A narrative review of treatment interventions to improve cognitive performance in schizophrenia, with an emphasis on at-risk and early course stages. (November 2022)

• Record Type: Journal Article
• Authors: Mayeli, Ahmad; Clancy, Kevin J.; Sonnenschein, Susan; Sarpal, Deepak K.; Ferrarelli, Fabio
• Is Part Of: Psychiatry research. Volume 317(2022)
• Publication Date: 2022-11
• Subjects: Schizophrenia -- Cognition -- Early interventions -- Pharmacotherapy -- Cognitive remediation therapy; SCZ Schizophrenia -- IQ Intelligence Quotient -- CHR Clinical High Risk -- APS Attenuated Psychotic Symptoms -- BLIPS Brief and Limited Intermittent Psychotic Symptoms -- UHR Ultra High Risk -- NMDA N-methyl-d-aspartate -- nAChR α7 nicotinic AcetylCholine Receptor -- CRT Cognitive Remediation Therapy -- RCTs Randomized Controlled Trials -- dlPFC dorsolateral Prefrontal Cortex -- TMS Transcranial Magnetic Stimulation -- tDCS transcranial Direct Current Stimulation -- rTMS repetitive TMS -- NIBS Non-Invasive Brain Stimulation; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2022.114926
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlights: Cognitive dysfunction is a core feature of Schizophrenia (SCZ). Cognitive deficits often present several years before manifestation of SCZ symptoms. We reviewed findings of cognitive interventions in at risk, early, and chronic SCZ. Cognitive interventions in at risk/early stages of SCZ are critically important and need more attention. Abstract: Cognitive dysfunction is a core feature of schizophrenia (SCZ), which unfavorably affects SCZ patients' daily functioning and overall clinical outcome. An increasing body of evidence has shown that cognitive deficits are present not only at the beginning of the illness but also several years before the onset of psychosis. Nonetheless, the majority of treatment interventions targeting cognitive dysfunction in SCZ, using both pharmacological and nonpharmacological approaches, have focused on chronic patients rather than individuals at high risk or in the early stages of the disease. In this article, we provide a narrative review of cognitive interventions in SCZ patients, with a particular focus on pre-emptive interventions in at-risk/early course individuals when available. Furthermore, we discuss current challenges for these pre-emptive treatment interventions and provide some suggestions on how future work may ameliorate cognitive dysfunction in these individuals.