2011•Journal of Psychiatric PracticeRequires access

Persistent Cognitive Dysfunction Despite Clinical Improvement in Schizophrenia

Amresh Shrivastava, Megan Johnston, Nilesh Shah, Meghana Thakar, Larry Stitt

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Abstract

One negative outcome associated with schizophrenia is a deterioration of cognitive functioning. Little is known about what happens to cognitive abilities in the years following a diagnosis of first-episode schizophrenia. This study assessed the cognitive functioning of 61 individuals with first-episode schizophrenia who showed significant clinical improvement (Clinical Global Improvement rating of much or very much improved) after 10 years of treatment, comparing their cognitive functioning at the time of the initial diagnosis and at 10-year follow-up. Our results indicated deterioration in some cognitive abilities at baseline with further decline in this area found after 10 years. Visuomotor integration, working memory, and executive functioning deteriorated in the 10 years of treatment following diagnosis, and many individuals who were classified as much or very much improved still demonstrated abnormal cognitive functioning. These findings suggest the need for greater focus on cognitive functioning in treatment for schizophrenia.

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What this paper is about

One negative outcome associated with schizophrenia is a deterioration of cognitive functioning. Little is known about what happens to cognitive abilities in the years following a diagnosis of first-episode schizophrenia. This study assessed the cognitive functioning of 61 individuals with first-episode schizophrenia who showed significant clinical improvement (Clinical Global Improvement rating of much or very much improved) after 10 years of treatment, comparing their cognitive functioning at the time of the initial diagnosis and at 10-year follow-up. Our results indicated deterioration in some cognitive abilities at baseline with further decline in this area found after 10 years. Visuomotor integration, working memory, and executive functioning deteriorated in the 10 years of treatment following diagnosis, and many individuals who were classified as much or very much improved still demonstrated abnormal cognitive functioning. These findings suggest the need for greater focus on cognitive functioning in treatment for schizophrenia.

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Available abstract

One negative outcome associated with schizophrenia is a deterioration of cognitive functioning. Little is known about what happens to cognitive abilities in the years following a diagnosis of first-episode schizophrenia. This study assessed the cognitive functioning of 61 individuals with first-episode schizophrenia who showed significant clinical improvement (Clinical Global Improvement rating of much or very much improved) after 10 years of treatment, comparing their cognitive functioning at the time of the initial diagnosis and at 10-year follow-up. Our results indicated deterioration in some cognitive abilities at baseline with further decline in this area found after 10 years. Visuomotor integration, working memory, and executive functioning deteriorated in the 10 years of treatment following diagnosis, and many individuals who were classified as much or very much improved still demonstrated abnormal cognitive functioning. These findings suggest the need for greater focus on cognitive functioning in treatment for schizophrenia.

Key concepts: Schizophrenia (object-oriented programming), Cognitive remediation therapy, Cognition, Cognitive skill, Effects of sleep deprivation on cognitive performance, Executive functions, Psychology, Clinical psychology

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