アクタ精神病理学 オープンアクセス

抽象的な

From “What” to “How”: The Effort to Fill the Gaps in Understanding Cognitive Processes Underpinning Remission in Schizophrenia

Thais Rabanea-Souza

Introduction: The accumulation of robust evidence culminated in the establishment of the cognitive deficits as a core symptom of Schizophrenia (SCZ). To date, there has been reliable evidence that cognitive deficits are associated with poor symptomatic outcomes in SCZ. Nevertheless, they have not been incorporated in definitions of remission and a systematic understanding of how cognition contributes to remission is still lacking. Although the standardized remission in SCZ criteria proposed in 2005 has encouraged studies to understand the role of cognitive function in symptomatic remission from SCZ, most investigations were cross-sectional and have studied samples of chronically ill patients. The purpose of the present study was to bring together the efforts of recent follow-up studies in early in earlier stages of the disease to fill the gap in the literature on understanding how cognitive impairment is related to remission.

Methods: A comprehensive search of the PsycINFO and MEDLINE/PUBMED databases was conducted.

Results: One study evaluated executive functioning in Early-Onset Schizophrenia (EOS) across stages of illness and suggested that executive impairment is present at the onset of SCZ and persists in attenuated but stable form after the resolution of psychotic symptoms. Studies in first-episode schizophrenia (FES) patients highlighted that despite verbal memory performance is strongly related to clinical remission in FES spectrum, it appears to have not a meaningful contribution to functional recovery. Longitudinal studies in SCZ patients suggested that executive function and higher premorbid Intelligence Quotient (IQ) were the best predictors of remission.

Conclusion: Since were emphasized the need to conduct longitudinal follow-up studies to assess the relation of cognitive performance to the proposed remission criteria, some efforts have been made to fill the gaps in understanding cognitive processes underpinning remission in schizophrenia. Notwithstanding the question regarding how aspects of symptomatic remission affect, and are affected by, aspects of cognitive function, remain not yet clarified, these long-term prospective studies addressing different domains of neurocognition in schizophrenia patients undergoing remission, mainly in early stages of illness, are being very enlightening to guide and encourage new researches.