Cognitive deficits in schizophrenia can be severe and associated with functional problems, on the other hand, the causes of these deficits are unclear and do not constitute a specific neuropsychological profile.
It should be noted that these deficits do not appear to be the product of positive symptoms (hallucinations, thinking disorders, delusions, among others) that accompany the disorder.
- To date.
- There has been no evidence of a direct link between the severity of hallucinations or delusions and the severity of cognitive deficits.
In fact, cognitive changes – attention, orientation, memory, etc. – are usually detected before the onset of properly psychotic symptoms, forming the framework that inflames warning signs.
On the other hand, it should be noted that certain cognitive impairments, such as attention and working memory, are present and remain stable after a psychotic episode.
Apparently, cognitive changes are independent of positive symptoms, nor do they appear to be caused by the negative symptoms of schizophrenia.
Some cases in which patients have been discharged after a long period of hospitalization have shown that negative symptoms (related to the way the person behaves socially) can improve while cognitive decline persists or even worsens, two relatively independent aspects.
Cognitive changes and negative symptoms are closely related; on the other hand, due to the number of interactions that can occur, this is not an easy association to analyze.
In general, loss of interest, activities and disconnection with a project affects each person’s cognitive abilities, so the combination of these variables can have a more significant influence on prognosis.
Cognitive changes in schizophrenia syndrome can be severe, limit personal autonomy, and are associated with a functional loss of daily life activities:
The person with schizophrenia may have difficulty paying attention and processing information when making decisions, or using the information immediately after learning it.
It is not known what causes cognitive deficits in schizophrenia, researchers even considered the possibility that these cognitive disorders are a consequence of antipsychotic treatment; however, there is no evidence to support this hypothesis.
Conventional antipsychotics have shown a positive but moderate effect on some basic psychological processes, such as attention, and their disadvantage is that they can affect motor skills.
As a result, it is not yet known whether antipsychotic therapy is the cause or solution of cognitive deficits in people with schizophrenia, it is necessary to deepen the topic and conduct new studies to understand it.
In 2018, researchers from the UPV/EHU of the University of the Basque Country published a study evaluating the effectiveness of various drugs to curb cognitive decline in patients with Alzheimer’s disease, and for this purpose significant improvements in cognitive changes experienced by schizophrenic patients have been evaluated.
Through the analysis of nine clinical trials conducted worldwide, researchers have identified a number of methodological improvements for the study of drugs that guarantee the recovery work of these patients.
Cognitive impairment in patients with schizophrenia is usually detected before antipsychotic treatment.
One of the main problems is that medications are helpful in treating positive symptoms. On the other hand, they usually don’t do very well with negative symptoms. However, they can be treated with other types of non-pharmacological therapies.
For example, to treat attention issues, occupational therapy can help the patient improve targeted care and concentration by conducting stimulation, concentration, and manual work exercises.
It is important and essential that any type of treatment, whether pharmacological or not, is adapted to the personal needs of each patient.
It should be noted that while some anatomical, neurochemical and functional changes have been found, it is impossible to establish a general neuropsychological profile for patients with schizophrenia due to the heterogeneity of the disorder so far.