Longitudinal studies of cognition in schizophrenia: Meta-analysis

Szöke, Andreı̈; Trandafir, Anca; Dupont, Marie-Estelle; Méary, Alexandre; Schürhoff, Franck; Leboyer, Marion

doi:10.1192/bjp.bp.106.029009

Cited by 293 publications

(216 citation statements)

References 69 publications

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“…Several studies have provided evidence indicating that cognitive and intellectual deficits are evident early in neurodevelopment, well before the onset of psychosis (Fuller et al 2002;Reichenberg et al 2010;Kahn & Keefe, 2013). Evidence also suggests that cognitive deficits are stable at follow-up in both chronic and early years of the illness even though performance of schizophrenia patients might improve less than healthy controls at follow-up (Szöke et al 2008;Bora & Murray, 2013;Hedman et al 2013). Neurodevelopmental theories argue that schizophrenia is related to genetic and non-genetic risk factors leading to abnormal development of the brain that can be associated with problems in acquiring cognitive abilities throughout development (Weinberger, 1986;Murray & Lewis, 1987), and that neurodevelopmental abnormality can be considered as the source of most of the cognitive deficits observed in adults with schizophrenia.…”

Section: Introductionmentioning

confidence: 99%

Neurodevelopmental origin of cognitive impairment in schizophrenia

2014

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Cognitive impairment is a common feature of schizophrenia; however, its origin remains controversial. Neurodevelopmental abnormalities clearly play a role in pre-morbid cognitive dysfunction in schizophrenia, yet many authors believe that schizophrenia is characterized by illness-related cognitive decline before and after onset of the psychosis that can be the result of neurodegenerative changes. The main reasons behinds such arguments include, first, the evidence showing that effect sizes of the cognitive deficits in subjects who develop adult schizophrenia gradually increase in the first two decades of life and, second, the fact that there is functional decline in many patients with schizophrenia over the years. In this Editorial, I argue that current evidence suggests that illness-related cognitive impairment is neurodevelopmental in origin and characterized by slower gain (developmental lag) but not cognitive decline continuing throughout the first two decades of life. I introduce a model suggesting that neurodevelopmental abnormality can in fact explain the course of cognitive dysfunction and variations in the trajectory of functional decline throughout the life in individuals with schizophrenia. In this model, the severity of underlying neurodevelopmental abnormality determines the age that cognitive deficits first become apparent and contributes to the cognitive reserve of the individual. Interaction of neurodevelopmental abnormality with clinical symptoms, especially negative symptoms and aging, vascular changes, psychological and iatrogenic factors contributes to the heterogeneity of the functional trajectory observed in this disorder.

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Section: Introductionmentioning

confidence: 99%

Neurodevelopmental origin of cognitive impairment in schizophrenia

2014

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“…In clinical high-risk populations, category fluency deficits-among the largest and most stable neurocognitive impairments in schizophrenia (Bokat & Goldberg, 2004;Szoke et al, 2008) -have shown promise as a clinical risk marker for psychosis (Becker et al, 2010;Eastvold, Heaton, & Cadenhead, 2007;Hawkins et al, 2004). The evidence is less clear, however, for using category fluency deficits as a clinical risk marker in psychometric schizotypy-a group at putative high risk for psychotic and other psychiatric disorders (Lenzenweger, 2006;Meehl, 1990; see Chun, Minor, & Cohen, 2013).…”

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confidence: 99%

Category fluency in psychometric schizotypy: how altering emotional valence and cognitive load affects performance

Minor

Luther

Auster

et al. 2015

Cognitive Neuropsychiatry

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“…[6][7] However, inconsistent data are available whether the research results based on patients in early stages of the illness can be generalized on more geriatric populations. 5,[8][9][10][11] Today, only few evaluated therapy approaches are available for middle-aged and older schizophrenia patients focusing on the defined treatment targets. A recent review 1 identified three social skills therapy approaches (SST) for elderly people with schizophrenia: the Functional Adaptation Skills Training 12 (FAST), Helping Older People Experience Success 13 (HOPES), and the Cognitive Behavioral Social Skills Training 14 (CBSST), which combines SST with cognitive-behavioral therapy.…”

mentioning

confidence: 99%

Integrated Psychological Therapy: Effectiveness in Schizophrenia Inpatient Settings Related to Patients' Age

Mueller¹,

Schmidt²,

Roder³

2013

The American Journal of Geriatric Psychiatry

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Objective: Elderly people with schizophrenia often suffer from cognitive impairments, which affect their social functioning. Today, only few therapy approaches for middleaged and older patients are available. The Integrated Psychological Therapy (IPT) combines neurocognitive and social cognitive interventions with social skills approaches. The aim of this study was to evaluate (1) whether IPT is effective in younger patients (age<40 years) and middle-aged patients (age≥40 years), and (2) whether control conditions (CC: treatment as usual or unspecific group activities) reveal some change in outcome depending on age. Method: A total of 15 controlled IPT studies with 632 schizophrenia inpatients were included into a standard meta-analytic procedure. Studies were categorized into two age-categories. Results: Significant medium to high effect sizes (ES) were evident for IPT independent of age on the global cognitive score (mean score of all cognitive variables), on neurocognition, social cognition, social functioning, psychopathology, and on the global therapy effect (mean of all variables). The IPT effects in middleaged patients were significantly higher on the global cognitive score, on neurocognition and on social cognition compared to younger patients. Opposite results could be observed in CC. Only younger patients participating in the CC showed small but significant ES on these variables, but almost middle-aged control patients did not. However, none of the differences in CC were significant between the two age-categories. A moderator analysis obtained no evidence for a strong impact of IPT variations, therapy setting, patient characteristics and methodological rigor of the research design. Conclusions: These results support evidence for the efficacy of IPT independent of age. Results further indicate the need of goal-oriented specific psychological interventions for middle-aged and older schizophrenia patients.Keywords: Schizophrenia, aged, middle-aged, elderly, cognition, therapy, integrated therapy, cognitive remediation, meta-analysis 3 There is evidence for a gradual aging of the population in developed countries all over the world, and also an increase of middle-aged and elderly schizophrenia patients. 1 Therefore, research focusing on the impact of the age on schizophrenia features as well as on the successful treatment of these features becomes important. During the last decades, a large bulk of data was published addressing younger people suffering from schizophrenia, but the needs of older schizophrenia patients were often neglected. Recent reviews of published data on the rehabilitation goals for older people with serious mental illness summarized that poor outcome in social functioning and lower quality of life are strongly associated with social isolation, depression, cognitive impairment, and chronic medical illness. 1,2 The authors concluded that specific interventions are needed with regard to these specific features associated with social functioning and quality of life in older patient...

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Longitudinal studies of cognition in schizophrenia: Meta-analysis

Abstract: Participants with schizophrenia displayed improvement in most cognitive tasks, but practice was more likely than cognitive remediation to account for most of the improvements observed. Semantic verbal fluency may be the best candidate cognitive endophenotype.

Cited by 293 publications

References 69 publications

Neurodevelopmental origin of cognitive impairment in schizophrenia

Neurodevelopmental origin of cognitive impairment in schizophrenia

Category fluency in psychometric schizotypy: how altering emotional valence and cognitive load affects performance

Integrated Psychological Therapy: Effectiveness in Schizophrenia Inpatient Settings Related to Patients' Age

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