Special Issue "Improving Cognitive Functioning in People with Schizophrenia"

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Psychiatry".

Deadline for manuscript submissions: closed (15 November 2019).

Special Issue Editors

Dr. Iria Grande
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Guest Editor
Assistant Professor of Psychiatry, Barcelona Bipolar and Depressive Disorders Program, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
Interests: psychosis; bipolar disorder; depressive disorder; functioning; staging; precision psychiatry; cognitive remediation; early intervention; procognitive drugs; gut microbiota
Dr. Eduard Vieta
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Guest Editor
Chair of de Department of Psychiatry and Psychology, Professor of Psychiatry, Director of the Barcelona Bipolar and Depressive Disorders Program, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
Interests: psychosis; bipolar disorder; depressive disorder; functioning; staging; precision psychiatry; cognitive remediation; psychoeducation; early intervention; procognitive drugs; drug development

Special Issue Information

Dear Colleagues,

Schizophrenia is a chronic disorder characterized by psychotic symptoms such as hallucinations, delusions and disorganization and negative symptoms such as apathy and social withdrawal. It is also characterized by cognitive dysfunctions, which are present from the onset or even before the onset of the disorder. Cognitive impairment predicts disability and poor general functioning in the daily life of people diagnosed with schizophrenia. Although cognition is not a formal part of the current diagnostic criteria for schizophrenia, it is considered as a core feature of this illness.

Impairments in a broad range of cognitive domains have been consistently reported in individuals with schizophrenia, and persist throughout the course of the illness. Thus, interventions that are designed to treat cognitive symptoms are of high priority. Although antipsychotic medications help to treat positive symptoms of schizophrenia, the existing literature demonstrates that they have minimal effects on cognition. Nevertheless, the current studies on procognitive drugs seem to show encouraging results, and different meta-analytic studies have shown the efficacy of cognitive remediation. Several factors could affect cognitive function, and the evidence suggests that one of the main factors could be the cognitive reserve. Higher cognitive reserve is associated with a later onset of psychosis; greater illness insight; and better clinical, cognitive, and functional outcomes in people with schizophrenia. Thus, increasing cognitive reserve could become a skill that will allow people with schizophrenia to cope better with the disease and minimize their decline in cognitive and psychosocial functioning. The present Special Issue aims to go in-depth about the cognitive and functional impairment that people with schizophrenia suffer from and to describe the lines of research that are currently ongoing about enhancers of the cognitive and functional status of people with schizophrenia.

Dr. Iria Grande
Dr. Eduard Vieta
Guest Editors

Manuscript Submission Information

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Keywords

  • functioning
  • schizophrenia
  • negative symptoms
  • cognition
  • procognitive drugs
  • remediation
  • cognitive reserve

Published Papers (3 papers)

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Research

Open AccessArticle
Role of Executive Function in Response to a Problem Solving Based Psychoeducational Intervention in Adolescents with Psychosis: The PIENSA Trial Revisited
J. Clin. Med. 2019, 8(12), 2108; https://doi.org/10.3390/jcm8122108 - 02 Dec 2019
Abstract
An improvement in negative symptoms and a reduction in the number of visits to the emergency department have been reported in a problem solving based psychoeducational group intervention (PE) for adolescents with psychosis relative to a nonstructured group (NS). One of the factors [...] Read more.
An improvement in negative symptoms and a reduction in the number of visits to the emergency department have been reported in a problem solving based psychoeducational group intervention (PE) for adolescents with psychosis relative to a nonstructured group (NS). One of the factors that may play a role on the response to PE treatment is executive function (EF), a crucial cognitive domain for problem-solving performance. We aimed to examine the role of EF in response to PE treatment versus an NS group. We examined the associations between changes in cognition and in clinical/functional variables within each treatment group using Spearman-ranked and partial correlation analyses. A total of 22 individuals (mean age: 16.3) were randomized to PE (N = 10) and NS (N = 12). We found an association between improvements in EF performance and a reduction in positive symptoms (rs = –0.756, p = 0.030 for semantic fluency), reduction in negative symptoms (r = 0.758, p = 0.029 for semantic; rs = –0,733, p = 0.025 for verbal fluency), and reduction in the number of visits to the emergency department (r = –0,743, p = 0.035 for semantic fluency) in the PE group. No associations were found in the NS group. Our results suggest that EF may play a role in the specific improvements observed in the PE group. This may have implications in the development of new areas of clinical intervention focusing on the role of cognitive functioning in response to psychosocial treatments in psychosis. Full article
(This article belongs to the Special Issue Improving Cognitive Functioning in People with Schizophrenia)
Open AccessArticle
Lifetime Psychotic Symptoms, Subthreshold Depression and Cognitive Impairment as Barriers to Functional Recovery in Patients with Bipolar Disorder
J. Clin. Med. 2019, 8(7), 1046; https://doi.org/10.3390/jcm8071046 - 18 Jul 2019
Abstract
(1) Background: bipolar disorder (BD) is a chronic disease that often leads to functional impairment. The objective of this study is to elucidate which variables are associated with better functional outcomes in a sample of euthymic patients with BD. (2) Methods: patients were [...] Read more.
(1) Background: bipolar disorder (BD) is a chronic disease that often leads to functional impairment. The objective of this study is to elucidate which variables are associated with better functional outcomes in a sample of euthymic patients with BD. (2) Methods: patients were recruited at the Hospital Clinic of Barcelona and they underwent a clinical interview, a functional assessment, and a comprehensive neuropsychological evaluation. After that, patients were divided into two groups according to the Functioning Assessment Short Test total score: functionally remitted vs. functionally impaired. Following this, a multivariate logistic regression was run in order to identify clinical, demographic and cognitive factors associated with functional remission. (3) Results: a total of 420 euthymic patients with BD were assessed for this study, distributed as follows: functionally remitted (n = 221) and functionally impaired (n = 199). Finally, the multivariate logistic regression revealed that only five variables significantly contributed to the model, including: lifetime history of psychotic symptoms (the variable that contributed the most to the model), followed by the Hamilton Depression total score, and cognitive performance (executive functions and verbal memory). (4) Conclusions: treatments to ensure a good functional outcome in BD should specially prevent psychosis, target subthreshold depressive symptoms and enhance cognition, more specifically executive functions and verbal memory. Full article
(This article belongs to the Special Issue Improving Cognitive Functioning in People with Schizophrenia)
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Open AccessArticle
Cognitive Reserve Assessment Scale in Health (CRASH): Its Validity and Reliability
J. Clin. Med. 2019, 8(5), 586; https://doi.org/10.3390/jcm8050586 - 28 Apr 2019
Cited by 1
Abstract
(1) Background: The cognitive reserve (CR) concept has not been precisely defined in severe mental disorders and has been estimated using heterogeneous methods. This study aims to investigate and develop the psychometric properties of the Cognitive Reserve Assessment Scale in Health (CRASH), an [...] Read more.
(1) Background: The cognitive reserve (CR) concept has not been precisely defined in severe mental disorders and has been estimated using heterogeneous methods. This study aims to investigate and develop the psychometric properties of the Cognitive Reserve Assessment Scale in Health (CRASH), an instrument designed to measure CR in people with severe mental illness; (2) Methods: 100 patients with severe mental illness (non-affective psychoses and affective disorders) and 66 healthy controls were included. The internal consistency and convergent validity of CRASH were assessed. Spearman’s correlations coefficients were also performed to examine the relationship between CRASH and neuropsychological tests, psychosocial functioning, and clinical course; (3) Results: The internal consistency was high (Cronbach’s alpha coefficient = 0.903). The CRASH global score had a large positive correlation with the Cognitive reserve questionnaire total score (r = 0.838, p < 0.001), demonstrating good convergent validity. The correlation coefficients between the CRASH total scores and clinical, functional, and neuropsychological performance were different between groups. In order to provide clinical interpretation, severity classification based on diagnosis (non-affective psychotic disorders, affective disorders, and healthy controls) have been created; (4) Conclusions: CRASH is the first CR measure developed specifically for patients with severe mental illness, facilitating reliable and valid measurement of this construct. The scale may aid in the stratification of patients and the implementation of personalized interventions. Full article
(This article belongs to the Special Issue Improving Cognitive Functioning in People with Schizophrenia)
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