tag:blogger.com,1999:blog-6886575137375451769.post732901642279846486..comments2023-08-08T00:53:58.434-07:00Comments on Garth Kroeker: Risk factors for psychotic relapseGKhttp://www.blogger.com/profile/14714377295981745087noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-6886575137375451769.post-16995580194915135772013-09-17T10:39:07.098-07:002013-09-17T10:39:07.098-07:00Interesting and valuable writing. Thanks also for ...Interesting and valuable writing. Thanks also for the comments on this article. I loved to read about risk increase in psychotic disorders. How can psychotherapy prevent to fall back in a psychosis? Of course, meds are most important but is counseling not also a predictor for improvement?Psychosehttp://www.psychotherapie-muenchen.denoreply@blogger.comtag:blogger.com,1999:blog-6886575137375451769.post-60496558719910128492013-07-11T08:59:09.331-07:002013-07-11T08:59:09.331-07:00Thanks for the comment!
It's certainly a comm...Thanks for the comment!<br /><br />It's certainly a common experience in psychiatry to see people in the midst of a psychotic relapse who had either stopped or reduced their medications (sometimes following medical advice), and whose symptoms then resolve after a few weeks of restarting medications. <br /><br />But the reasons for stopping the medication in the first place could be different in different people. For some, it could simply be that the medication is unpleasant in terms of side effects or tolerability. For others, there could be a lack of insight that medications are helpful or needed, especially between episodes. In others, the medication did not work adequately, and the relapse began despite full medication doses. Subsequent noncompliance with medication would then have occurred only after the relapse had started.<br /><br />It's interesting to consider the possibility of changeability over time, in which different strategies including different doses or varieties of medication might be best at different times. Right now we don't have a clear method--other than trial and error--to test this. GKhttps://www.blogger.com/profile/14714377295981745087noreply@blogger.comtag:blogger.com,1999:blog-6886575137375451769.post-50369743533705195782013-07-10T23:31:31.802-07:002013-07-10T23:31:31.802-07:00Your last paragraph is quite cute.
I wanted to co...Your last paragraph is quite cute.<br /><br />I wanted to comment on your interpretation of the results. As an alternative you suggest that there is something inherently different about the people who relapse, don't take meds, don't have good social relationships and use other drugs. This could very well be. But perhaps it might not just be the individual and their problem <br /><br />For causation to be inferred, three conditions must be met. <br />1)An association (or correlation) between the variables. (ie if medication compliance decreases relapse increases.)<br />2)Establishment of temporal order<br />(ie: medication compliance decreases before there is a relapse)<br />3) Elimination of confounding variables. <br /><br />The third criteria is not met (with certainty)<br /><br /><br />How about the possibility that there are a lack of good solutions to handle psychosis? <br /><br />It could be that the patients were not on the right meds or that the side effects were too awful. This caused them to go off their meds and or possibly use drugs because their illness was not managed correctly or appropriately. This could be the fault of professionals, the patient, their illness, their family, or our lack of understanding of psychosis and it's treatment.<br /><br />Yes-- the factor seem more correlational than causal. <br /><br /><br />IN addition:<br /><br />You have to look at the assumptions that are implied in this work. <br /><br />1) Psychotic relapse can be avoided if you stay on your medication.<br /><br />2) Each patient was on the right medication.<br /><br />3)The illness experienced by each person is non changing/ non evolving. (I think mental illness over time changes, adapts, and evolves much like viruses)<br /><br />There are obviously more...<br /><br />I don't know if we can trust these assumptions. <br /><br />Anonymousnoreply@blogger.com