Epidemiology dwells on scientific methods of inquiry that is data-driven and relies on a systematic and unbiased approach to the collection, analysis, and interpretation of data. The methods rely on careful observation and use of comparison groups to assess whether what was observed, such as disease(s) or an exposure among persons with a disease, differs from what should be expected. Observational studies evaluate the association between a risk factor (exposure) and an outcome (disease). Friss and Sellers (2021) assert that observational studies apply careful measurement of patterns of exposure and disease in populations to draw inferences about etiology. Observational studies have two main subtypes: Descriptive and analytical. Descriptive studies identify cases by person, place, and time and develop hypotheses about the patterns and factors that increase risk of the disease. Analytical studies establish relationships between causative factors and the incidence of disease. Observational study designs are ecologic, cross-sectional, case-control, and cohort. This discussion will identify association(s) between trauma and the development of paranoid schizophrenia.
Schizophrenia is a brain disorder with clinical manifestations of hallucinations, delusions, and thought process and movement disorders (Centers for Disease Control and Prevention [CDC], 2015). In paranoid schizophrenia, affected individuals experiencing delusions of persecution have an altered perception of reality and may see or hear things that do not exist. He or she may believe that they are being watched or others are trying to harm them. Exact cause(s) of this disorder is unknown. Scientists believe a combination of physical, genetics, psychological, and environmental factors are more likely to cause the condition. According to Smith, Robinson, and Segal (2021), environmental factors and high levels of stress are believed to cause episodes of schizophrenia by creating an imbalance in the neurotransmitters dopamine and serotonin (Smith, Robinson, & Segal, 2018). To examine the association between increased stress and development of paranoid schizophrenia, a case-control study design is appropriate.
In a case-control study, researchers enroll people with a disease (case group or case-patients) and a comparison group. The comparison group (controls), are people without the disease under study. Researchers then compare previous exposures between the two groups with the control group providing an estimate or baseline of the expected amount of exposure in that population. If the amount of exposure among the case group is significantly higher, then the disease is said to be associated with that exposure. An important aspect of a case-control study is to identify a control group comparable to the case group. This will help provide a reasonable estimate of the baseline or expected exposure. Case-control studies are inexpensive, quick, and easy (CDC, 2012). Once samples are identified, data collection can be obtained from hospital and laboratory records. Friis and Sellers (2021) speculated that deciding on the diagnostic categories to select a control group and the controls not being a true representation of the exposure rates are the challenges (Friis & Sellers, 2021).
A case-control study design can provide understanding into how the disease affects populations in order to provide appropriate interventions. Management may include individual therapy for people who experienced trauma. Medication regimen, relation, attending support groups and exercising, and referral to social support resources may be beneficial to individuals with paranoid schizophrenia.
Centers for Disease Control and Prevention (CDC, 2012). Lesson 1: Introduction to epidemiology. Retrieved December 15, 2021, from https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section7.html
Centers for Disease Control and Prevention ([CDC], 2015). Emergency department visits related to schizophrenia among adults aged 18–64: United States, 2009–2011. Retrieved December 15, 2021, from https://www.cdc.gov/nchs/products/databriefs/db215.htm
Friis, R. H. & Sellers, T. A. (2021). Epidemiology for public health practice (6th Ed.). Sudbury,
MA: Jones & Bartle.
Smith, M., Robinson, L. & Segal, J. (2021). Schizophrenia symptoms and coping tips. Retrieved December 15, 2021, from https://www.helpguide.org/articles/mental-disorders/schizophrenia-signs-and-symptoms.htm