Changes in neurocognitive functioning during transition to manifest disease: comparison of individuals at risk for schizophrenic and bipolar affective psychoses

Metzler, Sibylle; Dvorsky, Diane; Wyss, Christine; Müller, Mario; Gerstenberg, Miriam; Traber‐Walker, Nina; Walitza, Susanne; Theodoridou, Anastasia; Rössler, Wulf; Heekeren, Karsten

doi:10.1017/s0033291715000057

Cited by 21 publications

(14 citation statements)

References 71 publications

(107 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In contrast, a recent study showed that 10 prodromal individuals at clinical high risk for BD had non-significantly better baseline performance compared to both the 60 clinical high-risk SZ individuals and the 12 individuals converting to SZ during the 1 year follow-up. 27 However, as the group of 4 individuals who converted to BD were not included in the analysis, it is unknown whether cognitive performance in these individuals was impaired before or after the transition.…”

Section: Cognitive Functioning Pre-onset and In Cohorts At Familialmentioning

confidence: 99%

Current understandings of the trajectory and emerging correlates of cognitive impairment in bipolar disorder: An overview of evidence

et al. 2019

View full text Add to dashboard Cite

Objectives Cognitive dysfunction affects a significant proportion of people with bipolar disorder (BD), but the cause, trajectory and correlates of such dysfunction remains unclear. Increased understanding of these factors is required to progress treatment development for this symptom dimension. Methods This paper provides a critical overview of the literature concerning the trajectories and emerging correlates of cognitive functioning in BD. It is a narrative review in which we provide a qualitative synthesis of current evidence concerning clinical, molecular, neural and lifestyle correlates of cognitive impairment in BD across the lifespan (in premorbid, prodromal, early onset, post‐onset, elderly cohorts). Results There is emerging evidence of empirical links between cognitive impairment and an increased inflammatory state, brain structural abnormalities and reduced neuroprotection in BD. However, evidence regarding the progressive nature of cognitive impairment is mixed, since consensus between different cross‐sectional data is lacking and does not align to the outcomes of the limited longitudinal studies available. Increased recognition of cognitive heterogeneity in BD may help to explain some inconsistencies in the extant literature. Conclusions Large, longitudinally focussed studies of cognition and its covariation alongside biological and lifestyle factors are required to better define cognitive trajectories in BD, and eventually pave the way for the application of a precision medicine approach for individual patients in clinical practice.

show abstract

Section: Cognitive Functioning Pre-onset and In Cohorts At Familialmentioning

confidence: 99%

Current understandings of the trajectory and emerging correlates of cognitive impairment in bipolar disorder: An overview of evidence

et al. 2019

View full text Add to dashboard Cite

show abstract

“…People with SMI are also at increased risk of various other physical comorbidities, such as respiratory disease [12, 13], poor bone health [14] and physical multimorbidity [15]. Moreover, people with SMI typically experience pronounced cognitive impairment, which often worsens over time [16–18] and for which treatment approaches remain limited [19, 20].…”

Section: Introductionmentioning

confidence: 99%

EPA guidance on physical activity as a treatment for severe mental illness: a meta-review of the evidence and Position Statement from the European Psychiatric Association (EPA), supported by the International Organization of Physical Therapists in Mental Health (IOPTMH)

et al. 2018

View full text Add to dashboard Cite

Physical activity (PA) may be therapeutic for people with severe mental illness (SMI) who generally have low PA and experience numerous life style-related medical complications. We conducted a meta-review of PA interventions and their impact on health outcomes for people with SMI, including schizophrenia-spectrum disorders, major depressive disorder (MDD) and bipolar disorder. We searched major electronic databases until January 2018 for systematic reviews with/without meta-analysis that investigated PA for any SMI. We rated the quality of studies with the AMSTAR tool, grading the quality of evidence, and identifying gaps, future research needs and clinical practice recommendations. For MDD, consistent evidence indicated that PA can improve depressive symptoms versus control conditions, with effects comparable to those of antidepressants and psychotherapy. PA can also improve cardiorespiratory fitness and quality of life in people with MDD, although the impact on physical health outcomes was limited. There were no differences in adverse events versus control conditions. For MDD, larger effect sizes were seen when PA was delivered at moderate-vigorous intensity and supervised by an exercise specialist. For schizophrenia-spectrum disorders, evidence indicates that aerobic PA can reduce psychiatric symptoms, improves cognition and various subdomains, cardiorespiratory fitness, whilst evidence for the impact on anthropometric measures was inconsistent. There was a paucity of studies investigating PA in bipolar disorder, precluding any definitive recommendations. No cost effectiveness analyses in any SMI condition were identified. We make multiple recommendations to fill existing research gaps and increase the use of PA in routine clinical care aimed at improving psychiatric and medical outcomes.

show abstract

“…Cognitive impairments are usually evaluated using neuropsychological batteries, which assess memory, attention and related cognitive functions. The cognitive disorders are found to more or less preexist the clinical pathology, and persist after the onset of schizophrenia symptoms without any large variation ( Becker et al, 2010 ; Nuechterlein et al, 2014 ; Bora and Murray, 2015 ; Metzler et al, 2015 ; Bergh et al, 2016 ; but see Zhou et al, 2017 ). Moreover, they predict the functional outcome of the patients ( Lewandowski et al, 2013 ; Green, 2016 ; Thomas et al, 2017 ), but it is not clear how they relate with clinical symptoms.…”

Section: Introductionmentioning

confidence: 99%

Is Schizophrenia a Disorder of Consciousness? Experimental and Phenomenological Support for Anomalous Unconscious Processing

Giersch

Mishara

2017

Front. Psychol.

View full text Add to dashboard Cite

Decades ago, several authors have proposed that disorders in automatic processing lead to intrusive symptoms or abnormal contents in the consciousness of people with schizophrenia. However, since then, studies have mainly highlighted difficulties in patients’ conscious experiencing and processing but rarely explored how unconscious and conscious mechanisms may interact in producing this experience. We report three lines of research, focusing on the processing of spatial frequencies, unpleasant information, and time-event structure that suggest that impairments occur at both the unconscious and conscious level. We argue that focusing on unconscious, physiological and automatic processing of information in patients, while contrasting that processing with conscious processing, is a first required step before understanding how distortions or other impairments emerge at the conscious level. We then indicate that the phenomenological tradition of psychiatry supports a similar claim and provides a theoretical framework helping to understand the relationship between the impairments and clinical symptoms. We base our argument on the presence of disorders in the minimal self in patients with schizophrenia. The minimal self is tacit and non-verbal and refers to the sense of bodily presence. We argue this sense is shaped by unconscious processes, whose alteration may thus affect the feeling of being a unique individual. This justifies a focus on unconscious mechanisms and a distinction from those associated with consciousness.

show abstract

Changes in neurocognitive functioning during transition to manifest disease: comparison of individuals at risk for schizophrenic and bipolar affective psychoses

Abstract: Our data provide no evidence for a progressive cognitive decline in individuals at risk of psychosis. In line with the neurodevelopmental model, our findings suggest that cognitive deficits are already present very early, before or during the prodromal stage of the illness.

Cited by 21 publications

References 71 publications

Current understandings of the trajectory and emerging correlates of cognitive impairment in bipolar disorder: An overview of evidence

Current understandings of the trajectory and emerging correlates of cognitive impairment in bipolar disorder: An overview of evidence

EPA guidance on physical activity as a treatment for severe mental illness: a meta-review of the evidence and Position Statement from the European Psychiatric Association (EPA), supported by the International Organization of Physical Therapists in Mental Health (IOPTMH)

Is Schizophrenia a Disorder of Consciousness? Experimental and Phenomenological Support for Anomalous Unconscious Processing

Contact Info

Product

Resources

About