Cognitive Deficits In Schizophrenia

Cognitive deficits in schizophrenia can be severe and are often associated with functional problems. Unfortunately, however, it is not always easy to identify what is causing the deficits without a complete neuropsychological profile.

It is important to note that these deficits do not appear to be the product of the positive symptoms of schizophrenia (hallucinations, thought disorders, delusions, etc.). So far, there is no evidence for a direct relationship between the severity of the hallucinations or delusions and the severity of the cognitive deficits.

Individuals often experience cognitive changes related to attention, orientation, and memory before any psychotic symptoms. On the other hand, some cognitive changes, such as those related to attention and working memory, are present. However, these remain stable during psychotic episodes.

In some cases, for example, where patients are discharged after a long hospital stay, research shows that negative symptoms can improve, while cognitive impairment remains the same or even worsens. What this shows is that these two elements are relatively independent of each other.

However, cognitive changes and negative symptoms are closely related because of their interaction. However, this association is not easy to analyze.

In general, losing interest in things and feeling disconnected from a project affects a person’s cognitive abilities. As a result, the combination of these variables can have a greater impact on the prognosis.

The effects of cognitive deficits in schizophrenia

As we mentioned above, the cognitive alternations in schizophrenia can be severe. They limit the patient’s personal autonomy and ability to perform their daily tasks.

• Cognitive deficits can affect a patient’s ability to function socially because of deficits in explicit memory and the ability to sustain attention.
• Deficits in executive function, explicit memory, working memory and sustained attention can affect the patient’s occupational function. It compromises the ability to concentrate, remember information, and learn new things.

• Executive function deficits, explicit memory deficits, and working memory deficits can also affect the individual’s ability to live independently. It affects patients’ ability to perform daily tasks, such as cooking, shopping, and personal hygiene, to name a few.

Causes of cognitive deficits in schizophrenia

Scientists do not yet know what causes cognitive deficits in schizophrenia. Some experts suggest that these cognitive impairments may be a result of antipsychotic treatment. However, there is no data to support that hypothesis.

Research shows that conventional antipsychotics have a positive, albeit moderate, effect on some fundamental psychological processes such as attention. The downside is that they can also affect motor skills.

So we still don’t know whether antipsychotics cause or solve cognitive deficits in people with schizophrenia. Further research may shed more light on this topic.

In 2018, researchers from the University of the Basque Country UPV/EHU published a study evaluating the effectiveness of several drugs in slowing cognitive decline in patients with Alzheimer’s disease. To do that, they evaluated any significant improvement in cognitive mutations in patients with Alzheimer’s.

Through analysis of new world-class clinical trials, researchers have made a series of methodological improvements in drug discovery that ensure the functional recovery of these patients.

Non-pharmacological treatment

One of the main problems with antipsychotics is that they are only useful for treating positive symptoms. They are not very effective for the negative symptoms of schizophrenia. This is why other non-drug-based treatments are also important.

Occupational therapy, for example, can help treat attention problems. It can help the patient improve focused attention and concentration with stimulation, concentration and manual labor exercises.

All treatments should be tailored to the individual needs of each patient. Some anatomical and neurochemical changes are common in schizophrenic patients. However, the heterogeneity of the disorder makes it impossible to establish a general neuropsychological profile.