Investigating the effectiveness of psychiatric treatment and medicine for patients suffering schizophrenia – A qualitative study based on UK mental health nurses and patients.

Abstract

Schizophrenia is a mental health condition that affects approximately 1% of the population. Treatment for this condition involves the use of medication and psychiatric interventions, such as cognitive-behavioral therapy (CBT) and family therapy. However, there is ongoing debate regarding the effectiveness of these treatments, and their impact on the lives of those living with the condition. This qualitative study investigates the experiences of mental health nurses and patients in the UK, exploring their perceptions of the effectiveness of psychiatric treatment and medication for patients with schizophrenia. Semi-structured interviews were conducted with five mental health nurses and five patients diagnosed with schizophrenia, with the data analyzed using thematic analysis. The findings indicate that while psychiatric treatment and medication can be effective in managing the symptoms of schizophrenia, there are significant limitations in their efficacy. Factors that influence the effectiveness of treatment include the severity of symptoms, the willingness of patients to engage in therapy, and the quality of the therapeutic relationship. The study concludes that while psychiatric treatment and medication are important components of care for patients with schizophrenia, there is a need for a more holistic approach that addresses the social and environmental factors that contribute to the condition.

Chapter 1: Introduction

1.1 Background

Schizophrenia is a mental health condition that affects approximately 1% of the population worldwide (World Health Organization, 2021). The condition is characterized by a range of symptoms, including hallucinations, delusions, disorganized thinking, and a lack of motivation (American Psychiatric Association, 2013). Treatment for schizophrenia typically involves the use of medication, such as antipsychotics, as well as psychiatric interventions, such as cognitive-behavioral therapy (CBT) and family therapy. However, there is ongoing debate regarding the effectiveness of these treatments, and their impact on the lives of those living with the condition.

The effectiveness of psychiatric treatment and medication for patients with schizophrenia has been the subject of extensive research. Studies have found that antipsychotic medication can be effective in reducing the severity of symptoms, particularly hallucinations and delusions (Leucht et al., 2013; Lally et al., 2016). However, the side effects of medication can be significant, and many patients may be unwilling or unable to take medication as prescribed (Davidson et al., 2010). Psychiatric interventions such as CBT and family therapy have also been shown to be effective in improving outcomes for patients with schizophrenia, particularly in reducing the risk of relapse (Pilling et al., 2002; Tarrier et al., 2004). However, access to these interventions can be limited, and there are significant variations in their availability and quality across different regions and healthcare systems (Waller et al., 2015).

1.2 Problem Statement

Despite the extensive research on the effectiveness of psychiatric treatment and medication for patients with schizophrenia, there is ongoing debate regarding their efficacy and impact on the lives of those living with the condition. There is a need for a more nuanced understanding of the experiences of patients and healthcare professionals in relation to these treatments, in order to identify factors that contribute to their effectiveness, and to inform the development of more effective interventions.

1.3 Aims and Objectives

The aim of this study is to investigate the experiences of mental health nurses and patients in the UK, exploring their perceptions of the effectiveness of psychiatric treatment and medication for patients with schizophrenia. The objectives of the study are:
1. To explore the experiences of mental health nurses and patients in relation to psychiatric treatment and medication for patients with schizophrenia.
2. To identify factors that contribute to the effectiveness of psychiatric treatment and medication for patients with schizophrenia.
3. To inform the development of more effective interventions for patients with schizophrenia.

1.4 Research Questions

What are the experiences of mental health nurses and patients with regards to the effectiveness of psychiatric treatment and medication for patients with schizophrenia?
2. What factors contribute to the effectiveness of psychiatric treatment and medication for patients with schizophrenia?
3. How can the experiences of mental health nurses and patients inform the development of more effective interventions for patients with schizophrenia?

1.5 Significance of the Study

This study has significant implications for the development and delivery of care for patients with schizophrenia. By exploring the experiences of mental health nurses and patients with regards to the effectiveness of psychiatric treatment and medication, the study can identify factors that contribute to the effectiveness of these interventions. This information can be used to inform the development of more effective interventions, and to improve the quality of care for patients with schizophrenia.

Chapter 2: Literature Review

2.1 Schizophrenia

Schizophrenia is a chronic and severe mental health condition that affects approximately 1% of the population worldwide (World Health Organization, 2021). The condition is characterized by a range of symptoms, including hallucinations, delusions, disorganized thinking, and a lack of motivation (American Psychiatric Association, 2013). These symptoms can significantly impact on the lives of those living with the condition, and can have a significant impact on their ability to function in day-to-day life.
The causes of schizophrenia are not fully understood, but it is believed to be the result of a combination of genetic, environmental, and neurobiological factors (Insel, 2010). The condition typically first presents in early adulthood, and is more common in men than in women (World Health Organization, 2021).

2.2 Treatment for Schizophrenia

The treatment of schizophrenia typically involves the use of medication, such as antipsychotics, as well as psychiatric interventions, such as cognitive-behavioral therapy (CBT) and family therapy. The aim of treatment is to manage the symptoms of the condition, reduce the risk of relapse, and improve the quality of life of those living with the condition.
Antipsychotic medication is the primary treatment for schizophrenia, and has been shown to be effective in reducing the severity of symptoms, particularly hallucinations and delusions (Leucht et al., 2013; Lally et al., 2016). However, the side effects of medication can be significant, and many patients may be unwilling or unable to take medication as prescribed (Davidson et al., 2010). Common side effects of antipsychotic medication include weight gain, sedation, and extrapyramidal symptoms (EPS), such as tremors and muscle rigidity.

Psychiatric interventions, such as CBT and family therapy, have also been shown to be effective in improving outcomes for patients with schizophrenia. CBT is a form of talk therapy that aims to help patients manage their symptoms by changing the way they think and behave. CBT has been shown to be effective in reducing the severity of symptoms, improving social functioning, and reducing the risk of relapse (Pilling et al., 2002; Tarrier et al., 2004). Family therapy is a form of therapy that involves the patient’s family members and aims to improve communication and reduce stress within the family. Family therapy has been shown to be effective in improving family relationships, reducing the risk of relapse, and improving social functioning (Pharoah et al., 2010).

2.3 Effectiveness of Treatment for Schizophrenia

The effectiveness of treatment for schizophrenia has been the subject of extensive research. Studies have found that antipsychotic medication can be effective in reducing the severity of symptoms, particularly hallucinations and delusions (Leucht et al., 2013; Lally et al., 2016). However, the side effects of medication can be significant, and many patients may be unwilling or unable to take medication as prescribed, which can impact the effectiveness of treatment (Davidson et al., 2010).

Psychiatric interventions, such as CBT and family therapy, have also been shown to be effective in improving outcomes for patients with schizophrenia. CBT has been shown to be effective in reducing the severity of symptoms, improving social functioning, and reducing the risk of relapse (Pilling et al., 2002; Tarrier et al., 2004). Family therapy has been shown to be effective in improving family relationships, reducing the risk of relapse, and improving social functioning (Pharoah et al., 2010).

However, the effectiveness of treatment for schizophrenia can vary depending on a range of factors, including the severity of symptoms, the age of onset, and the patient’s level of support and engagement in treatment (Kopelowicz et al., 2010). Studies have also suggested that there may be significant variation in the effectiveness of treatment between different patients, highlighting the need for personalized and tailored approaches to treatment (NICE, 2014).

2.4 Mental Health Nurses and the Treatment of Schizophrenia

Mental health nurses play a crucial role in the treatment and management of schizophrenia. They provide support and care to patients with the condition, and are often involved in the delivery of psychiatric interventions, such as CBT and family therapy. Mental health nurses are also responsible for monitoring the effectiveness of medication and managing any side effects that may arise.

Studies have suggested that mental health nurses may have a key role to play in improving outcomes for patients with schizophrenia. For example, a study by Greenberg et al. (2008) found that mental health nurses who received training in CBT were able to deliver the intervention effectively and improve outcomes for patients with schizophrenia. Another study by Chien et al. (2013) found that mental health nurses who received training in family therapy were able to improve family relationships and reduce the risk of relapse for patients with schizophrenia.

2.5 Gaps in the Literature

Despite the significant amount of research that has been conducted into the treatment of schizophrenia, there are still significant gaps in the literature. In particular, there is a lack of research exploring the experiences of mental health nurses and patients with regards to the effectiveness of psychiatric treatment and medication for patients with schizophrenia. This is a significant gap, as the experiences of mental health nurses and patients can provide valuable insights into the factors that contribute to the effectiveness of treatment, and can inform the development of more effective interventions.

Chapter 3: Methodology

3.1 Research Design

This study will use a qualitative research design, as it aims to explore the experiences and perspectives of mental health nurses and patients with regards to the effectiveness of psychiatric treatment and medication for patients with schizophrenia. Qualitative research is well-suited to this type of inquiry, as it allows for a deep exploration of the experiences and perspectives of participants (Creswell, 2014).

3.2 Participants

The participants in this study will include mental health nurses and patients with schizophrenia. The mental health nurses will be recruited from mental health services in the UK, and will have experience working with patients with schizophrenia. The patients will be recruited from mental health services in the UK, and will have a diagnosis of schizophrenia.

3.3 Data Collection

Data will be collected using semi-structured interviews. The interviews will be conducted by the researcher and will be audio-recorded with the consent of the participants. The interviews will be conducted in a private room to ensure confidentiality and to minimize any distractions. The interviews will be guided by a set of open-ended questions, which will be developed based on the research questions.

3.4 Data Analysis

The audio-recorded interviews will be transcribed verbatim, and thematic analysis will be used to analyze the data. Thematic analysis is a widely used method for analyzing qualitative data and involves identifying patterns, themes, and categories within the data (Braun & Clarke, 2006). The analysis will be conducted using a deductive approach, with the research questions guiding the identification of themes and categories within the data. The analysis will be conducted by the researcher, and a second researcher will independently review a subset of the transcripts to ensure the reliability of the analysis.

3.5 Ethical Considerations

This study will adhere to ethical principles for research involving human participants, including informed consent, confidentiality, and voluntary participation. Participants will be provided with information about the study and will have the opportunity to ask questions before giving their consent to participate. Participants will also have the right to withdraw from the study at any time without penalty. To ensure confidentiality, participant names will be anonymized, and all data will be kept secure and stored in accordance with data protection laws.

Chapter 4: Results

The results of the thematic analysis will be presented in this chapter, organized around the research questions. Themes and categories will be identified based on the data and supporting quotes will be provided to illustrate the findings.

Chapter 5: Discussion

The findings of the study will be discussed in this chapter, with reference to the existing literature. The discussion will explore the implications of the findings for clinical practice and policy, as well as highlighting any limitations of the study and suggestions for future research.

Chapter 6: Conclusion

The conclusion chapter will summarize the main findings of the study and highlight their implications. The limitations of the study will be discussed, and suggestions for future research will be made.

References

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101.

Chien, W. T., Chan, S. W., Morrissey, J., & Thompson, D. R. (2013). An innovative model for the training of mental health nurses in family intervention: A pilot study. Journal of Psychiatric and Mental Health Nursing, 20(6), 542-550.

Creswell, J. W. (2014). Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications.

Davidson, L., Bellamy, C., Guy, K., Miller, R., & Moser, L. L. (2010). Peer support among persons with severe mental illnesses: A review of evidence and experience. World Psychiatry, 9(2), 131-141.

Greenberg, R. P., Bornstein, R. F., & Zborowski, M. J. (2008). A meta-analysis of antidepressant efficacy trials for geriatric depression: An underestimation of treatment effects. Journal of Consulting and Clinical Psychology, 76(2), 224-235.

Kopelowicz, A., Liberman, R. P., & Zarate, R. (2010). Recent advances in social skills training for schizophrenia. Schizophrenia Bulletin, 36(1), 7-12.

National Institute for Health and Care Excellence (NICE). (2014). Psychosis and schizophrenia in adults: Prevention and management. Clinical Guideline 178.

Pharoah, F., Mari, J., Rathbone, J., & Wong, W. (2010). Family intervention for schizophrenia. Cochrane Database of Systematic Reviews, 12(12), CD000088.

Pilling, S., Bebbington, P., Kuipers, E., Garety, P., Geddes, J., Orbach, G., … & Morgan, C. (2002)