Schizophrenia is considered to be one of the most sever psychiatric disorders. The incidence of the condition each year is approximately 15 in every 100,000 people, and the lifetime risk of developing schizophrenia is 0.7% (Tandon et al., 2008). Family history and genetics have been identified as contributing to the development of schizophrenia in 80% of cases (Tandon et al., 2008). Some environmental factors associated with increased likelihood of the development of schizophrenia include prenatal malnutrition or infection, use of cannabis, birth complications, and winter birth (Tandon et al., 2008). However, the mechanisms by which genetic and genetic-environmental factors interact to cause the onset of schizophrenia are not well understood. It is important that effective treatments be developed to help individuals cope with this serious and debilitating psychiatric disorder. What types of therapies outside of pharmaceuticals have been found to be successful in the treatment of schizophrenia? Is any type of therapy more effective than the others in the management of symptoms associated with schizophrenia?
Study objectives and hypothesis
The proposed study in the present discussion will explore what factors cause or lead up to the manifestation of schizophrenia and whether any actions can be taken in order to prevent development of the psychiatric disorder. Is it possible that certain interventions could effectively act to prevent onset of the condition? The three interventions under investigation in this proposed study are exercise, cognitive therapy, and aspirin use. The study will examine the histories of exercise, cognitive therapy, and aspirin use among individuals with schizophrenia, targeting their experience with these factors prior to developing schizophrenia. Do individuals that are especially physically active demonstrate less risk for developing schizophrenia? How about people that have undergone a lot of cognitive therapy? Are they potentially at less risk of the disorder? Does regular aspirin use possibly offer some protection against developing schizophrenia? Based on prior research findings regarding effective non-pharmaceutical interventions for schizophrenia, it may be hypothesized that exercise and physical activity, cognitive therapy, and aspirin use may all provide some sort of protective effects against the development of schizophrenia among individuals predisposed to the disorder due to family history.
Cognitive therapy has been used to treat schizophrenia with some success (Eack et al., 2010). In particular, cognitive rehabilitation strategies have been demonstrated to be effective in improving cognitive functioning in schizophrenia patients. However, the reasons why this is effective and the underlying changes that happen during cognitive treatments that result in cognitive improvements in individuals with schizophrenia are not well understood. In order to better understand the physiological processes at work with this type of therapy, Eack et al. (2010) sought to examine changes in brain morphology that occurred during cognitive rehabilitation therapy in comparison with supportive types of therapy. The cognitive rehabilitation consisted of computer-assisted neurocognitive training as well as group-based neurocognitive exercises, while supportive therapy entailed illness management through psychoeducation and instruction in applied coping strategies (Eack et al., 2010). Brain morphology was assessed using structural magnetic resonance imaging. Results of this study indicated that gray matter of the brain was significantly more preserved in patients that underwent cognitive enhancement therapy in comparison with those who received supportive therapy. Improved cognition was associated with less gray matter loss in several areas of the brain. Based on these results, the researchers concluded that cognitive enhancement rehabilitation effectively offered neurobiologic enhancement and protection for individuals with schizophrenia, which also resulted in improvements in cognitive outcomes for the long-term.
Another non-pharmaceutical approach to the treatment of schizophrenia includes exercise therapy. Gorczynski & Faulkner (2010) investigated what effects exercise and physical activity programs had on the mental health of individuals with schizophrenia. They conducted this examination through a systematic review of scientific literature on this topic. The results of the study indicated that exercise significantly improved the experience of negative symptoms of mental state associated with schizophrenia. Also, physical health overall was found to improve due to participation in exercise and physical activity programs. Furthermore, yoga was found to result in even better mental state outcomes than exercise, and yoga also resulted in significantly better quality of life scores. Based on these results the researchers concluded that exercise-based programs have healthful effects both physically and mentally, and they could prove to be of great value for improving the overall well-being of individuals with schizophrenia.
Along these same lines, yoga therapy was investigated as a potential complementary treatment for schizophrenia in a study by Visceglia & Lewis (2011). In particular, the researchers investigated the effects that yoga therapy has on quality of life and symptomatology for patients with schizophrenia. The yoga therapy consisted of yoga postures, relaxation, and breathing exercises. The results of the study indicated that an 8-week therapeutic yoga program resulted in significant improvements in symptoms of schizophrenia and quality of life measures in comparison to a control group. Beyond cognitive therapy and exercise therapy, over the counter medication may also help improve symptomatology for patients with schizophrenia. Laan et al. (2010) assessed the effectiveness of aspirin in reducing symptoms associated with schizophrenia. Their rationale for studying the effects of aspirin is that it has been determined that inflammatory processes may play an important role in the development of schizophrenia, and aspirin has anti-inflammatory properties. Results of the study indicated that patients with schizophrenia that took aspirin demonstrated a significantly greater decrease in symptoms compared to patients with schizophrenia that did not take aspirin (Laan et al.,2010). Interestingly, the reduction in schizophrenic symptoms was found to be greater in patients demonstrating more altered immune function, pointing even further to the idea that inflammation may play a role in the presentation of schizophrenia, and the researchers suggested that this could indicate a potential new direction for the development of anti-psychotic drugs.
In exploring how these non-pharmaceutical therapies affect symptomatology and quality of life for individuals with schizophrenia, it is evident that cognitive rehabilitation, exercise therapy (including yoga therapy), as well as aspirin and its anti-inflammatory properties result in improved outcomes. This provides a solid foundation upon which the current study will explore these interventions with regard to their possible effectiveness as preventive measures against the development of schizophrenia.
The sample in the proposed study will consist of 120 individuals between the ages of 15 years and 17 years who are identified as being at increased risk of developing schizophrenia due to having one parent who suffers from the disorder. The sample will be recruited through local organizations supporting individuals with schizophrenia and their families. Informed consent will be obtained from the sample prior to commencement of the study. Demographic information will be collected from all participants in the study.
The study will be longitudinal in design, which will follow the participants for a period of 15 years. The sample will be divided into two main experimental and control groups, and further into 3 sub-categories within the experimental group. The groups will all be matched for demographic variables such as age, sex, and economic status. All groups will be tested for schizophrenia at the outset of the study, based on the presence of symptoms necessary for diagnosis of the disorder as it is outlined in the DSM -- IV. A questionnaire will be used that will allow the presence or absence or symptoms to be quantified and coded for purposes of analysis for the study. Measuring all of the groups at the outset of the study will provide a baseline measure for the entire sample prior to the introduction of the experimental treatments.
The control group in the study will not receive any intervention. Baseline measurements will be obtained, and this group, along with all of the experimental groups in the study, will be periodically tested for symptoms of schizophrenia every 2.5 years for the duration of the study. The experimental group will be divided into three sub-groups. All of the participants in the study will receive psychoeducation regarding schizophrenia at the outset of the study, as well as periodically throughout the study as presence of symptoms is assessed.
The first sub-group will be the cognitive-behavioral condition. This group will receive cognitive-behavioral therapy twice per month for the duration of the study. The therapy will include neurocognitive training and supportive therapy, which will include education on stress management and coping mechanisms.
The second sub-group in the experimental condition will be exposed to exercise therapy. This section of the sample will undergo a weekly exercise intervention, which will include cardiovascular exercise and yoga components. This intervention will run for the duration of the study.
The third sub-group involved in the experimental condition will be the aspirin group. The participants in this condition will be regularly administered aspirin on a daily basis. This intervention will also last for the duration of the study.
The data obtained from the various stages of the study will be analyzed through the application of a standard T-test. The three sub-groups of the experimental condition (cognitive behavioral therapy, exercise therapy, and aspirin intervention) will all be compared to the…