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Erschienen in: Der Nervenarzt 1/2020

26.09.2019 | Schizophrenie | Leitthema

Kognitive Störungen bei Schizophrenie

verfasst von: Prof. Dr. Axel Krug, Frederike Stein, Tilo Kircher

Erschienen in: Der Nervenarzt | Ausgabe 1/2020

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Zusammenfassung

Kognitive Störungen bei Schizophrenie korrelieren hoch mit dem psychosozialen Niveau (soziale Beziehungen, Arbeit, Lebensqualität u. a.) und können bereits bei gesunden Angehörigen sowie bei Hochrisikopersonen (UHR) nachgewiesen werden. Sie verstärken sich parallel mit einem psychotischen Schub und bilden sich dann wieder auf das Ausgangsniveau zurück. Auf psychopathologischer Ebene zeigen Negativsymptome sowie auch das Desorganisationssyndrom die deutlichsten Assoziationen zu kognitiven Defiziten. Der Ausprägungsgrad korreliert mit der Symptomatik. Kognitive Remediation kann mithilfe von Trainings die kognitive Leistung verbessern. Im Hinblick auf die medikamentöse Therapie existiert derzeit noch kein Medikament mit positiver Auswirkung auf die kognitiven Störungen.
Literatur
3.
Zurück zum Zitat Bozikas VP, Kosmidis MH, Kioperlidou K, Karavatos A (2004) Relationship between psychopathology and cognitive functioning in schizophrenia. Compr Psychiatry 45:392–400CrossRef Bozikas VP, Kosmidis MH, Kioperlidou K, Karavatos A (2004) Relationship between psychopathology and cognitive functioning in schizophrenia. Compr Psychiatry 45:392–400CrossRef
4.
Zurück zum Zitat Bryson G, Bell MD (2003) Initial and final work performance in schizophrenia: cognitive and symptom predictors. J Nerv Ment Dis 191:87–92PubMed Bryson G, Bell MD (2003) Initial and final work performance in schizophrenia: cognitive and symptom predictors. J Nerv Ment Dis 191:87–92PubMed
5.
Zurück zum Zitat Christensen TØ (2007) The influence of neurocognitive dysfunctions on work capacity in schizophrenia patients: a systematic review of the literature. Int J Psychiatry Clin Pract 11:89–101CrossRef Christensen TØ (2007) The influence of neurocognitive dysfunctions on work capacity in schizophrenia patients: a systematic review of the literature. Int J Psychiatry Clin Pract 11:89–101CrossRef
7.
Zurück zum Zitat Fett A‑KJ, Viechtbauer W, Dominguez M‑G et al (2011) The relationship between neurocognition and social cognition with functional outcomes in schizophrenia: a meta-analysis. Neurosci Biobehav Rev 35:573–588CrossRef Fett A‑KJ, Viechtbauer W, Dominguez M‑G et al (2011) The relationship between neurocognition and social cognition with functional outcomes in schizophrenia: a meta-analysis. Neurosci Biobehav Rev 35:573–588CrossRef
8.
Zurück zum Zitat de Gracia Dominguez M, Viechtbauer W, Simons CJP et al (2009) Are psychotic psychopathology and neurocognition orthogonal? A systematic review of their associations. Psychol Bull 135:157–171CrossRef de Gracia Dominguez M, Viechtbauer W, Simons CJP et al (2009) Are psychotic psychopathology and neurocognition orthogonal? A systematic review of their associations. Psychol Bull 135:157–171CrossRef
9.
Zurück zum Zitat Gur RE, Nimgaonkar VL, Almasy L et al (2007) Neurocognitive endophenotypes in a multiplex multigenerational family study of schizophrenia. Am J Psychiatry 164:813–819CrossRef Gur RE, Nimgaonkar VL, Almasy L et al (2007) Neurocognitive endophenotypes in a multiplex multigenerational family study of schizophrenia. Am J Psychiatry 164:813–819CrossRef
10.
Zurück zum Zitat Harvey PD, Heaton RK, Carpenter WT et al (2012) Functional impairment in people with schizophrenia: focus on employability and eligibility for disability compensation. Schizophr Res 140:1–8CrossRef Harvey PD, Heaton RK, Carpenter WT et al (2012) Functional impairment in people with schizophrenia: focus on employability and eligibility for disability compensation. Schizophr Res 140:1–8CrossRef
11.
Zurück zum Zitat Heilbronner U, Samara M, Leucht S et al (2016) The longitudinal course of schizophrenia across the lifespan: clinical, cognitive, and neurobiological aspects. Harv Rev Psychiatry 24:118–128CrossRef Heilbronner U, Samara M, Leucht S et al (2016) The longitudinal course of schizophrenia across the lifespan: clinical, cognitive, and neurobiological aspects. Harv Rev Psychiatry 24:118–128CrossRef
12.
Zurück zum Zitat Huang M, Huang Y, Yu L et al (2016) Relationship between negative symptoms and neurocognitive functions in adolescent and adult patients with first-episode schizophrenia. BMC Psychiatry 16:344CrossRef Huang M, Huang Y, Yu L et al (2016) Relationship between negative symptoms and neurocognitive functions in adolescent and adult patients with first-episode schizophrenia. BMC Psychiatry 16:344CrossRef
13.
Zurück zum Zitat Karambelas GJ, Allott KA, Killackey E et al (2018) The contribution of employment duration to 18-month neurocognitive outcomes in first-episode psychosis. Psychiatr Rehabil J 41:319–327CrossRef Karambelas GJ, Allott KA, Killackey E et al (2018) The contribution of employment duration to 18-month neurocognitive outcomes in first-episode psychosis. Psychiatr Rehabil J 41:319–327CrossRef
14.
Zurück zum Zitat Keefe RSE (2014) The longitudinal course of cognitive impairment in schizophrenia. J Clin Psychiatry 75:8–13CrossRef Keefe RSE (2014) The longitudinal course of cognitive impairment in schizophrenia. J Clin Psychiatry 75:8–13CrossRef
15.
Zurück zum Zitat Kircher T, Gauggel S (2008) Neuropsychologie der Schizophrenie: Symptome, Kognition, Gehirn. Springer, Berlin, Heidelberg Kircher T, Gauggel S (2008) Neuropsychologie der Schizophrenie: Symptome, Kognition, Gehirn. Springer, Berlin, Heidelberg
16.
Zurück zum Zitat Kurtz MM, Richardson CL (2012) Social cognitive training for schizophrenia: a meta-analytic investigation of controlled research. Schizophr Bull 38:1092–1104CrossRef Kurtz MM, Richardson CL (2012) Social cognitive training for schizophrenia: a meta-analytic investigation of controlled research. Schizophr Bull 38:1092–1104CrossRef
17.
Zurück zum Zitat Lencz T, Smith CW, McLaughlin D et al (2006) Generalized and specific neurocognitive deficits in prodromal schizophrenia. Biol Psychiatry 59:863–871CrossRef Lencz T, Smith CW, McLaughlin D et al (2006) Generalized and specific neurocognitive deficits in prodromal schizophrenia. Biol Psychiatry 59:863–871CrossRef
19.
Zurück zum Zitat Malla AK, Norman RMG, Manchanda R, Townsend L (2002) Symptoms, cognition, treatment adherence and functional outcome in first-episode psychosis. Psychol Med 32:1109–1119CrossRef Malla AK, Norman RMG, Manchanda R, Townsend L (2002) Symptoms, cognition, treatment adherence and functional outcome in first-episode psychosis. Psychol Med 32:1109–1119CrossRef
20.
Zurück zum Zitat McGurk SR, Twamley EW, Sitzer DI et al (2007) A meta-analysis of cognitive remediation in schizophrenia. Am J Psychiatry 164:1791–1802CrossRef McGurk SR, Twamley EW, Sitzer DI et al (2007) A meta-analysis of cognitive remediation in schizophrenia. Am J Psychiatry 164:1791–1802CrossRef
21.
Zurück zum Zitat Mesholam-Gately RI, Giuliano AJ, Goff KP et al (2009) Neurocognition in first-episode schizophrenia: a meta-analytic review. Neuropsychology 23:315–336CrossRef Mesholam-Gately RI, Giuliano AJ, Goff KP et al (2009) Neurocognition in first-episode schizophrenia: a meta-analytic review. Neuropsychology 23:315–336CrossRef
22.
Zurück zum Zitat Nielsen RE, Levander S, Kjaersdam Telléus G et al (2015) Second-generation antipsychotic effect on cognition in patients with schizophrenia—a meta-analysis of randomized clinical trials. Acta Psychiatr Scand 131:185–196CrossRef Nielsen RE, Levander S, Kjaersdam Telléus G et al (2015) Second-generation antipsychotic effect on cognition in patients with schizophrenia—a meta-analysis of randomized clinical trials. Acta Psychiatr Scand 131:185–196CrossRef
23.
Zurück zum Zitat Puig O, Thomas KR, Twamley EW (2016) Age and improved attention predict work attainment in combined compensatory cognitive training and supported employment for people with severe mental illness. J Nerv Ment Dis 204:869–872CrossRef Puig O, Thomas KR, Twamley EW (2016) Age and improved attention predict work attainment in combined compensatory cognitive training and supported employment for people with severe mental illness. J Nerv Ment Dis 204:869–872CrossRef
24.
Zurück zum Zitat Pukrop R, Ruhrmann S, Schultze-Lutter F et al (2007) Neurocognitive indicators for a conversion to psychosis: comparison of patients in a potentially initial prodromal state who did or did not convert to a psychosis. Schizophr Res 92:116–125CrossRef Pukrop R, Ruhrmann S, Schultze-Lutter F et al (2007) Neurocognitive indicators for a conversion to psychosis: comparison of patients in a potentially initial prodromal state who did or did not convert to a psychosis. Schizophr Res 92:116–125CrossRef
25.
Zurück zum Zitat Pukrop R, Schultze-Lutter F, Ruhrmann S et al (2006) Neurocognitive functioning in subjects at risk for a first episode of psychosis compared with first- and multiple-episode schizophrenia. J Clin Exp Neuropsychol 28:1388–1407CrossRef Pukrop R, Schultze-Lutter F, Ruhrmann S et al (2006) Neurocognitive functioning in subjects at risk for a first episode of psychosis compared with first- and multiple-episode schizophrenia. J Clin Exp Neuropsychol 28:1388–1407CrossRef
26.
Zurück zum Zitat Reddy LF, Kern RS (2014) Supported employment among veterans with serious mental illness: the role of cognition and social cognition on work outcome. Schizophr Res Cogn 1:144–148CrossRef Reddy LF, Kern RS (2014) Supported employment among veterans with serious mental illness: the role of cognition and social cognition on work outcome. Schizophr Res Cogn 1:144–148CrossRef
27.
Zurück zum Zitat Revell ER, Neill JC, Harte M et al (2015) A systematic review and meta-analysis of cognitive remediation in early schizophrenia. Schizophr Res 168:213–222CrossRef Revell ER, Neill JC, Harte M et al (2015) A systematic review and meta-analysis of cognitive remediation in early schizophrenia. Schizophr Res 168:213–222CrossRef
28.
Zurück zum Zitat Roiser JP, Sahakian BJ (2013) Hot and cold cognition in depression. CNS Spectr 18:139–149CrossRef Roiser JP, Sahakian BJ (2013) Hot and cold cognition in depression. CNS Spectr 18:139–149CrossRef
29.
Zurück zum Zitat Ruhrmann S, Schultze-Lutter F, Klosterkötter J (2003) Early detection and intervention in the initial prodromal phase of schizophrenia. Pharmacopsychiatry 36:162–167CrossRef Ruhrmann S, Schultze-Lutter F, Klosterkötter J (2003) Early detection and intervention in the initial prodromal phase of schizophrenia. Pharmacopsychiatry 36:162–167CrossRef
30.
Zurück zum Zitat Seidman LJ, Giuliano AJ, Meyer EC et al (2010) Neuropsychology of the prodrome to psychosis in the NAPLS consortium relationship to family history and conversion to psychosis. Arch Gen Psychiatry 67:578CrossRef Seidman LJ, Giuliano AJ, Meyer EC et al (2010) Neuropsychology of the prodrome to psychosis in the NAPLS consortium relationship to family history and conversion to psychosis. Arch Gen Psychiatry 67:578CrossRef
31.
Zurück zum Zitat Velligan DI, Bow-Thomas CC, Mahurin RK et al (2000) Do specific neurocognitive deficits predict specific domains of community function in schizophrenia? J Nerv Ment Dis 188:518–524CrossRef Velligan DI, Bow-Thomas CC, Mahurin RK et al (2000) Do specific neurocognitive deficits predict specific domains of community function in schizophrenia? J Nerv Ment Dis 188:518–524CrossRef
32.
Zurück zum Zitat Ventura J, Thames AD, Wood RC et al (2010) Disorganization and reality distortion in schizophrenia: a meta-analysis of the relationship between positive symptoms and neurocognitive deficits. Schizophr Res 121:1–14CrossRef Ventura J, Thames AD, Wood RC et al (2010) Disorganization and reality distortion in schizophrenia: a meta-analysis of the relationship between positive symptoms and neurocognitive deficits. Schizophr Res 121:1–14CrossRef
33.
Zurück zum Zitat Watzke S, Brieger P, Kuss O et al (2008) A longitudinal study of learning potential and rehabilitation outcome in schizophrenia. Psychiatr Serv 59:248–255CrossRef Watzke S, Brieger P, Kuss O et al (2008) A longitudinal study of learning potential and rehabilitation outcome in schizophrenia. Psychiatr Serv 59:248–255CrossRef
35.
Zurück zum Zitat Wells R, Swaminathan V, Sundram S et al (2015) The impact of premorbid and current intellect in schizophrenia: cognitive, symptom, and functional outcomes. npj Schizophr 1:15043CrossRef Wells R, Swaminathan V, Sundram S et al (2015) The impact of premorbid and current intellect in schizophrenia: cognitive, symptom, and functional outcomes. npj Schizophr 1:15043CrossRef
36.
Zurück zum Zitat Woodward ND, Purdon SE, Meltzer HY, Zald DH (2005) A meta-analysis of neuropsychological change to clozapine, olanzapine, quetiapine, and risperidone in schizophrenia. Int J Neuropsychopharmacol 8:457–472CrossRef Woodward ND, Purdon SE, Meltzer HY, Zald DH (2005) A meta-analysis of neuropsychological change to clozapine, olanzapine, quetiapine, and risperidone in schizophrenia. Int J Neuropsychopharmacol 8:457–472CrossRef
37.
Zurück zum Zitat Woodward ND, Purdon SE, Meltzer HY, Zald DH (2007) A meta-analysis of cognitive change with haloperidol in clinical trials of atypical antipsychotics: dose effects and comparison to practice effects. Schizophr Res 89:211–224CrossRef Woodward ND, Purdon SE, Meltzer HY, Zald DH (2007) A meta-analysis of cognitive change with haloperidol in clinical trials of atypical antipsychotics: dose effects and comparison to practice effects. Schizophr Res 89:211–224CrossRef
38.
Zurück zum Zitat Wykes T, Huddy V, Cellard C et al (2011) A meta-analysis of cognitive remediation for schizophrenia: methodology and effect sizes. Am J Psychiatry 168:472–485CrossRef Wykes T, Huddy V, Cellard C et al (2011) A meta-analysis of cognitive remediation for schizophrenia: methodology and effect sizes. Am J Psychiatry 168:472–485CrossRef
39.
Zurück zum Zitat Zhang H, Wang Y, Hu Y et al (2019) Meta-analysis of cognitive function in Chinese first-episode schizophrenia: MATRICS consensus cognitive battery (MCCB) profile of impairment. Gen Psychiatry 32:e100043CrossRef Zhang H, Wang Y, Hu Y et al (2019) Meta-analysis of cognitive function in Chinese first-episode schizophrenia: MATRICS consensus cognitive battery (MCCB) profile of impairment. Gen Psychiatry 32:e100043CrossRef
40.
Zurück zum Zitat Zhu Y, Womer FY, Leng H et al (2019) The relationship between cognitive dysfunction and symptom dimensions across schizophrenia, bipolar disorder, and major depressive disorder. Front Psychiatry 10:253CrossRef Zhu Y, Womer FY, Leng H et al (2019) The relationship between cognitive dysfunction and symptom dimensions across schizophrenia, bipolar disorder, and major depressive disorder. Front Psychiatry 10:253CrossRef
Metadaten
Titel
Kognitive Störungen bei Schizophrenie
verfasst von
Prof. Dr. Axel Krug
Frederike Stein
Tilo Kircher
Publikationsdatum
26.09.2019
Verlag
Springer Medizin
Schlagwort
Schizophrenie
Erschienen in
Der Nervenarzt / Ausgabe 1/2020
Print ISSN: 0028-2804
Elektronische ISSN: 1433-0407
DOI
https://doi.org/10.1007/s00115-019-00809-8

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