Schizophrenia: Symptoms, Prevalence, and Treatment

This report elaborates on schizophrenia, a prevalent psychotic disorder affecting young adults. It discusses the symptoms, prevalence, and treatment of the disorder, including the use of antipsychotic medications and psychosocial interventions. The report also presents the results of a study that compared the effects of antipsychotic medications and placebo treatment on schizophrenia symptoms in young adults. The study found that the placebo treatment was more effective in reducing perceived symptoms than antipsychotic medications. The report concludes with implications for further research on placebo treatment for schizophrenia.

Running head: PSYCHOLOGY
PSY10006 Psychology Fundamentals
TP1 2018
Assignment 2
Name of the Student
Name of the University
Author Note

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Introduction
Psychotic disorders refer to a group of serious diseases or illnesses that are found to
affect the human mind. These psychotic disorders often make it difficult for the individuals to
make good judgments, think apropriately, communicate effectively, respond emotionally, behave
appropriately, and understand reality. Presence of severe symptoms, results in extreme
difficulties for the people to remain in contact with the reality. This in turn leads to severe
impairment in carrying out daily activities (Heckers et al., 2013). Major psychotic disorders
result in an abnormal condition of the state of mind that makes it difficult for the individuals to
distinguish between things and events that are real and not real.
Major symptoms include false belief, observing or hearing things that others fail to
perceive, incoherent speech, sleep difficulties, social withdrawal and lack of motivation. The
most common psychotic disorders include bipolar disorder, schizophrenia, general anxiety
disorder, and postpartum psychosis. This report will elaborate on schizophrenia, a prevalent
psychotic disorder.
Schizophrenia is a highly prevalent psychotic disorder that is primarily characterized by
manifestation of an abnormal social behavior that makes the individuals display a failure to
understand basic reality (Hallak et al., 2013). The major symptoms of the disorder include
confused or unclear thinking, false beliefs, auditory hallucinations, lack of emotional expression,
reduced social engagement and complete loss of motivation. Furthermore, the individuals
suffering from schizophrenia report additional mental health problems namely, depressive,
anxiety, or substance-use disorders (Shinn et al., 2013).

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Distortions of self-experience that manifests in the form of one’s feelings or thoughts
lead to passivity phenomena, one of the most common symptom of schizophrenia. Social
isolation also occurs. This in turn leads to difficulties in long-term and working memory,
executive functioning, processing speed and attention. Furthermore, visual and auditory
hallucinations are the most commonly reported symptoms of schizophrenia. These symptoms are
also accompanied by delusions, persecutory or bizarre thinking and disordered speech.
Schizophrenic disorder is found to affect individuals during their early childhood and late
adolescents that act as crucial years in the vocational and social development. Research studies
have provided evidence that correlates occurrence of schizophrenia among people aged above 19
years of age. In other words, it affects young adults. The psychotic symptoms related to
schizophrenia are commonly found to emerge in individuals in early 20s and late teens, primarily
in their mid-20s to their early 30s (Agnew-Blais & Seidman, 2013). In addition, schizophrenia
seldom occurs after before puberty or after the age of 45 years. However, researchers have
provided evidence for the onset of schizophrenia related symptoms among children, as young as
5 years. The high prevalence of the psychotic disorder in adolescents are generally manifested in
the form of first signs that include drop in grades, change of friends, irritability and
sleep problems. Hence, unlike other psychotic disorders, schizophrenia occurrence is fairly
unique in young adulthood (De Herdt et al., 2013). Hence, the age group of 19-26 years can be
considered at an increased likelihood of suffering from this condition.
Sex differences do exist in the aforementioned psychotic disorder that is more commonly
found in men, compared to women. The male to female ratio of schizophrenia is found to be 4:1.
Women exhibit more susceptibility to experience range of symptoms that pertain to this
psychotic disorder in their life (Eranti et al., 2013). More emotional and psychotic problems are

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displayed by women, than men. Furthermore, women diagnosed with schizophrenia also have
fewer offspring, than females who are not affected (Wischhof et al., 2015).
Treatment of the disorder should involve administration of antipsychotic medications to
the individuals, in combination with social and psychological support. This might also require
voluntary or forced hospitalization. Antipsychotic medications are considered as the first-line
psychiatric treatment for schizophrenic symptoms. They play a crucial role in reducing the
positive symptoms related to psychosis in approximately 7-14 days (Leucht et al., 2013).
Furthermore, the antipsychotics also bring about significant improvements in cognitive
dysfunction and negative symptoms. Thus, continuous administration of antipsychotics reduces
the risks of relapse. However, prolonged use of antipsychotics often result in dopamine
hypersensitivity, which in turn increases the risks of recurrence of major psychotic symptoms,
upon stopping the medicines (Mueser et al., 2013). The major antipsychotics that are used for
treating schizophrenic individuals include olanzapine, riserpidone, clozapine and amisulpride. In
addition, certain psychosocial interventions that include family therapy, supported employment,
cognitive remediation and assertive community treatment are also considered useful (Morrison et
al., 2014).
Research hypotheses refer to statements that are created by researchers for the purpose of
speculating upon the direct or indirect outcomes of an experiment or research. The current study
involved two hypotheses that are given below:
 H1- Antipsychotic medications will improve the symptoms that are associated with high
prevalence of schizophrenia among young adults aged 18-26 years.
 H2- Women belonging to the young adult age group, suffering from schizophrenia will
benefit more from the antipsychotic treatment, upon comparison to men

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Methods
Participants
All participants, recruited for the study were diagnosed with schizophrenia and/or
schizoaffective disorder, according to the DSM-V criteria, in addition to a confirmation of their
psychotic disorder by family informants, direct assessment, and medical history (Tandon,
Bruijnzeel & Rankupalli, 2013). The participants were recruited from the psychology wards
across five major hospitals, located in the city by randomisation. Detailed brochures that
contained information about the purpose of the study were sent to the hospitals, following which
the participants were selected based on the following criteria:
 Must be within 18-26 years of age
 Must not suffer from any developmental disabilities
 Must have normal auditory skills
 Must not gave history of any other severe neurological problems, except those associated
with the disorder
A total of 66 participants met the eligibility criteria, of whom 27 were males, and 39 females.
All of them belonged to the age group 18-26 years. The participants were initially subjected to
antipsychotic medications for 3 months, followed by placebo effect for the following three
months.
Materials
A self-administered questionnaire was provided to the participants to demonstrate the
effects of antipsychotic medications (injections) compared to placebo treatment (saline injection)
on manifestation of schizophrenia symptoms. The questionnaire was kept close ended that made

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the participants provide responses in either ‘yes’ or ‘no’. Questions such as, “do you hear or see
things that are unreal after taking medicines?”, or “has the medicines increased your ability to
control your thoughts?” were presented. The responses were given scores, based on which the
final scores for the baseline treatment and the placebo group were computed. The questionnaires
were provided at the beginning and end of treatment of both the treatment periods.
Data collection
Prior to the recruitment, the participants were provided consent forms in sealed envelope
that also contained detailed information on the nature and purpose of the study. They were
enlisted for the study after obtaining their informed consent that demonstrated their voluntary
participation. Prior approval was obtained from the ethics committee for conducting the study on
human subjects. Furthermore, signed documents were presented to the hospital authorities and
the participants to show that adequate efforts would be taken to protect the privacy of the
subjects and maintain confidentiality of the obtained data.
Results
Table 1
Comparison of the baseline treatment and placebo treatment
Total Males Females
Mean age for whole sample 21.151515
Age range for whole sample 8
Total number 66 27 39
Range of baseline scores 36
Range for end of treatment scores 8

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Final scores for active treatment groups 2623
Final scores for placebo treatment group 1404
Mean scores for baseline treatment group 50.65 (active),
51.42 (placebo)
Mean score for end of treatment group 10.91 (active),
30.15 (placebo)
Mean final scores for active treatment group 39.74424
Mean final score for placebo treatment group 21.2727
At the end of the study, all patients could not be accounted for, since some refused to
show compliance to the treatment and some withdrew. Thus, a total of 66 participants were
analysed at the end of both treatments. More number of females was recruited for the study. The
end of treatment scores were subtracted from the initial scores obtained from the baseline
treatment, which in turn provided the final scores. The final scores suggested that participants
reported less symptoms related to auditory of visual hallucinations, delusions, disorganized
thoughts, sleeping problems and apathy, at the end of placebo treatment (saline injections). The
data presented above indicates that lower scores were obtained in the placebo group, which in
turn establishes the fact that the treatment was considered by the patients as real medical
treatment. This fake treatment did not contain any active substance that might have altered the
functions of the neurotransmitters and affected development of schizophrenia symptoms (Loebel
et al., 2013). Thus, the data in table 1 demonstrates that the placebo was successful in changing
the perceptions of the participants regarding the potential benefits experienced by them, thereby
making them provide responses that indicated lower scores and better health status.

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0
20
40
60
Graph 1: Scores for active and placebo
treatment
Graph 1: Scores for active and
placebo treatment
Females were found to report more symptoms and had scores that ranged from 24-61, at
the end of treatment, upon administration of antipsychotics. On the other hand, males reported
fewer symptoms that can be deciphered from the low score range of 22-56, at the end of
treatment. In addition, the males present in placebo group showed higher scores (range 5-45).
However, the females having received placebo treatment demonstrated lower scores (range 0-
38). This establishes the fact women were more affected by the placebo treatment, which in turn
made them perceive fewer events that were related to schizophrenia symptoms. Thus, the data in
graph 1 demonstrates a large reduction in symptoms associated with hallucinations, delusions,
and trouble in concentrating. Moreover, upon receiving the placebo treatment, lower rates of
symptoms related to confused speech and disoriented thoughts were observed. These lowered
symptoms were more common in females, than males. Hence, the placebo treatment showed
more significant effects on females.

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Discussion
An interpretation of the results suggested that the placebo treatment that involved
administration of saline injections were more effective than the antipsychotic medications in
reducing perceived presence of schizophrenia symptoms in young adults. The results helped to
determine that all kinds of antipsychotic medications that were administered such as, risperidol,
clozapine and olanzapine were not able to induce feelings in the participants that were associated
with fewer experiences of acute schizophrenic symptoms. The saline injection placebo treatment
was given to all participants to deceive them into thinking that the antipsychotics were being
administered. The patients failed to distinguish between the differences in the two treatments that
they were subjected to, and considered an enhancement of their health status, after the placebo
treatment.
Although, the scores obtained at end of treatment in the active treatment group and the
placebo group support the hypothesis that antipsychotic medications will improve the symptoms
among the participants, the final scores do not support the hypothesis. The final scores suggest
that the placebo treatment was able to improve the schizophrenia symptoms, upon comparison to
active treatment. However, the second hypothesis that stated women will experience more
improvement of symptoms, in comparison to men was supported by the final result scores.
Women gave responses that added up to less scores, thereby indicating fewer symptoms.
Previous literature review suggested that antipsychotic treatments are generally used as
the first line of medications for treating symptoms, presented by patients, suffering from
schizophrenia (Frances, 2013). These medications have shown considerable benefits in managing
psychosis such as, hallucinations, delusions, paranoia and disordered thoughts (Mueser et al.,
2013). However, the final scores did not provide sufficient evidence to confirm the previous

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findings. Considerable benefits were demonstrated by the participants, on receiving the placebo
treatment. Furthermore, the literature evidence also indicated the fact that women were more
likely to experience psychotic disorders and emotional problems, later on in their lives. This
finding was validated by the final scores that helped in drawing conclusion that women reported
greater rates of improved or lowered symptoms (Eranti et al., 2013). The fact that more number
of females had been recruited in the sample, might have resulted in a bias in the final scores.
The major limitations are associated with recruitment of small sample and obtaining
scores based on self-reports. This could have been improved by conducting an assessment of the
mental state, with the use of the DSM-V criteria, which in turn would have facilitated better
assessment of any improvement in the presenting complaints. Implications of the findings
suggest that further research on placebo treatment, with the use of saline injection should be
conducted, to determine its direct effects on schizophrenia symptoms.
To conclude, it can be stated that the placebo treatment effect is more than reinforcing a
positive thinking, which makes the patients believe that the procedure or treatment will work.
Placebo effect creates a stronger connection with the neural networks that gives rise to
perceptions, related to less schizophrenia symptoms.

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References
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