scholarly journals Cognitive Deficit in Schizophrenia: From Etiology to Novel Treatments

2021 ◽  
Vol 22 (18) ◽  
pp. 9905
Author(s):  
Antón L. Martínez ◽  
José Brea ◽  
Sara Rico ◽  
María Teresa de los Frailes ◽  
María Isabel Loza
Keyword(s):  
Mental Illness ◽  
Cognitive Impairment ◽  
Negative Symptoms ◽  
Genetic Factors ◽  
Cognitive Deficit ◽  
Pharmacological Treatments ◽  
Novel Treatments ◽  
Novel Drugs ◽  
Positive And Negative Symptoms ◽  
Effective Treatments

Schizophrenia is a major mental illness characterized by positive and negative symptoms, and by cognitive deficit. Although cognitive impairment is disabling for patients, it has been largely neglected in the treatment of schizophrenia. There are several reasons for this lack of treatments for cognitive deficit, but the complexity of its etiology—in which neuroanatomic, biochemical and genetic factors concur—has contributed to the lack of effective treatments. In the last few years, there have been several attempts to develop novel drugs for the treatment of cognitive impairment in schizophrenia. Despite these efforts, little progress has been made. The latest findings point to the importance of developing personalized treatments for schizophrenia which enhance neuroplasticity, and of combining pharmacological treatments with non-pharmacological measures.

scholarly journals Issues and developments related to assessing function in serious mental illness

2016 ◽  
Vol 18 (2) ◽  
pp. 135-144 ◽  
Keyword(s):  
Mental Illness ◽  
Clinical Trials ◽  
Cognitive Impairment ◽  
Serious Mental Illness ◽  
Daily Activity ◽  
Functional Outcomes ◽  
Negative Symptoms ◽  
Functional Disability ◽  
Assessment Instruments ◽  
Novel Treatments

Serious mental illness (SMI) results in functional disability that imposes a significant burden on individuals, caregivers, and society. Development of novel treatments is under way in an effort to improve the illness domains of cognitive impairment and negative symptoms and subsequently to improve functional outcomes. The assessment of functional outcomes in SMI faces a number of challenges, including the proliferation of assessment instruments and the differential prioritization of functional goals among stakeholder groups. Functional assessments relying on self- and informant report present a number of limitations. Identifying alternative strategies to assess functioning that are reliable, valid, and sensitive to change is necessary for use in clinical trials. Measures of functional capacity have been proposed for clinical trials investigating compounds to treat cognitive impairment in schizophrenia. Alternative approaches employing effort-based decision making or daily activity recording using instruments such as the Daily Activity Report may be more appropriate for studies focused on improving negative symptoms.

Three Syndromes in Chronic Schizophrenia

1989 ◽  
Vol 155 (S7) ◽  
pp. 119-122 ◽  
Author(s):  
P.F. Liddle ◽  
Thomas R.E. Barnes ◽  
D. Morris ◽  
S. Haque
Keyword(s):  
Cognitive Impairment ◽  
Clinical Features ◽  
Negative Symptoms ◽  
Chronic Schizophrenia ◽  
Brain Abnormalities ◽  
Brain Abnormality ◽  
Schizophrenic Patients ◽  
Extensive Body ◽  
Positive And Negative Symptoms

In recent years, exploration of the distinction between positive and negative symptoms of schizophrenia has provided a fruitful basis for attempts to relate the clinical features of schizophrenia to the accumulating evidence of brain abnormalities in schizophrenic patients. By 1982, there was an extensive body of evidence supporting the hypothesis that negative schizophrenic symptoms, such as poverty of speech and flatness of affect, were associated with substantial brain abnormalities, such as increased ventricular to brain ratio, and extensive cognitive impairment (Crow, 1980; Andreasen & Olsen, 1982). However, at that stage there were several fundamental unanswered questions about the nature of negative symptoms, and their relationship to indices of brain abnormality. This paper presents some findings of a series of studies initiated in 1982 to seek answers to some of these questions.

Rumination, Depressive Symptoms and Awareness of Illness in Schizophrenia

2012 ◽  
Vol 42 (2) ◽  
pp. 143-155 ◽  
Author(s):  
Neil Thomas ◽  
Darryl Ribaux ◽  
Lisa J. Phillips
Keyword(s):  
Mental Illness ◽  
Depressive Symptoms ◽  
Cognitive Processes ◽  
Negative Symptoms ◽  
Chronic Schizophrenia ◽  
Social Consequences ◽  
Stable Phase ◽  
Negative Thinking ◽  
The Social ◽  
Positive And Negative Symptoms

Background: Depressive symptoms are common in schizophrenia. Previous studies have observed that depressive symptoms are associated with both insight and negative appraisals of illness, suggesting that the way in which the person thinks about their illness may influence the occurrence of depressive responses. In affective disorders, one of the most well-established cognitive processes associated with depressive symptoms is rumination, a pattern of perseverative, self-focused negative thinking. Aims: This study examined whether rumination focused on mental illness was predictive of depressive symptoms during the subacute phase of schizophrenia. Method: Forty participants with a diagnosis of schizophrenia and in a stable phase of illness completed measures of rumination, depressive symptoms, awareness of illness, and positive and negative symptoms. Results: Depressive symptoms were correlated with rumination, including when controlling for positive and negative symptoms. The content of rumination frequently focused on mental illness and its causes and consequences, in particular social disability and disadvantage. Depressive symptoms were predicted by awareness of the social consequences of mental illness, an effect that was mediated by rumination. Conclusions: Results suggest that a process of perseveratively dwelling upon mental illness and its social consequences may be a factor contributing to depressive symptoms in people with chronic schizophrenia.

scholarly journals Atypical antipsychotics and the negative symptoms of schizophrenia

1998 ◽  
Vol 4 (1) ◽  
pp. 53-61 ◽  
Author(s):  
David J. King
Keyword(s):  
Nervous System ◽  
Antipsychotic Medication ◽  
Negative Symptoms ◽  
Atypical Antipsychotics ◽  
Genetic Factors ◽  
Cortical Atrophy ◽  
Positive Symptoms ◽  
Type I ◽  
Type Ii ◽  
Positive And Negative Symptoms

The concept of positive and negative symptoms in schizophrenia can be traced back to Hughlings Jackson (1889) who taught that disease does not create, it sets free, and accordingly positive symptoms could be seen as ‘release’ phenomena resulting from ‘dissolution’ of the highest cerebral centres of the nervous system. Crow (1980) revived the dichotomy and proposed a Type I syndrome, characterised by positive symptoms, and a Type II syndrome, characterised by negative symptoms. He thought the latter was due to cortical atrophy and responded poorly to antipsychotic medication. In their review of the distinction, Walker & Lewine (1988) found a stronger relationship between premorbid dysfunction and negative symptoms than with positive symptoms. They also found there was a stronger influence of genetic factors on negative symptoms than positive symptoms.

The Positive: Negative Dichotomy in Schizophrenia

1990 ◽  
Vol 157 (1) ◽  
pp. 41-49 ◽  
Author(s):  
A. M. Mortimer ◽  
C. E. Lund ◽  
P. J. McKenna
Keyword(s):  
Cognitive Impairment ◽  
Negative Symptom ◽  
Negative Symptoms ◽  
Thought Disorder ◽  
Motor Disorder ◽  
Positive Symptoms ◽  
Formal Thought Disorder ◽  
Symptom Scores ◽  
Schizophrenic Patients ◽  
Positive And Negative Symptoms

Two studies are reported. In the first, of 62 schizophrenic patients, no correlation between negative symptom scores (rated blindly) and any measure of positive symptoms was found. This independence was confirmed by factor and cluster analyses, which left the question of a third ‘disorganisation’ class of schizophrenic symptoms open. In the second study, of 80 patients, formal thought disorder separated unequivocally into ‘positive formal thought disorder’ and ‘alogia’ syndromes on the basis of correlations with positive and negative symptoms. Catatonic motor disorder also showed evidence of a corresponding positive: negative division, although this only emerged when severity or chronicity of illness was controlled for. Cognitive impairment showed a broad range of affiliations and its particular correlation with negative symptoms was perhaps artefactual.

scholarly journals Effect of Cuscuta epithymum Acquainted with Risperidone on the Improvement of Clinical Symptoms and Cognitive Impairment in Patients with Schizophrenia: A Triple-Blind Randomized Placebo-Controlled Trial

2019 ◽  
Vol 8 ◽  
Author(s):  
Maedeh Parvizi ◽  
Farbod Fadai ◽  
Moahammad Reza Khodaei-Ardakani ◽  
Gholamreza Amin ◽  
Leila Abdi ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Negative Symptoms ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
Intervention Group ◽  
Substantial Improvement ◽  
Control Group ◽  
Post Intervention ◽  
The Status ◽  
Positive And Negative Symptoms

Background: Cuscuta epithymum (CE) is an established medicinal herb utilized for treating psychosis in Persian medicine. The aim of this study was to investigate the effect of CE combined with risperidone on the clinical symptoms and the cognitive impairment in patients diagnosed with schizophrenia. Materials and Methods: In this triple-blind randomized placebo-controlled trial, the intervention group received a dose of 500 mg of CE in the form of a capsule to be taken twice a day accompanied by an appropriate dose of risperidone. The control group was presented with a placebo identical to that of the CE capsule plus the allocated dose of risperidone. The PANSS and SCoRS questionnaires were used to assess the status of subjects prior to the initiation of the intervention as well as being put to use at the end of the second, fourth, and eighth week post-intervention. Registering and recording intel concerning positive and negative symptoms felt by participants (PANNS), and a test to assess the cognitive impairment of the individuals. Results: After eight weeks of treatment, all negative and positive symptoms besides hostility and somatic concern exhibited a significant improvement in the CE group (P <0.05). In contrast, the CE placebo group displayed no substantial improvement in the cases of the positive, negative and general symptoms (P>0.05) regarding cognitive impairment, after eight weeks of treatment, all symptoms were greatly improved in the CE group (P<0.05), while the effect of the placebo  on the patients cognitive impairment remained mostly stationary (P>0.05). Consequently, after eight weeks after the intervention, we can determine that the CE treatment has been noticeably more effective at improving positive, negative and cognitive symptoms of patients with schizophrenia. Conclusion: The results of this study demonstrated that CE, possessing possible antioxidant and neuroprotective properties, safely improved the positive and negative symptoms, and cognitive impairment of patients with schizophrenia.[GMJ.2019;8:e1334]

Cognitive deficit in schizophrenia and its neurochemical basis

1999 ◽  
Vol 174 (S37) ◽  
pp. 16-18 ◽  
Author(s):  
Alan Breier
Keyword(s):  
Cognitive Impairment ◽  
Negative Symptoms ◽  
Antipsychotic Drugs ◽  
Cognitive Deficit ◽  
Cognitive Enhancement ◽  
Emission Tomography ◽  
Central Feature ◽  
Positron Emission ◽  
Underlying Causes ◽  
Neurochemical Correlates

Cognitive impairment is a central feature of schizophrenia and has been correlated with negative symptoms and impaired social functioning. There is a growing body of data suggesting that the so-called atypical antipsychotic drugs (e.g. clozapine, risperidone, and olanzapine) are better at enhancing cognitive function than traditional neuroleptics. Preclinical studies of information processing using a pre-pulse inhibition model show that the mechanism of action of both olanzapine and clozapine for cognitive enhancement may involve glutamatergic/N-methyl-D-aspartate (NMDA) antagonism. Using positron emission tomography, we have described the metabolic and neurochemical correlates of cognitive impairment induced by glutamatergic/ NMDA antagonism. A better understanding of the underlying causes of cognitive impairment may contribute to elucidating the pathophysiology of schizophrenia and the development of more efficacious treatments for this disorder.

scholarly journals Positive and negative symptoms of schizophrenia as correlates of help-seeking behaviour and the duration of untreated psychosis in south-east Nigeria

2014 ◽  
Vol 20 (4) ◽  
pp. 6 ◽  
Author(s):  
Paul Chigozie Odinka ◽  
A C Ndukuba ◽  
R C Muomah ◽  
M Oche ◽  
M U Osika ◽  
...  
Keyword(s):  
Mental Illness ◽  
Help Seeking ◽  
Negative Symptoms ◽  
Early Recognition ◽  
Treatment Options ◽  
Psychiatric Hospitals ◽  
World Health ◽  
Duration Of Untreated Psychosis ◽  
Early Presentation ◽  
Positive And Negative Symptoms

<p><strong>Background.</strong> Duration of untreated psychosis (DUP) has been widely recognised in recent years as a potentially important predictor of illness outcome, and the manifestations of schizophrenia have been known to influence its early recognition as a mental illness. </p><p><strong>Objective.</strong> To assess the association between the positive and negative symptoms of schizophrenia, help-seeking and DUP. </p><p><strong>Methods.</strong> We performed a cross-sectional study of 360 patients with schizophrenia, who had had no previous contact with Western mental health services. The Sociodemographic Questionnaire, World Health Organization Pathway Encounter Form and a questionnaire to establish DUP were used. The positive and negative syndrome scale and Composite International Diagnostic Interview were used for the assessment of mental disorders and to diagnose.</p><p><strong>Results.</strong> Respondents who had predominant positive symptoms and who had a median DUP of 8 weeks or 24 weeks, tended to use psychiatric hospitals and other Western medical facilities, respectively, as their first treatment options. However, those who had predominant negative symptoms and who had a median DUP of 144 weeks or 310 weeks, tended to use faith healers and traditional healers, respectively, as first treatment options.</p><p><strong>Conclusion.</strong> The predominance of negative symptoms could militate against early presentation among people with schizophrenia, probably because negative symptoms are poorly recognised as indicating mental illness in Nigeria, as they could be interpreted as deviant behaviour or spiritual problems that would require spiritual solutions.</p>

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