Slides Shared Resource

1. Biomedical Approaches to Treatment 2. Trepanning: drilling holes into the skull to relieve intracranial problems and mental disorders; evidence of this practice dates…
of 9
All materials on our website are shared by users. If you have any questions about copyright issues, please report us to resolve them. We are always happy to assist you.
Related Documents
  • 1. Biomedical Approaches to Treatment
  • 2. Trepanning: drilling holes into the skull to relieve intracranial problems and mental disorders; evidence of this practice dates back to the Neolithic period (9500 BC). Bosch c. 1494 The Extraction of the Stone of Madness Iron age skull
  • 3. Lobotomy <ul><li>Moniz (1935) </li></ul><ul><li>Walter Freeman (1936) </li></ul>  
  • 4. <ul><li>Severing connection between frontal lobes and deeper underlying structures </li></ul><ul><li>Tens of thousands were given lobotomies up until70s for range of disorders: mood, anxiety, personality, psychoses etc. </li></ul><ul><li>Particularly used in schizophrenia for which there were no effective drug treatments at the time </li></ul><ul><li>Cheap, effective (brought about calm behaviour!) </li></ul><ul><li>Long term ineffective in treating precise symptoms </li></ul><ul><li>1976 review by National Commission in USA said it is effective in treating some conditions such as severe depression that is resistant to all other treatments </li></ul><ul><li>Today only used for severe depression and OCD </li></ul>
  • 5. Insulin Coma therapy <ul><li>introduced 1930s, mainly for schizophrenia </li></ul><ul><li>used extensively through the 40s and 50s </li></ul><ul><li>coma induced by injecting large amounts of insulin </li></ul><ul><li>Seizures sometimes occurred before or during the coma </li></ul><ul><li>patients would toss and turn, moan, twitch and spasm </li></ul><ul><li>No detailed theory ever proposed regarding how this helped, though success rates of up to 80% were claimed </li></ul><ul><li>some claimed that the process “jolted” patients out of their mental illness! </li></ul><ul><li>   7 minute clip of a man who was treated using this little understood procedure. </li></ul><ul><li>   a 16 second clip of a person undergoing treatment </li></ul>
  • 6. Electro-Convulsive Therapy <ul><li>  Longer 8 minute clip about a woman with severe depression and ECT. </li></ul><ul><li> Short 2-3 minute clip about ECT and depression </li></ul><ul><li>Less risky and more controlled than insulin coma therapy </li></ul><ul><li>originally pioneered by Cerletti and Bini (1938) as a treatment for schizophrenia. </li></ul><ul><li>now used as a last-resort for treatment resistant, severe depression/suicide risk; </li></ul><ul><li>Electrodes on temples shock the brain with approx. 100 volts (can be unilateral or bilateral). </li></ul>
  • 7. ECT cont’d... <ul><li>Results in seizure. </li></ul><ul><li>Early days process was painful/distressing-nowadays anaesthetics and muscle relaxants are used to make the process more humane. </li></ul><ul><li>Patients remember nothing of the procedure </li></ul><ul><li>60-80% achieve relief from symptoms </li></ul><ul><li>side effect of severe memory loss (robs a person of their sense of self) </li></ul>
  • 8. More on ECT <ul><li>6 treatments in the space of 3-4 weeks. </li></ul><ul><li>Mortality rate= 3 in 10,000 (fairly acceptable given the risk of suicide without treatment?) </li></ul><ul><li>Discuss: If ECT can save lives of depressed patients should practitioners be allowed to administer the procedure without patient consent?   </li></ul>
  • 9. How does it work? <ul><li>Nobody sure how it works </li></ul><ul><ul><li>shocks destroy neuronal circuits linked to emotion </li></ul></ul><ul><ul><li>Shocks affect neurotransmitter levels in brain regions associated with emotion </li></ul></ul><ul><ul><li>treatment is negative reinforcement of recovery behaviour (avoidance of unpleasant stimulus (shocks) or punishment for depressive behaviour </li></ul></ul><ul><ul><li>memory loss aspect allows restructuring of thinking patterns. </li></ul></ul><ul><li>Discuss: When doctors don't know how and why a treatment works, should they be allowed to use it? </li></ul>
  • We Need Your Support
    Thank you for visiting our website and your interest in our free products and services. We are nonprofit website to share and download documents. To the running of this website, we need your help to support us.

    Thanks to everyone for your continued support.

    No, Thanks