Updates In Cognitive Impairment In Schizophrenia

Abstract

Cognitive dysfunction represents a core deficit in schizophrenia, and a number of studies (Green et al., 2000) illustrate how cognitive deficits may strongly influence the clinical presentation and daily functioning of people with this illness. Cognitive deficits in schizophrenia have been associated with disorganization and negative symptoms (Kerns and Berenbaum 2002) as well as with poor functional outcomes (Green 1998). Despite these links, cognitive dysfunction shows only modest improvement with currently available therapies and the vast majority of patients treated with second-generation antipsychotic drugs continue to experience significant cognitive disability (Harvey and Keefe 2001). In response to the increased awareness of the clinical importance of impaired cognition in schizophrenia, there has been a dramatic increase in research directed toward understanding the pathophysiological mechanisms underlying these deficits as well as developing effective therapies for this aspect of the illness. Some studies in schizophrenia have utilized standardized neuropsychological batteries to examine various aspects of cognition in the disorder. Findings reveal that cognitive deficits are present in schizophrenia regardless of illness stage, as 131 individuals experiencing their first episode of schizophrenia show a pattern of deficits on tasks related to frontal and temporal lobe functioning, including attention, processing speed, executive functioning, verbal fluency, verbal memory, and learning (Schuepbach et al., 2002). Deficits in these domains have been consistently associated with poor social functioning as well as poor work/school outcome (Smith et al., 2002). Understanding the early and central role of cognitive problems may help clinicians to more accurately diagnose incipient schizophrenia by telling it apart from other neuropsychiatric disorders that also have cognitive problems. It could also allow them to provide more appropriate treatment. Combining schizophrenia‘s cognitive warning signs with family history and signs of worsening daily functioning may also aid early diagnosis. Early intervention for cog