Cognitive performance in schizophrenia patients assessed before and following the first psychotic episode

Caspi, Asaf; Reichenberg, Abraham; Weiser, Mark; Rabinowitz, Jonathan; Kaplan, Zeev; Knobler, Haim Y.; Davidson-Sagi, Noa; Davidson, Michael

doi:10.1016/s0920-9964(03)00056-2

Cited by 170 publications

(117 citation statements)

References 56 publications

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“…Caspi et al [4] compared draft board IQ results with later IQ and noted that the major portion of the deficit was already present at the age of 16-17 years (at the draft), before the first psychotic episode. An additional, non-significant decline took place from the premorbid phase (the time of the draft IQ test) to the time the IQ was measured after the schizophrenia diagnosis had been established.…”

Section: Intellectual and Neurocognitive Declinementioning

confidence: 99%

“…This research framework is very much linked to a cluster of ideas about cognitive impairment either as a dementia-like decline (i.e. decrease in the intellectual abilities over time) or as more subtle and specific cognitive dysfunctions occurring early in the course of the illness [4][5][6] . The cognitive deficit is often assumed to be the major source of the subsequent functional and social decline typical of schizophrenia, and is ascribed a causative role with respect to psychopathological features [7,8] : 'cognitive deficits are a core feature of schizophrenia, which may precipitate psychotic and negative symptoms' (italics added) [ 8 , p. 26].…”

Section: Introductionmentioning

confidence: 99%

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Core of Schizophrenia: Estrangement, Dementia or Neurocognitive Disorder?

Urfer-Parnas¹,

Mortensen²,

Parnas³

2010

Psychopathology

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Background: The recent literature frequently represents schizophrenia as a deteriorating neurocognitive process similar to organic degenerative dementia. Methods: This study addresses the following questions: (1) Did the classic authors equate degenerative dementia with schizophrenia? (2) Is there empirical evidence pointing to a close similarity between schizophrenia and organic dementia? (3) Does empirical evidence support the view that intellectual impairment and/or more specific neuropsychological dysfunctions are core features of schizophrenia? The classic authors agreed that the intellectual dysfunctions were most likely a consequence rather than a primary, causal factor in the manifestation of schizophrenia despite their consensus on the assumption of its neurobiological origins. Rather, they considered impairments of intelligence and neurocognition as an expression of pseudodementia, i.e. a dementia-like clinical picture caused by a weakening of motivation. Results: The empirical data from the draft, high-risk birth cohort and clinical samples show a low IQ and a variety of neurocognitive dysfunctions in schizophrenia. These findings are far from universal since substantial proportions of patients do not show deficits. In addition, the empirical morphological and neuropathological evidence does not support any close analogy of schizophrenia with neurodegenerative dementia. Moreover, neurocognitive dysfunctions cannot be considered a core feature of schizophrenia if core is understood as ‘essential’, i.e. constitutive of a diagnosis, or as ‘generative’, i.e. symptom producing. In the phenomenological psychopathological tradition, schizophrenia is seen as a progressive condition marked by autism, which is a profound alteration in the structures (frameworks) of subjectivity (consciousness), manifest in self-relation (self-disorders) and in the relation to the world (lack of natural evidence) and to others (eccentricity, solipsism and isolation). Conclusion: It is suggested that the neurodevelopmental model should integrate interactions between emerging psychological structures and genetic and environmental factors.

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Section: Intellectual and Neurocognitive Declinementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Core of Schizophrenia: Estrangement, Dementia or Neurocognitive Disorder?

Urfer-Parnas¹,

Mortensen²,

Parnas³

2010

Psychopathology

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“…[251][252][253] There is remarkable agreement in the literature that deficits in multiple cognitive domains predate the onset of clinical symptoms; [254][255][256][257][258] are not attributable to antipsychotic medications; 259 persist over the course of the illness; are unrelated to its duration; [260][261][262] and behave like a stable trait. 233,263,264 Pervasive cognitive dysfunction has been reported in > 50% of schizophrenia patients in a community-based survey in Scotland, 265 and there…”

Section: Cognitive Dysfunction As An Endophenotypementioning

confidence: 99%

Subtyping schizophrenia: implications for genetic research

2006

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Phenotypic variability and likely extensive genetic heterogeneity have been confounding the search for the causes of schizophrenia since the inception of the diagnostic category. The inconsistent results of genetic linkage and association studies using the diagnostic category as the sole schizophrenia phenotype suggest that the current broad concept of schizophrenia does not demarcate a homogeneous disease entity. Approaches involving subtyping and stratification by covariates to reduce heterogeneity have been successful in the genetic study of other complex disorders, but rarely applied in schizophrenia research. This article reviews past and present attempts at delineating schizophrenia subtypes based on clinical features, statistically derived measures, putative genetic indicators, and intermediate phenotypes, highlighting the potential utility of multidomain neurocognitive endophenotypes.

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“…Impairments in some NP domains can be detected before psychosis becomes manifest and disruptive positive and negative symptoms emerge [5]. The developmental achievement of typical milestones is less common in those with schizophrenia than in the healthy population; perhaps because NP deficits disrupt skills acquisition early on and many functional skills themselves (i.e., social, vocational, and independent living skills) are performed at lower levels over the course of the lifespan [6].…”

Section: Introductionmentioning

confidence: 99%

Cognitive deficits, obesity and disability in schizophrenia

Strassnig

Cáceda

Newcomer

et al. 2012

Translational Neuroscience

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Despite 50 years of pharmacological and psychosocial interventions schizophrenia remains one of the leading causes of disability. The inability to function in everyday settings includes deficits in performance of social, occupational, and independent living activities. Schizophrenia is also a life-shortening illness, caused mainly by poor physical health and its complications. Dysfunctional lifestyles including sedentary behavior and lack of physical activity prevail, while treatment with adipogenic antipsychotic medication interacts with poor performance in screening, monitoring, and intervention that result in shortening of life expectancies by 25-30 years. Disability interferes with self-care and medical care, further worsening physical health to produce a vicious cycle of disability. Further, the neurobiological impact of obesity on brain functioning is substantial and relevant to schizophrenia. Decision making deficits that lead to choices resulting in obesity themselves have neurobiological determinants. Simultaneous treatment of cognitive deficits and related deficits in functional skills, ubiquitous determinants of everyday functioning in schizophrenia, and targeted interventions aimed at poor physical health, especially obesity and associated comorbidities, may lead to additive or even interactive gains in everyday functioning in patients with schizophrenia not previously realized with other interventions.

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Cognitive performance in schizophrenia patients assessed before and following the first psychotic episode

Cited by 170 publications

References 56 publications

Core of Schizophrenia: Estrangement, Dementia or Neurocognitive Disorder?

Core of Schizophrenia: Estrangement, Dementia or Neurocognitive Disorder?

Subtyping schizophrenia: implications for genetic research

Cognitive deficits, obesity and disability in schizophrenia

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