoms in many people.

How antipsychotic drugs function

• Dopamine reduction - Many antipsychotics block dopamine receptors in the brain, preventing dopamine from attaching and transmitting signals. This minimises the overactivity thought to cause psychotic experiences.
• Administration and goals - Drugs are given to sedate the person, reduce the intensity and frequency of hallucinations and delusions, and stabilise disturbed thinking. They are most effective when started early in the course of schizophrenia.

Typical antipsychotic drugs

Typical antipsychotics, introduced in the 1950s, are an older class of medications that primarily block dopamine receptors. They are effective for reducing positive symptoms.

Examples of typical antipsychotics

• Chlorpromazine - Often used to calm agitation and reduce hallucinations.
• Thioridazine - Helps manage delusions and psychotic behaviours.
• Haloperidol - Targets disturbed thinking and minimises delusional intensity.
• Trifluoperazine - Reduces the frequency of positive symptoms like hallucinations.

These drugs fit into dopamine receptor sites, blocking the neurotransmitter and lessening its impact on brain function. This leads to a decrease in psychotic thought processes.

Atypical antipsychotic drugs

Atypical antipsychotics are a newer generation of medications, developed to have fewer side effects than typical ones. They also block dopamine receptors.

Examples of atypical antipsychotics

• Risperidone
• Olanzapine
• Quetiapine
• Clozapine - Appears to reduce negative symptoms, though there is some debate about its full impact on these.

These drugs tend to cause fewer side effects compared to typical antipsychotics.

Community psychology approach to schizophrenia

Community psychology shifts the focus from individual biology to the environment's role in mental health. It views psychological problems as arising from interactions between the person, their social setting, and broader community systems. This approach emphasises how surroundings can both contribute to disorders and aid in recovery.

Key principles include recognising diversity, such as cultural differences, and a person's ecology - their specific role and relationships within their community. There is less emphasis on labelling someone as inadequate or forcing them to fit rigid norms. Instead, treatments aim to understand and improve the dynamic between the individual and their environment.

Traditional versus community care for schizophrenia

Traditionally, people with schizophrenia were placed in mental hospitals for long periods. These institutions often had poor conditions, with the main goal being containment rather than recovery. Patients became institutionalised, meaning they grew dependent on the hospital structure, losing skills for independent living like decision-making or daily tasks.

Community care represents a modern alternative, aiming to integrate individuals back into society. It provides supportive environments outside hospitals, encouraging independence while offering help when needed. This approach reduces reliance on long-term hospitalisation and focuses on rehabilitation.

Key features of community care

• Day hospitals - Facilities where patients attend during the day for therapy and skill-building, returning home at night.
• Halfway houses - Residential settings that bridge hospital and independent living, with staff providing oversight and support for daily activities.
• Short-term psychiatric wards - Used only as a last resort for acute episodes, with the goal of quick stabilisation and return to the community.

In community care, residents are encouraged to manage their own lives as much as possible. Care staff offer guidance for tasks like cooking or budgeting, helping patients resume responsible roles in society. This interaction with the community fosters recovery by addressing environmental factors that may influence symptoms.