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									                                                              Applied Research II 1


                               Chapter One

                               Komal Patel

                 University of the Sciences in Philadelphia
                                                                       Applied Research II 2

Chapter 1
Statement of the problem

       Schizophrenia is a severe, chronic mental disorder that affects about 1.1% of

Americans over the age of 18 in a given year. Both men and women are affected equally

in all ethnic groups (National Institute of Mental health, 2007). The cause of this

disorder is unknown; however genetics seems to play a role. Psychological and social

factors may also play a role; researchers believe that events in a person’s life may trigger

schizophrenia (Ballas, 2006).

       Schizophrenia has three major categories of symptoms, positive, negative and

cognitive symptoms. Positive symptoms include hallucinations, delusions, thought

disorder and disorder of movements. These symptoms are usually easy to notice and are

not always present. Negative symptoms are a decrease in emotions and behavioral states.

They include flat affects, lack of pleasure in everyday life and a decrease in the ability to

initiate plans. Negative symptoms are harder to recognize. Cognitive symptoms include

inability to sustain attention, poor decision making and memory problems. These

symptoms are subtle and usually recognized through tests (National Institute of Mental

health, 2007). Many approaches are available for treating the symptoms of

schizophrenia; however, it is difficult to say which is most effective. Two popular forms

of therapy are cognitive behavioral therapy and pharmacotherapy.

       Cognitive behavioral therapy (CBT) is based on the idea that thoughts control a

person’s feelings and behaviors. “The cognitive therapist teaches people with

schizophrenia how to test the reality of their thoughts and perceptions, how to "not listen"

to their voices, and how to shake off the apathy that often immobilizes them (National

Institute of Mental health, 2007).” “CBT has been shown to produce large clinical effects
                                                                     Applied Research II 3

on measures of positive and negative symptoms of schizophrenia (Rector & Beck,


        Pharmacotherapy is the use of medications such as risperidone, olanzapine,

quietiapine, sertindole, ziprasidone and other antipsychotic drugs to control symptoms of

the disorder (National Institute of Mental health, 2007). “Antipsychotic or neuroleptic

medications work by changing the balances of chemicals in the brain and are used to

control the symptoms of the illness. These medications are effective, but are also

associated with side effects that may discourage a patient from taking them regularly

(Ballas, 2006).” Pharmacotherapy does not cure schizophrenia however it allows persons

with the disorder to live a some what normal life by alleviating some of the symptoms

(National Institute of Mental health, 2007).

        The study proposed is designed to determine which form of treatment, cognitive

behavioral therapy or pharmacotherapy, produces better results. This study will

investigate how these forms of treatment are administered. Both the short term and long

term effects will be looked at in determining effectiveness. The information gathered

from this study will be beneficial for both persons with schizophrenia and those treating



        The primary purpose of this study is to determine whether cognitive behavioral

therapy or pharmacotherapy is more effective in the treatment of persons with

                                                                  Applied Research II 4

Research Question

       The proposed study is designed to answer the following question. Is cognitive

behavioral therapy more effective than pharmacotherapy in treating persons with

                                                                     Applied Research II 5


Ballas, P. (2006). Medline Plus: Schizophrenia. Retrieved on February 8, 2008 from

Miyamoto, S., Duncan, G.E., Marx, C.E. & Lieberman, J.A. (2005). Treatments for

       schizophrenia: a critical review of pharmacology and mechanisms of action of

       antipsychotic drugs. Molecular Psychiatry. 10, 79-104.

National Institute of Mental Health. (2007). Schizophrenia. Retrieved on February 8,

       2008 from


Rector, N.A. & Beck, A.T. (2001). Cognitive behavioral therapy for schizophrenia: an

       empirical review. J Nerv Ment Dis. 189(5), 278-287.

Sensky, T., Turkington, D., Kingson, D., Scott, J.L., Scott, J., Siddle, R., O’Carroll, M. &

       Barnes, T. (2000). A randomized controlled trial of cognitive - behavioral

       therapy for persistent symptoms of schizophrenia resistant to mediation. Arch

       Gen Psychiatry. 57(2).

Turkington, D., Kingdon, D. & Weiden, J. (2006). Cognitive behavior therapy for

       schizophrenia. Am. J. Psychiatry. 163, 365-373.

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