Cognitive deficits in patients with schizophrenia Flashcards
Describe the profile of cognitive deficits in schizophrenia.
Global deficits from automatic sensory processing to higher cognitive functions, incl.
- sensory gating
- simple reaction time and processing speed
- attention
- verbal and visual learning and memory
- working memory
- executive functions
- social cognition
- intelligence
Describe the progression of cognitive deficits from premorbid phases across the illness.
- ## The function decreases before the onset of psychosis (but around illness onset, before age 15): in the end of the premorbid phase –> predromal phase. After the onset of psychosis the function is at a plataeu (progressive phase) –> small increase with treatment
Describe the relation between cognitive deficits and psychopathology.
- cognitive deficits are largely independent of clinical state
- independent from positive symptoms, some correlation between cognition and negative symptoms
- patients with comprehensive paranoid delusions generally have better cognitive functions
Describe the relation between cognitive deficits and functional outcome.
High premorbid function + late onset of first episode –> predictors of good illness course
Give examples of the heritability of cognitive functions and overlap with schizophrenia liability
- The regions, connections and functions of the brain develop and mature are staggered, overlapping stages
- parallel cognitive development and maturation
Describe the neurodevelopment of schizophrenia - how are neuroplasticity affecting the patients?
Some stages of brain development are characterized by more plasticity –> increased sensitivity to impact of both endogenous and environmental factors
Describe the neurodevelopmental hypothesis of schizophrenia.
Disturbed pruning process in gray matter and disturbed myelination of white matter –> extended period from birth until full ilness presentation
Describe the correlation between cognition and diagnosis in schizophrenia.
- patients with results within the normal range have an estimated premorbid cognitive functional level 1 SD higher than healthy control with similar results
- 96 % patients have lower cognitive scores than expected based on maternal education
Describe the severity of cognitive deficits in schizophrenia.
- most domains between 1-1,5 SD below the norm
- most common deficits: executive and attention
- largest effect sizes: processing speed, and for some verbal memory