Download PDF
Fortschr Neurol Psychiatr 2017; 85(05): 292-304
DOI: 10.1055/s-0043-109048
CME-Fortbildung
Georg Thieme Verlag KG Stuttgart · New York

Kognitive Störungen bei Schizophrenie

Cognitive Disorders in Schizophrenia
Axel Krug
,
Tilo Kircher
Subject Editor: Prof. Dr. med. Max Schmauß
Further Information

Publication History

Publication Date:
23 May 2017 (online)

    Permissions and Reprints

Zusammenfassung

Risikopatienten für eine spätere Schizophrenie zeigen bereits vor einer 1. Episode kognitive Funktionseinbußen. Im Verlauf bleiben diese relativ stabil auf niedrigem Niveau. Trainingsprogramme können hier psychosoziale und kognitive Defizite verbessern.

Abstract

Cognitive disorders in schizophrenia can be observed in relatives and persons even before the first episode. The patterns of these disorders may be specific to the occurrence of a later episode. After the first episode, the disorders remain relatively stable and are partly correlated with negative symptoms. Furthermore, the cognitive deficits have a negative impact on the social and occupational functional level. Recent studies suggest that cognitive remediation has small to moderate effects on cognition, and thus can also improve overall patient function.

Kernaussagen

Kognitive Störungen lassen sich bereits bei Verwandten und Personen vor einer 1. Episode beobachten. Die Muster dieser Störungen können spezifisch für das Auftreten einer späteren Episode sein. Nach Auftreten der 1. Episode bleiben die Störungen relativ stabil und sind teilweise mit negativer Symptomatik korreliert. Weiterhin haben die kognitiven Defizite einen negativen Einfluss auf das soziale und berufliche Funktionsniveau. Neuere Studien legen nahe, dass kognitive Remediation kleine bis mittlere Effekte auf die Kognition hat und dadurch auch das allgemeine Funktionsniveau von Patienten verbessern kann.

Erstveröffentlichung

DOI http://dx.doi.org/10.1055/s-0042-117556
PSYCH up2date 2017; 11: 35–47
© Georg Thieme Verlag KG Stuttgart · New York
ISSN 2194-8895

Schlüsselwörter

Kognitive Störungen - Schizophrenie - Therapie

Key words

cognitive disorders - schizophrenia - therapy
 

  • Literatur

  • 1 Neisser U, Boodoo G, Bouchard TJ. et al. Intelligence: Knowns and unknowns. Am Psychol 1996; 51: 77-101
    CrossrefPubMedGoogle Scholar
  • 2 Wechsler D. Wechsler Memory Scale. New York: The Psychological Corporation; 2009
    Google Scholar
  • 3 Golden CJ, Freshwater SM. Stroop color and word test. Chicago: Stoelting; 1978
    Google Scholar
  • 4 Reitan RM. Trail Making Test: Manual for administration and scoring. Reitan Neuropsychology Laboratory; 1992
    Google Scholar
  • 5 Wechsler D, Coalson DL, Raiford SE. WAIS-IV: Wechsler Adult Intelligence Scale. San Antonio, TX: Pearson; 2008
    Google Scholar
  • 6 Delis DC, Kramer JH, Kaplan E, Thompkins BAO. CVLT, California Verbal Learning Test: Adult Version: Manual. Psychological Corporation; 1987
    Google Scholar
  • 7 Heaton RK, Chelune GJ, Talley JL. et al. Wisconsin card sort test manual: Revised and expanded. Odessa, FL: Psychol Assess Resour; 1993
    Google Scholar
  • 8 Kaplan E, Goodglass H, Weintraub S. Boston Naming Test. Philadelphia: Lippincott Williams & Wilkins; 2001
    Google Scholar
  • 9 Benton AL, Hamsher KD. Multilingual Aphasia Examination. Iowa City: AJA Assoc; 1989
    Google Scholar
  • 10 Miller TJ, Mcglashan TH, Rosen JL. et al. Prodromal assessment with the structured interview for prodromal syndromes and the scale of prodromal symptoms: Predictive validity, interrater reliability, and training to reliability. Schizophr 2003; 29: 703-716
    CrossrefPubMedGoogle Scholar
  • 11 Biesenbach J. Früherkennung der Schizophrenie Evaluation der deutschsprachigen Version der SIPS. Dissertationsarbeit; Universität Köln; 2009
    Google Scholar
  • 12 Yung AR, Yung AR, Pan Yuen H. et al. Mapping the onset of psychosis: the comprehensive assessment of at-risk mental states. Aust N Z J Psychiatry 2005; 39: 964-971
    CrossrefPubMedGoogle Scholar
  • 13 Häfner H, Riecher-Rössler A, Hambrecht M. et al. IRAOS: an instrument for the assessment of onset and early course of schizophrenia. Schizophr Res 1992; 6: 209-223
    CrossrefPubMedGoogle Scholar
  • 14 Riecher-Rössler A, Gschwandtner U, Aston J. et al. The Basel early-detection-of-psychosis (FEPSY)-study – design and preliminary results. Acta Psychiatr Scand 2007; 115: 114-125
    CrossrefPubMedGoogle Scholar
  • 15 Gross G, Huber G, Klosterkötter J, Linz M. BSABS: Bonner Skala für die Beurteilung von Basissymptomen. Manual, Kommentar, Dokumentationsbogen. Heidelberg, Berlin: Springer-Verlag; 2013
    Google Scholar
  • 16 Schultze-Lutter F, Addington J, Ruhrmann S, Klosterkötter J. Schizophrenia proneness instrument, adult version (SPI-A). Rom: Giovanni Fioriti Ed srl; 2007
    Google Scholar
  • 17 Conklin HM, Curtis CE, Calkins ME. et al. Working memory functioning in schizophrenia patients and their first-degree relatives: cognitive functioning shedding light on etiology. Neuropsychologia 2005; 43: 930-942
    CrossrefPubMedGoogle Scholar
  • 18 Snitz BE, MacDonald III AW, Carter CS. Cognitive deficits in unaffected first-degree relatives of schizophrenia patients: A meta-analytic review of putative endophenotypes. Schizophr Bull 2006; 32: 179-194
    PubMedGoogle Scholar
  • 19 Jahn T, Hubmann W, Karr M. et al. Motoric neurological soft signs and psychopathological symptoms in schizophrenic psychoses. Psychiatry Res 2006; 142: 191-199
    CrossrefPubMedGoogle Scholar
  • 20 Özgürdal S, Juckel G. Verlauf kognitiver Störungen bei Schizophrenien. In: Neuropsychologie der Schizophrenie. Heidelberg, Berlin: Springer; 2008: 58-69
    Google Scholar
  • 21 Eastvold AD, Heaton RK, Cadenhead KS. Neurocognitive deficits in the (putative) prodrome and first episode of psychosis. Schizophr Res 2007; 93: 266-277
    CrossrefPubMedGoogle Scholar
  • 22 Lencz T, Smith CW, McLaughlin D. et al. Generalized and specific neurocognitive deficits in prodromal schizophrenia. Biol Psychiatry 2006; 59: 863-871
    CrossrefPubMedGoogle Scholar
  • 23 Keefe RSE, Perkins DO, Gu H. et al. A longitudinal study of neurocognitive function in individuals at-risk for psychosis. Schizophr Res 2006; 88: 26-35
    CrossrefPubMedGoogle Scholar
  • 24 Keefe RSE. The longitudinal course of cognitive impairment in schizophrenia: An examination of data from premorbid through posttreatment phases of illness. J Clin Psychiatry 2014; 75 (Suppl. 02) 8-13
    CrossrefPubMedGoogle Scholar
  • 25 Ruhrmann S, Schultze-Lutter F, Klosterkötter J. Early detection and intervention in the initial prodromal phase of schizophrenia. Pharmacopsychiatry 2003; 36: 162-167
    Article in Thieme ConnectPubMedGoogle Scholar
  • 26 Klosterkötter J, Ruhrmann S, Schultze-Lutter F. et al. The European Prediction of Psychosis Study (EPOS): integrating early recognition and intervention in Europe. World Psychiatry 2005; 4: 161-167
    PubMedGoogle Scholar
  • 27 Huber G, Gross G. The concept of basic symptoms in schizophrenic and schizoaffective psychoses. Recenti Prog Med 1989; 80: 646-652
    PubMedGoogle Scholar
  • 28 Hawkins KA, Addington J, Keefe RSE. et al. Neuropsychological status of subjects at high risk for a first episode of psychosis. Schizophr Res 2004; 67: 115-122
    CrossrefPubMedGoogle Scholar
  • 29 Gschwandtner U, Aston J, Borgwardt S. et al. Neuropsychological and neurophysiological findings in individuals suspected to be at risk for schizophrenia: preliminary results from the Basel early detection of psychosis study – Früherkennung von Psychosen (FEPSY). Acta Psychiatr Scand 2003; 108: 152-155
    CrossrefPubMedGoogle Scholar
  • 30 Mesholam-Gately RI, Giuliano AJ, Goff KP. et al. Neurocognition in first-episode schizophrenia: a meta-analytic review. Neuropsychology 2009; 23: 315-336
    CrossrefPubMedGoogle Scholar
  • 31 Leger M, Neill JC. A systematic review comparing sex differences in cognitive function in schizophrenia and in rodent models for schizophrenia, implications for improved therapeutic strategies. Neurosci Biobehav Rev 2016; 68: 979-1000
    CrossrefPubMedGoogle Scholar
  • 32 Mendrek A, Mancini-Marïe A. Sex/gender differences in the brain and cognition in schizophrenia. Neurosci Biobehav Rev 2016; 67: 57-78
    CrossrefPubMedGoogle Scholar
  • 33 Wells R, Swaminathan V, Sundram S. et al. The impact of premorbid and current intellect in schizophrenia: cognitive, symptom, and functional outcomes. NPJ Schizophr 2015; 1: 15043
    CrossrefPubMedGoogle Scholar
  • 34 Addington J, Saeedi H, Addington D. The course of cognitive functioning in first episode psychosis: Changes over time and impact on outcome. Schizophr Res 2005; 78: 35-43
    CrossrefPubMedGoogle Scholar
  • 35 Gold S, Arndt S, Nopoulos P. et al. Longitudinal study of cognitive function in first-episode and recent-onset schizophrenia. Am J Psychiatry 1999; 156: 1342-1348
    PubMedGoogle Scholar
  • 36 Heaton RK, Gladsjo J, Palmer BW. et al. Stability and course of neuropsychological deficits in schizophrenia. Arch Gen Psychiatry 2001; 58: 24-32
    CrossrefPubMedGoogle Scholar
  • 37 Hoff AL, Svetina C, Shields G. et al. Ten year longitudinal study of neuropsychological functioning subsequent to a first episode of schizophrenia. Schizophr Res 2005; 78: 27-34
    CrossrefPubMedGoogle Scholar
  • 38 Kurtz MM. Neurocognitive impairment across the lifespan in schizophrenia: an update. Schizophr Res 2005; 74: 15-26
    CrossrefPubMedGoogle Scholar
  • 39 Pukrop R, Schultze-Lutter F, Ruhrmann S. et al. Neurocognitive functioning in subjects at risk for a first episode of psychosis compared with first- and multiple-episode schizophrenia. J Clin Exp Neuropsychol 2006; 28: 1388-1407
    CrossrefPubMedGoogle Scholar
  • 40 Heilbronner U, Samara M, Leucht S. et al. The longitudinal course of schizophrenia across the lifespan: Clinical, cognitive, and neurobiological aspects. Harv Rev Psychiatry 2016; 24: 118-128
    CrossrefPubMedGoogle Scholar
  • 41 Bryson G, Bell MD. Initial and final work performance in schizophrenia: cognitive and symptom predictors. J Nerv Ment Dis 2003; 191: 87-92
    PubMedGoogle Scholar
  • 42 Bell MD, Bryson G. Work rehabilitation in schizophrenia: does cognitive impairment limit improvement?. Schizophr Bull 2001; 27: 269-279
    CrossrefPubMedGoogle Scholar
  • 43 Gold JM, Goldberg RW, McNary SW. et al. Cognitive correlates of job tenure among patients with severe mental illness. Am J Psychiatry 2002; 159: 1395-1402
    CrossrefPubMedGoogle Scholar
  • 44 Addington J, Addington D. Neurocognitive and social functioning in schizophrenia: A 2.5 year follow-up study. Schizophr Res 2000; 44: 47-56
    CrossrefPubMedGoogle Scholar
  • 45 Robinson DG, Woerner MG, McMeniman M. et al. Symptomatic and functional recovery from a first episode of schizophrenia or schizoaffective disorder. Am J Psychiatry 2004; 161: 473-479
    CrossrefPubMedGoogle Scholar
  • 46 Malla AK, Norman RMG, Manchanda R. et al. Symptoms, cognition, treatment adherence and functional outcome in first-episode psychosis. Psychol Med 2002; 32: 1109-1119
    CrossrefPubMedGoogle Scholar
  • 47 Velligan DI, Bow-Thomas CC, Mahurin RK. et al. Do specific neurocognitive deficits predict specific domains of community function in schizophrenia?. J Nerv Ment Dis 2000; 188: 518-524
    CrossrefPubMedGoogle Scholar
  • 48 Fujii DE, Wylie AM. Neurocognition and community outcome in schizophrenia: Long-term predictive validity. Schizophr Res 2002; 59: 219-223
    CrossrefPubMedGoogle Scholar
  • 49 Fujii DE, Wylie AM, Nathan JH. Neurocognition and long-term prediction of quality of life in outpatients with severe and persistent mental illness. Schizophr Res 2004; 69: 67-73
    CrossrefPubMedGoogle Scholar
  • 50 Stirling J, White C, Lewis S. et al. Neurocognitive function and outcome in first-episode schizophrenia: A 10-year follow-up of an epidemiological cohort. Schizophr Res 2003; 65: 75-86
    CrossrefPubMedGoogle Scholar
  • 51 Kay SR, Fiszbein A, Opler LA. The Positive and Negative Syndrome Scale for schizophrenia. Schizophr Bull 1987; 13: 261-276
    CrossrefPubMedGoogle Scholar
  • 52 Overall JE, Gorham DR. The Brief Psychiatric Rating Scale. Psychol Rep 1962; 10: 799-812
    CrossrefPubMedGoogle Scholar
  • 53 Andreasen NC. The Scale for the Assessment of Negative Symptoms (SANS). Br J Psychiatry 1989; 7: 49-58
    CrossrefPubMedGoogle Scholar
  • 54 Andreasen NC. The Scale for the Assessment of Positive Symptoms (SAPS). University of Iowa; 1984
    Google Scholar
  • 55 Wittchen H-U, Wunderlich U, Gruschwitz S, Zaudig M. SKID I. Strukturiertes Klinisches Interview für DSM-IV. Achse I: Psychische Störungen. Interviewheft und Beurteilungsheft. Eine deutschsprachige, erweiterte Bearb. der amerikanischen Originalversion des SKID I. 1997
    PubMedGoogle Scholar
  • 56 First MB, Spitzer RL, Gibbon M, Williams JBW. User’s Guide for the Structured Clinical Interview for DSM-IV Axis I Disorders SCID-I: Clinician Version. Washington D.C.: American Psychiatric Press; 1997
    Google Scholar
  • 57 Haddock G, McCarron J, Tarrier N. et al. Scales to measure dimensions of hallucinations and delusions: the psychotic symptom rating scales (PSYRATS). Psychol Med 1999; 29: 879-889
    CrossrefPubMedGoogle Scholar
  • 58 O’Leary DS, Flaum M, Kesler ML. et al. Cognitive correlates of the negative, disorganized, and psychotic symptom dimensions of schizophrenia. J Neuropsychiatry Clin Neurosci 2000; 12: 4-15
    CrossrefPubMedGoogle Scholar
  • 59 Heydebrand G, Weiser M, Rabinowitz J. et al. Correlates of cognitive deficits in first episode schizophrenia. Schizophr Res 2004; 68: 1-9
    CrossrefPubMedGoogle Scholar
  • 60 Nieuwenstein MR, Aleman A, De Haan EHF. Relationship between symptom dimensions and neurocognitive functioning in schizophrenia: A meta-analysis of WCST and CPT studies. J Psychiatr Res 2001; 35: 119-125
    CrossrefPubMedGoogle Scholar
  • 61 Ventura J, Hellemann GS, Thames AD. et al. Symptoms as mediators of the relationship between neurocognition and functional outcome in schizophrenia: A meta-analysis. Schizophr Res 2009; 113: 189-199
    CrossrefPubMedGoogle Scholar
  • 62 Bell MD, Mishara AL. Does negative symptom change relate to neurocognitive change in schizophrenia? Implications for targeted treatments. Schizophr Res 2006; 81: 17-27
    CrossrefPubMedGoogle Scholar
  • 63 Hughes C, Kumari V, Soni W. et al. Longitudinal study of symptoms and cognitive function in chronic schizophrenia. Schizophr Res 2003; 59: 137-146
    CrossrefPubMedGoogle Scholar
  • 64 Wykes T, Huddy V, Cellard C. et al. A meta-analysis of cognitive remediation for schizophrenia: Methodology and effect sizes. Am J Psychiatry 2011; 168: 472-485
    CrossrefPubMedGoogle Scholar
  • 65 Twamley E, Jeste D, Bellack A. A review of cognitive training in schizophrenia. Schizophr Bull 2003; 29: 359-382
    CrossrefPubMedGoogle Scholar
  • 66 McGurk SR, Twamley EW, Sitzer DI. et al. A meta-analysis of cognitive remediation in schizophrenia. Am J Psychiatry 2007; 164: 1791-1802
    CrossrefPubMedGoogle Scholar
  • 67 Roberts DL, Penn DL. Social cognition and interaction training (SCIT) for outpatients with schizophrenia: a preliminary study. Psychiatry Res 2009; 166: 141-147
    CrossrefPubMedGoogle Scholar
  • 68 Iwata Y, Nakajima S, Suzuki T. et al. Effects of glutamate positive modulators on cognitive deficits in schizophrenia: a systematic review and meta-analysis of double-blind randomized controlled trials. Mol Psychiatry 2015; 20: 1151-1160
    CrossrefPubMedGoogle Scholar
  • 69 Carruthers SP, Gurvich CT, Rossell SL. The muscarinic system, cognition and schizophrenia. Neurosci Biobehav Rev 2015; 55: 393-402
    CrossrefPubMedGoogle Scholar
  • 70 Vreeker A, van Bergen AH, Kahn RS. Cognitive enhancing agents in schizophrenia and bipolar disorder. Eur Neuropsychopharmacol 2015; 25: 969-1002
    CrossrefPubMedGoogle Scholar
  • 71 Gründer G. Pharmakotherapie kognitiver Störungen. In: Kircher T, Gauggel S. Hrsg. Neuropsychologie der Schizophrenie – Symptome, Kognition, Gehirn. Heidelberg, Berlin: Springer; 2008
    Google Scholar