Resilience Improves Neurocognition and Treatment Outcomes in Schizophrenia: A Hypothesis

Abstract

There has been a revolutionary advance in the treatment and management of schizophrenia from a clinical aspect yet the social and functional outcomes remain poor. Cognitive function is impaired in schizophrenia and shows various domains of dysfunction like verbal memory, processing speed and working memory. It is also known to be a factor associated with poor outcome in schizophrenia. Resilience is a new concept psychobiological concept which is defined as individual's ability to adapt swiftly to adverse life events and bounces back to normalcy. Resilience has genetic, neurobiological, neurochemical and psychological underpinnings. It is the ability to effectively deal with psychosocial stressors and appears to be one of the many factors associated with favourable outcomes in schizophrenia. Besides several neurobiological abnormalities associated with resilience, neucognitive functions are of particular interest. Persistent psychosocial stressors also lead to significant neurobiological changes which may be synergetic to poor outcome due to cognitive changes. Though there has been extensive research in the field of cognitive function in schizophrenia, the trajectory of its pathway of poor outcome remains undetermined. Resilience being a protective factor may be one of the psychobiological functions which modulate the effect of neurocognition on the outcome of schizophrenia. There has been some success with interventions aimed at improving cognitive function in schizophrenia whether pharmacological or non pharmacological. In this paper, we discuss a hypothesis that resilience may be a "linkage" between cognition and outcome. There is a need for interventions aimed at increasing resilience in patients with schizophrenia and we hypothesize giving evidence that this may in turn improve outcome and neurocognitive functioning in schizophrenia.

Resilience and Cognitive Function in Patients With Schizophrenia and Bipolar Disorder, and Healthy Controls

“…More recently, it has been hypothesized that cognitive function may influence the course of serious mental illness through its impact on resilience which, in turn, may mediate functional outcomes ( 10 ). The aim of the present study was to compare resilience and cognitive function in patients diagnosed with schizophrenia, patients diagnosed with bipolar disorder, and a sample of healthy controls and to determine if observed deficits in resilience are attributable to deficits in cognitive function.…”

Epigenetics, Resilience, Comorbidity and Treatment Outcome

“…In addition to clinical remission, secondary resilience may lead to personal growth and developing a meaningful life after mental illness. On the opposite side, lack of resilience determines onset, course, outcome, distress and burden of mental illness (see Shrivastava et al 2016). Tertiary resilience enables patients to develop a healthy and productive way to live with their illness, helps them to adapt to limitations in life associated with illness and have positive and creative life attitudes.…”

Examining the impact of mindfulness and self-compassion on the relationship between mental health and resiliency

“…They reported that these individuals possess resilience through the belief that adversity can be overcome by adhering to cultural values (e.g., religion, family unity, morals, and daily perseverance). Research by Shrivastava, De Sousa, Sonavane, and Shah (2016) led to hypothesising and verifying that an individual's resilience may be linked between positive cognition and the outcome of mental wellbeing.…”