Case Study Schizophrenia Patients

Case Study Schizophrenia Patients-72
In both cases GAF scores were improved significantly and at the end of treatment, both patients did not meet the diagnostic criteria of negative symptomatology any longer.Symptom reduction went along with an obvious improvement of social, interpersonal, and cognitive abilities according to the clinical impression.

In both cases GAF scores were improved significantly and at the end of treatment, both patients did not meet the diagnostic criteria of negative symptomatology any longer.

More recently, a special volume of ) summarized these results indicating that negative symptoms can be explained by “a dysfunction of frontocortico-temporal networks […] together with a disruption of cortico-striatal circuits, though other structures are also involved, like the insular and parietal cortices, amygdala and thalamus” (p. Thus, negative symptoms cannot be attributed to the dysfunction of a single, circumscribed area of the brain but rather “reflect anomalies of distributed neural networks” (Millan et al.

) pointed to “an important role of glutamate-dopamine interactions within cortico-striato-thalamo-cortical (CSTC) loops, which are modulated by hippocampal and amygdala inputs, in the pathophysiology of schizophrenic disorders” (p. It may be speculated that negative symptoms, in part at least, can be explained by attention deficits that are caused by the neurobiological alterations outlined above.

The female patient had been hospitalized over five times and the male patient over three times because of acute psychotic symptoms.

First negative symptoms were assessed in both patients after the first three hospitalizations.

Considering these encouraging results, neurofeedback should be examined as an intervention specifically addressing the reduction of negative symptoms in schizophrenia. These were the research questions: Two patients participated in this study.

One patient was female, 45-year old, former bank clerk and in retirement, since over 15 years diagnosed with ICD-10 schizophrenia, residual type (F 20.5). Currently, positive symptoms had remitted under medication (Abilify 15 mg 1 × 1 and Topamax 2 × 1).Negative symptoms of schizophrenia, like diminished emotional expression and a dearth of self-initiated behavior do not respond reliably to anti-psychotic medication or to conventional psychotherapeutic approaches.Starting from evidence on the probable neural basis of such symptoms and on the effectiveness of neurofeedback with other psychological disorders, the present case study applied 20 sessions of EEG neurofeedback to a 45-year-old female and a 30-year-old male, both diagnosed with severe negative symptoms of schizophrenia.The male patient had terminated his post-high school education due to the illness and was not able to pursue a regular employment any longer due to his negative symptoms.Social contact was reduced in both patients but both of them have been integrated well into their families.As compared to men, female patients had a higher amplitude and relative power of beta-1 and beta-2 activity and their mean theta was significantly lower than in men over left-frontal temporal and parietal regions.) extensive review, there is only limited evidence for the effectiveness of medication for the reduction of negative symptoms: antipsychotics, antidepressants, stimulants, anxiolytics, and substances addressing anomalies of glutamatergic transmission were examined in numerous clinical trials during the past years, but no clear recommendation for pharmacological treatment of negative symptoms resulted.A meta-analysis of 168 placebo-controlled studies comprising a total of 6503 participants in the treatment arm and 5815 participants in the placebo arm has shown that second-generation neuroleptics and antidepressants as well as other medication and psychological interventions had statistically significant effects, but did not lead to clinically relevant symptom reduction.By watching this display the subject receives feedback about his or her cortical activity and learns to control it.Feedback on the screen is given separately for each of the EEG frequency bands that are of interest according to the clinical diagnosis.Both patients continued medication during neurofeedback treatment.Inclusion criteria were (1) a clinical diagnosis of schizophrenia, (2) marked negative symptoms, and (3) good compliance.

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