This paper summarizes schizophrenia, including common symptoms like delusions, hallucinations, and disorganized thinking. It discusses the social implications such as high costs and increased rates of incarceration rather than treatment. A history of treatments is provided, from exorcisms to lobotomies to modern medications and therapies. The conclusion calls for more facilities to help patients recover and return to productivity.

1. Schizophrenia
Stacey Troup
PSY-275
July 25, 2015
University of Phoenix

2. Schizophrenia 2
This Week 5 Final Exam paper on schizophrenia will cover different aspects of
schizophrenia including range of impairment, implications on society and treatment options.
This topic was chosen following inspirational lectures in previous weeks given by Elyn Saks,
Associate Dean at the University of Southern California (USC). Having been diagnosed with
schizophrenia during her college years, she struggles daily with the condition yet manages to
hold a highly coveted position while educating others on the condition she, herself, suffers from.
Range of Impairment
As we begin to examine schizophrenia, knowing what types of symptoms present in the
condition and the impact they have on the people who suffer from the condition is an important
first step.
While symptoms vary between participants, some of the more common impairments
include delusions, hallucinations, disorganized thinking, extremely disorganized or abnormal
motor behavior and negative symptoms. (Mayo Clinic Staff, NA)
Delusions
Affecting 4 out of 5 people who are diagnosed with schizophrenia, this condition causes
confusion between thought and reality. It can vary in its context but causes a split of sorts in the
ability to decipher fact from fiction in their reality/everyday life. (Mayo Clinic Staff, NA)
Hallucinations
Another condition which interferes with reality is that of experiencing hallucinations.
Seeing things or people that are not there or hearing voices are common among participants.
Hearing voices is by far the most common hallucination among patients. (Mayo Clinic Staff,
NA)

3. Schizophrenia 3
Disorganized Thinking
Disorganized thinking is a condition whereby sentences or words are put in to order that
make little or no sense. This can cause impairment in the ability to communicate effectively
with others. Mixed thoughts put into sentences seem to make sense to the person speaking them
but appear discombobulated to the recipient. (Mayo Clinic Staff, NA)
Disorganized Motor Behavior
This can be the most difficult symptom to diagnose. Starting in childhood it can consist
of things like resistance to follow instructions, inappropriate and/or bizarre posture, complete
lack of response and useless or excessive movement. (Mayo Clinic Staff, NA)
Negative Symptoms
This symptom refers to the “reduced ability or lack of ability to function normally.”
(Mayo Clinic Staff, NA) This can include things like failure to make eye contact when speaking
to someone, lack of emotion or facial expressions, speech lacking tone or emotion and lacking
hand or head movements considered normal for emotional emphasis of a statement during
conversation. In addition to these social issues, the person can also experience a lack of interest
in things they once took an interest in, hygiene issues and finally, lack of ability to experience
pleasure. (Mayo Clinic Staff, NA)
Age Based Symptoms
While conditions typically begin to show in men during their early to mid 20’s and
women in their late 20s, teens are often affected by symptoms of the condition. (Mayo Clinic
Staff, NA)
Symptoms in teenagers can include things like withdrawal from friends and family, drop
in performance at school, trouble sleeping, irritability or depressed mood and lack of motivation.

4. Schizophrenia 4
However, compared to their same sex elders, teens are less likely to experience delusions but are
more likely to experience hallucinations. (Mayo Clinic Staff, NA)
Impairments – Thoughts
Keeping in mind that symptoms vary between different people, cognitive impairments
affect up to 75% of patients. Memory, attention, motor skills, executive function and
intelligence are all affected by the condition in some way or another. Suicidal thoughts or
actions often accompany onset of symptoms and it is important to seek professional help or
admit the patient into an emergency room for the safety of themselves and those around them.
(O'Carroll, 2000)
Social Implications
Schizophrenia can be costly to families and those afflicted with the condition. According
to a 2002 study, costs were “estimated to be $62.7 billion, with $22.7 billion excess direct health
care cost ($7.0 billion outpatient, $5.0 billion drugs, $2.8 billion inpatient, $8.0 billion long-term
care)”. (Schizophrenia Facts and Statistics, NA)
With state hospitals closing, more prisons are filled with people who have committed
crimes during the onset of a schizophrenic symptom outburst and belong rather in hospitals
where they can become medicated and treated rather than in the prison system. The United
States has failed the mentally ill residents of the country through the closure of these facilities
and forcing these people into dangerous hospitals where they are likely put into seclusion,
shackled and mistreated.
In addition to the medical costs associated with this condition, these patients are rarely
able to work and must be upheld through social service programs such as Medicare for
sustainable living solutions (food, housing, insurance). (Schizophrenia Facts and Statistics, NA)

5. Schizophrenia 5
Causes
It is thought that schizophrenia is brought on through stresses during pregnancy which
contribute to (or trigger) the condition. In addition, it is widely thought that genetic
predispositions are responsible for the onset of the condition. Identifying specific gene
misalignments during pregnancy may assist in the prevention of the condition as science furthers
its research. (Schizophrenia Facts and Statistics, NA)
Treatments
Treatments for this condition vary (or have varied) through the ages. During the middle
ages, causes for schizophrenia were thought to be witchcraft or demonic possession and
therefore, exorcisms were performed to help rid the patient of the symptoms. (Korn, N.A.) In
10,000 B.C., medical practitioners would bore holes into the skulls of patients to release the evil
spirit from the bodies (believing as well that the condition was the result of demonic possession).
(Lobotomy)
In 1934, ECT (electronic convulsive therapy) was introduced. This practice has come
under fire due to the method used for administration of the ECT therapy, including a lack of
patient’s rights, loss of memory and fractured or broken bones from lack of proper methods to
secure the patient before administration of the ECT. These improper treatments have led to
numerous deaths in patients. (Tartakovsky, N.A.)
Pharmaceutical therapies were introduced by a team of French scientists in the 1950’s.
Major drug advancements and scientific research has improved the strains of these drugs to assist
with the offset symptoms as well as improve quality of life have been introduced since that initial
introduction in the 50’s. (Korn, N.A.)

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Frontal lobotomy was introduced in 1936 by psychiatrist Walter Freedman. He
performed his first lobotomy for the purpose of alleviation of psychological symptoms on
January 17, 1946. His procedure led to more than 2500 lobotomy’s being performed by the
physician including the lobotomy of a 12 year old boy. Dr. Freedman was banned from the
medical practice and from performing such procedures as lobotomies in 1967 due to insufficient
medical treatment following the procedure. (Tartakovsky, N.A.)
The U.S. leads the world in lobotomies performed (around 50,000) between the late
1940’s and early 1950’s. Several countries have banned the procedure as inhumane and the ban
on this procedure continues in countries today. Within the U.S., certain states have banned the
procedure but it is not widely banned. (Lobotomy)
Modern Treatments
Antipsychotics have been often prescribed to help with the symptoms of schizophrenia.
(Korn, N.A.) Along with antipsychotic medication therapies is in-patient or out-patient therapy,
behavioral therapy, and constant monitoring. It is important to remember that not all APD
(antipsychotic drugs) are the same. (Luh, 2003) Different APD’s have different receptive
binding agents that offer different results. By grouping these medications into one class or
referring to them as the same types of medications can be dangerous to the patient and have
adverse reactions to the patient. (Luh, 2003)
In recent years, a drug called Ivega® Sustenna® has been introduced. (Invega Sustenna -
Information, NA) This drug is part of a family of drugs referred to as atypical antipsychotics and
is administered via a shot in a psychiatrist’s office once a month. (Invega Sustenna -
Information, NA) This family of drugs is still under great debate among medical professionals
because of the side effects which aren’t being discussed.

7. Schizophrenia 7
This drug is designed to alleviate symptoms such as hallucinations and voices and return
the patient to a more normal existence. (Invega Sustenna - Information, NA) However, when
you have a patient who is used to solitude and their only friends are the voices in their head, what
happens when you take the voices away? The result we may experience is a significant increase
in suicidal thoughts and actions. The destitute nature of the solitude the patient is now
experiencing is so depressing to them that they often have nothing left in their lives worth living
for. By way of comparison, it would be like someone dropping you in the middle of a deserted
island with no friends or anyone around you. The loss you would feel would cause a great
depression and likely lead to suicide.
Suicide rates are at an alarming level among patients diagnosed with schizophrenia.
(Limosin, Lozec, Casadebaigd, & Rouillonc, 2007) According to a 1993 study which included
vital statistic data of schizophrenic patients over a 10 year period, an alarming 53.9% of patients
had committed suicide. In addition to these high rates, it was also determined that of first year
diagnosed patients exhibited at 31.8% suicide rate. (Limosin, Lozec, Casadebaigd, & Rouillonc,
2007) Statistics such as these make you wonder if the shot that is available to patients is really
worth the risk. With an already high suicide rate, I would be curious to see what clinical data
experiences in another 10 years as to the rate of suicide among patients who received these shots.
Some therapists and doctors believe that behavioral therapies, in addition to medication,
will help with auditory hallucinations and subsequent symptoms. (Buccheri, Trysgstad, Dowling,
Hopkins, & White, 2004) A 1997 study determined that 25-30% of patients had little or no
positive response to antipsychotic medications in an attempt to alleviate their auditory
hallucinations. Behavioral therapies were given to patients to help alleviate both the auditory
symptoms and the resulting symptoms of schizophrenia, including anxiety and depression.

8. Schizophrenia 8
(Buccheri, Trysgstad, Dowling, Hopkins, & White, 2004)Patients in this study exhibited a 40%
improvement in both hallucinations and the underlying symptoms of anxiety and depression
through the use of both medication and behavioral therapies in conjunction with each other.
(Buccheri, Trysgstad, Dowling, Hopkins, & White, 2004)
When we look at the costs on a worldwide basis, we can see that the U.S. is significantly
behind in its costs associated with treating schizophrenia. (Mangalore, Judit, & Napp, 2004).
Without information relating to the increase of costs vs the implementation of a national health
plan (such as exists in Canada), we are less able to render this data to determine the true position
the U.S. is in comparitively to other countries and the true costs. Could our position in costs be
related to our unwillingness to treat these patients but rather put them behind prison walls? Only
proper data will compel these true results.
Conclusion
With schizophrenia come a lot of confusion, fright and lack of education for the people
around the patient. We have all seen someone walking down the street talking to themselves and
been afraid of how they might react to us if we get too close. The U.S., through its closures of
nearly all government funded psychiatric wards, has effectively pushed these people out on to
the streets. They commit crimes they are unknowing of committing due to their symptoms and
end up in the most inhumane conditions while incarcerated.
If the U.S. would examine the cost of preventative care and that of hospitalizations under
the new Obama Care Act (requiring everyone to have insurance of some sort in the U.S.) and
requiring the Medicare and Medicaid plans to cover these conditions could greatly reduce the
number of homeless, institutionalized and otherwise lost members of our society who may be,

9. Schizophrenia 9
one day, returned to being a productive member of society if we just gave them the opportunity
to get well rather than jump to conclusion and incarcerate them.
While this condition is brought on usually at a young age, some symptoms can be
confused for normal childhood issues and defiance related teen behavior. It is important that if
you suspect tendencies of schizophrenia in children that you get them help immediately. With
the use of a 24 hour psych hold (for observation) you may end up saving a life rather than blindly
looking another direction.
Dr. Elyn Saks has proven that through the loving support of family and the proper
medication combined with hospital stays (as needed) one can lead a productive (or in her case, a
better than productive) life. It is important that these people have the loving support of family
and friends and accept the inpatient therapies and medications as needed. Stressing maintenance
of medication rather than avoidance and combining these medications with behavioral therapies
can present a winning combination to alleviate symptoms and return the patient to a non-
dangerous status in their condition.
Let’s turn a blind eye no more, let’s do something about the status in our country and
demand that facilities be built to assist these patients with their recovery.

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References
Buccheri, D. R., Trysgstad, D. R., Dowling, P. R., Hopkins, M. R., & White, F. M. (2004).
Presistent Auditory Hallucinations in Schizophrenia. Journal of Psychosocial Nursing & Mental
Health Services , 42.1, pp. 18-27.
Green, M. F., & Horan, W. P. (2010). Social Cognition in Schizophrenia. Current Directions in
Psychological Science , 19 (4), 243-248.
Invega Sustenna - Information. (NA). Retrieved 07 25, 2015, from Invega Sustenna:
http://www.invegasustenna.com/about-invega-sustenna
Korn, M. M. (N.A.). Historical Roots of Schizophrenia. Retrieved 07 25, 2015, from Medscape:
http://www.medscape.org/viewarticle/418882_6
Limosin, F., Lozec, J.-Y., Casadebaigd, F., & Rouillonc, F. (2007). Ten-year prospective follow-
up study of the mortality by suicide in schizophrenic patients. Elseiver Schizophrenia Research ,
94 (1-3), pp. 23-28.
Lobotomy. (n.d.). Retrieved 07 25, 2015, from Wikipedia:
https://en.wikipedia.org/wiki/Lobotomy
Luh, J. Y. (2003). Atypical antipsychotic drugs for schizophrenia. Mayo Clinic Proceedings , 78
(3), pp 381-382.
Mangalore, R., Judit, S., & Napp, M. (2004). The Global Costs of Schizophrenia. Schizophrenia
Bulletin , 30 (2), pp 27-293.
Mayo Clinic Staff. (NA). Schizophrenia Symptoms - Diseases and Conditions. Retrieved 07 25,
2015, from Mayo Clinic: http://www.mayoclinic.org/diseases-
conditions/schizophrenia/basics/symptoms/con-20021077
O'Carroll, R. (2000). Cognitive impairment in schizophrenia. Advances in Psychiatric Treatment
, 6 (3), 161-168.
Schizophrenia Facts and Statistics. (NA). Retrieved 07 25, 2015, from Schizophrenia.com:
http://www.schizophrenia.com/szfacts.htm
Tartakovsky, M. M. (N.A.). The Surprising History of Lobotomy. Retrieved 07 25, 2015, from
Psych Central: http://psychcentral.com/blog/archives/2011/03/21/the-surprising-history-of-the-
lobotomy/