Kognitive Störungen bei Schizophrenie

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
• 2 Wechsler D. Wechsler Memory Scale. New York: The Psychological Corporation; 2009
• 3 Golden CJ, Freshwater SM. Stroop color and word test. Chicago: Stoelting; 1978
• 4 Reitan RM. Trail Making Test: Manual for administration and scoring. Reitan Neuropsychology Laboratory; 1992
• 5 Wechsler D, Coalson DL, Raiford SE. WAIS-IV: Wechsler Adult Intelligence Scale. San Antonio, TX: Pearson; 2008
• 6 Delis DC, Kramer JH, Kaplan E, Thompkins BAO. CVLT, California Verbal Learning Test: Adult Version: Manual. Psychological Corporation; 1987
• 7 Heaton RK, Chelune GJ, Talley JL. et al. Wisconsin card sort test manual: Revised and expanded. Odessa, FL: Psychol Assess Resour; 1993
• 8 Kaplan E, Goodglass H, Weintraub S. Boston Naming Test. Philadelphia: Lippincott Williams & Wilkins; 2001
• 9 Benton AL, Hamsher KD. Multilingual Aphasia Examination. Iowa City: AJA Assoc; 1989
• 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
• 11 Biesenbach J. Früherkennung der Schizophrenie Evaluation der deutschsprachigen Version der SIPS. Dissertationsarbeit; Universität Köln; 2009
• 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
• 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
• 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
• 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
• 16 Schultze-Lutter F, Addington J, Ruhrmann S, Klosterkötter J. Schizophrenia proneness instrument, adult version (SPI-A). Rom: Giovanni Fioriti Ed srl; 2007
• 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
• 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
• 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
• 20 Özgürdal S, Juckel G. Verlauf kognitiver Störungen bei Schizophrenien. In: Neuropsychologie der Schizophrenie. Heidelberg, Berlin: Springer; 2008: 58-69
• 21 Eastvold AD, Heaton RK, Cadenhead KS. Neurocognitive deficits in the (putative) prodrome and first episode of psychosis. Schizophr Res 2007; 93: 266-277
• 22 Lencz T, Smith CW, McLaughlin D. et al. Generalized and specific neurocognitive deficits in prodromal schizophrenia. Biol Psychiatry 2006; 59: 863-871
• 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
• 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
• 25 Ruhrmann S, Schultze-Lutter F, Klosterkötter J. Early detection and intervention in the initial prodromal phase of schizophrenia. Pharmacopsychiatry 2003; 36: 162-167
• 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
• 27 Huber G, Gross G. The concept of basic symptoms in schizophrenic and schizoaffective psychoses. Recenti Prog Med 1989; 80: 646-652
• 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
• 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
• 30 Mesholam-Gately RI, Giuliano AJ, Goff KP. et al. Neurocognition in first-episode schizophrenia: a meta-analytic review. Neuropsychology 2009; 23: 315-336
• 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
• 32 Mendrek A, Mancini-Marïe A. Sex/gender differences in the brain and cognition in schizophrenia. Neurosci Biobehav Rev 2016; 67: 57-78
• 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
• 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
• 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
• 36 Heaton RK, Gladsjo J, Palmer BW. et al. Stability and course of neuropsychological deficits in schizophrenia. Arch Gen Psychiatry 2001; 58: 24-32
• 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
• 38 Kurtz MM. Neurocognitive impairment across the lifespan in schizophrenia: an update. Schizophr Res 2005; 74: 15-26
• 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
• 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
• 41 Bryson G, Bell MD. Initial and final work performance in schizophrenia: cognitive and symptom predictors. J Nerv Ment Dis 2003; 191: 87-92
• 42 Bell MD, Bryson G. Work rehabilitation in schizophrenia: does cognitive impairment limit improvement?. Schizophr Bull 2001; 27: 269-279
• 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
• 44 Addington J, Addington D. Neurocognitive and social functioning in schizophrenia: A 2.5 year follow-up study. Schizophr Res 2000; 44: 47-56
• 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
• 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
• 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
• 48 Fujii DE, Wylie AM. Neurocognition and community outcome in schizophrenia: Long-term predictive validity. Schizophr Res 2002; 59: 219-223
• 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
• 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
• 51 Kay SR, Fiszbein A, Opler LA. The Positive and Negative Syndrome Scale for schizophrenia. Schizophr Bull 1987; 13: 261-276
• 52 Overall JE, Gorham DR. The Brief Psychiatric Rating Scale. Psychol Rep 1962; 10: 799-812
• 53 Andreasen NC. The Scale for the Assessment of Negative Symptoms (SANS). Br J Psychiatry 1989; 7: 49-58
• 54 Andreasen NC. The Scale for the Assessment of Positive Symptoms (SAPS). University of Iowa; 1984
• 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
• 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
• 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
• 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
• 59 Heydebrand G, Weiser M, Rabinowitz J. et al. Correlates of cognitive deficits in first episode schizophrenia. Schizophr Res 2004; 68: 1-9
• 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
• 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
• 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
• 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
• 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
• 65 Twamley E, Jeste D, Bellack A. A review of cognitive training in schizophrenia. Schizophr Bull 2003; 29: 359-382
• 66 McGurk SR, Twamley EW, Sitzer DI. et al. A meta-analysis of cognitive remediation in schizophrenia. Am J Psychiatry 2007; 164: 1791-1802
• 67 Roberts DL, Penn DL. Social cognition and interaction training (SCIT) for outpatients with schizophrenia: a preliminary study. Psychiatry Res 2009; 166: 141-147
• 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
• 69 Carruthers SP, Gurvich CT, Rossell SL. The muscarinic system, cognition and schizophrenia. Neurosci Biobehav Rev 2015; 55: 393-402
• 70 Vreeker A, van Bergen AH, Kahn RS. Cognitive enhancing agents in schizophrenia and bipolar disorder. Eur Neuropsychopharmacol 2015; 25: 969-1002
• 71 Gründer G. Pharmakotherapie kognitiver Störungen. In: Kircher T, Gauggel S. Hrsg. Neuropsychologie der Schizophrenie – Symptome, Kognition, Gehirn. Heidelberg, Berlin: Springer; 2008