The role of education in executive functions, behavioral problems and functional performance in people with schizophrenia.

Abstract

Objective: This cross-sectional study examined the influence of education on executive functions, behavioral problems and functional performance in people with chronic schizophrenia. Method: Our sample was composed of 116 subjects with a schizophrenia diagnosis (evolution time = 17.5±9.5 years) from consecutive referrals to the Rehabilitation Unit of Benito Menni Hospital (Valladolid, Spain). All participants completed an extensive standardized protocol including a neuropsychological testing of executive functions (processing speed, working memory, inhibition, interference control, mental flexibility), the assessment of behavioral symptoms, and functional performance.Hierarchical regression models (HRMs) were carried out to determine whether education (in years) relates to executive functions after controlling for the effect of demographics, IQ, and clinical factors. Results: Both IQ and years of education were associated with a later onset of the illness. Specifically, high education (in years) significantly correlated with fewer behavioral problems and better functional performance in daily life. Further, HRMs showed that education was associated with digit span and sematic verbal fluency tasks after controlling for the effect of age, sex, and IQ as covariates. Conclusions: Higher education may ameliorate executive deficits in patients with chronic schizophrenia and, in turn, diminish the behavioral and functional problems of the illness.

Evaluation of the Relationship between Disability and Disease Severity, Cognitive Functions, and Insight in Patients with Schizophrenia

“…Furthermore, our research has shown that higher levels of education are associated with better cognitive test performance, improved social functioning, and higher cognitive insight. This is consistent with previous studies that have also suggested a positive correlation between education levels and social functioning in schizophrenia patients [40].…”

Anticholinergic load: A commonly neglected and preventable risk to cognition during schizophrenia treatment?

“…Among these factors, educational level emerged as a significant predictor of cognitive performance, positively associated with both global cognition and most cognitive domains. This finding does not surprise us, since the association between educational level and cognition is a well-established fact, supported by a wealth of scientific evidence ( Ayesa-Arriola et al, 2016 ; Ayesa-Arriola et al, 2023 ; Cámara et al, 2021 ; Lövdén et al, 2020 ). Regarding clinical characteristics associated with cognition, a history of psychiatric hospitalization was associated with poorer performance in Verbal Learning, consistent with prior findings linking a higher number of hospitalizations to diminished Verbal Learning ( Hori et al, 2020 ).…”

Exploring the Effectiveness of Group Cognitive Stimulation Training in People With Schizophrenia: A Randomized Controlled Trial

“…Cervello et al (2021) showed that working memory is not easy to significantly improve. Moreover, age is negatively associated with cognitive function, and schooling is positively associated with cognitive function (Gil-Berrozpe et al, 2020) and working memory (Cámara et al, 2021). The longer a patient has experienced schizophrenia, the more the overall cognitive function, working memory, and executive function tend to be degraded (Puig et al, 2017), as reflected in increasing difficulties faced in rearranging and reassembling numbers and words in the brain within a short time, reciting new messages, and then storing them in the brain for a few minutes before speaking them (Mihaljević-Peleš et al, 2019).…”