Abstract
Schizophrenia is a major mental illness characterized by positive and negative symptoms, and by cognitive deficit. Although cognitive impairment is disabling for patients, it has been largely neglected in the treatment of schizophrenia. There are several reasons for this lack of treatments for cognitive deficit, but the complexity of its etiology—in which neuroanatomic, biochemical and genetic factors concur—has contributed to the lack of effective treatments. In the last few years, there have been several attempts to develop novel drugs for the treatment of cognitive impairment in schizophrenia. Despite these efforts, little progress has been made. The latest findings point to the importance of developing personalized treatments for schizophrenia which enhance neuroplasticity, and of combining pharmacological treatments with non-pharmacological measures.
Highlights
Schizophrenia is a major mental illness characterized by psychosis, apathy, social withdrawal and cognitive impairment [1]
Cognitive deficit in schizophrenia has been related to an increase in inflammatory cytokines, to an imbalance in hormones such as cortisol and prolactin, in neurotrophic factors such as BDNF and in neurotransmitters such as GABA and glutamate [24]
It has been observed that an increase in blood levels of C-reactive protein (CRP) is related to a lower cognitive performance, especially in verbal management, visual and working memory, processing speed, problem solving, executive function speed and in attention according to the meta-analysis by Bora et al [5]
Summary
Schizophrenia is a major mental illness characterized by psychosis, apathy, social withdrawal and cognitive impairment [1]. The symptoms of schizophrenia have been placed into three categories: positive symptoms such as delusions and hallucinations [2]; negative symptoms such as affective flattening, alogia and diminished emotional expression; and cognitive deficit [3]. In the last few years, there has been a growing interest in the study of cognitive impairment [5]. The reasons for this are that cognitive impairment is one of the first symptoms to manifest in schizophrenia, it is disabling for schizophrenic patients, and it contributes to their functional impairment [6]. Cognitive deficit cannot be treated with current antipsychotic drugs, which can only effectively treat positive symptoms of the disease [7]. Cognitive impairment in schizophrenia is still a clear unmet clinical need
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