1) Cognitive deficits are a core feature of schizophrenia that present during active illness, remission, before illness onset, and in high-risk individuals.
2) Major cognitive domains affected include attention, executive function, processing speed, working memory, and verbal/visual memory. Nearly 80% of individuals with schizophrenia exhibit some cognitive deficit.
3) The causes of cognitive deficits in schizophrenia are thought to include prefrontal cortex dysfunction, neurodevelopmental abnormalities, and genetic factors. Cognitive deficits are also seen in unaffected first-degree relatives, suggesting a possible genetic component.
8. Major cognitive domains affected in
schizophrenia
Attention
Executive function
Processing speed
Social cognition
Verbal memory
Visuo-spatial memory
Working memory
General intellectual ability
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based and brain imaging findings Psychol
Bull 2007;133:833-858.
What
?
9. •Reichenberg A. The assessment of neuropsychological functioning in schizophrenia. Dialogues
Clin Neurosci. 2010;12:383-392.
What
?
10. Cognitive deficits in
schizophrenia present
• During active illness
• During remission
• Before the onset of illness
• In high risk individuals
• In first degree relatives of patients
with schizophrenia
Bora E, Lin A, Wood SJ, Yung AR, McGorry PD, Pantelis C. Cognitive deficits in youth with familial and
clinical high risk to psychosis: a systematic review and meta-analysis. Acta Psychiatr Scand. 2014
Jul;130(1):1-15.
Üçok A, Direk N, Koyuncu A, Keskin-Ergen Y, Yüksel Ç, Güler J, Karadayı G, Akturan E, Devrim-Üçok M.
Cognitive deficits in clinical and familial high risk groups for psychosis are common as in first
episode schizophrenia. Schizophr Res. 2013 Dec;151(1-3):265-9.
When
?
11. Why ?
• Dysfunction of the prefrontal cortex -
perfusion defect, defective metabolism
and defective synaptic pruning
[Stip E. 2006]
• Neurodevelopmental abnormality
12. • Genetic
– Cognitive deficits in first degree relatives of
patients with schizophrenia
Why ?
13. How
much ?
• Nearly four out of every five individuals
suffering from schizophrenia exhibit
some sort of cognitive deficit which
hamper the normal functioning of the
individual [Raffard et al, 2009].
14.
15. How to ?
• Cognitive remediation
– Compensatory Vs Restorative
– Top down Vs Bottom up
• Role of medications
– Antipsychotics
– Pro-cognitive agents
• Neuromodulation
Levels of
evidence
