Journal
SCHIZOPHRENIA RESEARCH-COGNITION
Volume 28, Issue -, Pages -Publisher
ELSEVIER
DOI: 10.1016/j.scog.2022.100237
Keywords
Cognition; Schizophrenia; Lifespan; Heterogeneity
Categories
Funding
- Netherlands Organisation for Scientific Research (NWO) VENI [916-15-005]
- Brain and Behavior Research Foundation
- Seaver Foundation
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Cognitive impairment is a key feature of schizophrenia, with evidence suggesting that it is present even in early childhood. Studies show that cognitive impairments increase from pre- to post-psychosis onset, with the greatest declines occurring during adolescence, the prodrome, and the first psychotic episode. Longitudinal studies support mild cognitive declines after psychosis onset until late adulthood. Heterogeneity in cognitive performance and impairment profiles are also observed in schizophrenia. The review emphasizes the need for long-term studies to understand critical periods of cognitive change and their predictors, as well as the importance of interventions targeting cognitive decline during the prodromal years.
Cognitive impairment is a well-recognized key feature of schizophrenia. Here we review the evidence on (1) the onset and sensitive periods of change in cognitive impairment before and after the first psychotic episode, and (2) heterogeneity in neurocognitive presentations across cognitive domains between and within individuals. Overall, studies suggest that mild cognitive impairment in individuals who develop schizophrenia or related disorders is already present during early childhood. Cross-sectional studies further suggest increasing cognitive impairments from pre-to post-psychosis onset, with the greatest declines between adolescence, the prodrome, and the first psychotic episode and with some variability between domains. Longitudinal studies with more than 10 years of observation time are scarce but support mild cognitive declines after psychosis onset until late adulthood. Whether and how much this cognitive decline exceeds normal aging, proceeds further in older patients, and is specific to certain cognitive domains and subpopulations of patients remains to be investigated. Finally, studies show substantial heterogeneity in cognitive performance in schizophrenia and suggest a variety of impairment profiles.This review highlights a clear need for long-term studies that include a control group and individuals from adolescence to old age to better understand critical windows of cognitive change and their predictors. The available evidence stresses the importance of interventions that aim to counter cognitive decline during the prodromal years, as well as careful assessment of cognition in order to determine who will profit most from which cognitive training.
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