Abstract
There has been a revolutionary advance in the treatment and management of schizophrenia from a clinical aspect yet the social and functional outcomes remain poor. Cognitive function is impaired in schizophrenia and shows various domains of dysfunction like verbal memory, processing speed and working memory. It is also known to be a factor associated with poor outcome in schizophrenia. Resilience is a new concept psychobiological concept which is defined as individual’s ability to adapt swiftly to adverse life events and bounces back to normalcy. Resilience has genetic, neurobiological, neurochemical and psychological underpinnings. It is the ability to effectively deal with psychosocial stressors and appears to be one of the many factors associated with favourable outcomes in schizophrenia. Besides several neurobiological abnormalities associated with resilience, neucognitive functions are of particular interest. Persistent psychosocial stressors also lead to significant neurobiological changes which may be synergetic to poor outcome due to cognitive changes. Though there has been extensive research in the field of cognitive function in schizophrenia, the trajectory of its pathway of poor outcome remains undetermined. Resilience being a protective factor may be one of the psychobiological functions which modulate the effect of neurocognition on the outcome of schizophrenia. There has been some success with interventions aimed at improving cognitive function in schizophrenia whether pharmacological or non pharmacological. In this paper, we discuss a hypothesis that resilience may be a “linkage” between cognition and outcome. There is a need for interventions aimed at increasing resilience in patients with schizophrenia and we hypothesize giving evidence that this may in turn improve outcome and neurocognitive functioning in schizophrenia.
Highlights
Schizophrenia is a disorder both biological and neurocognitive in nature seen in about 0.6% to 1% of the population [1]
Despite this body of knowledge, there lack a clear trajectory of changes both biological and psychosocial that can explain how neurocognitive impairment leads to poorer outcome and whether improvement in neurocognitive function (NCF) will be effective for better outcomes [16]
Good resilience may cause less cognitive dysfunction leading to better treatment outcomes by decreasing the individual’s response to psychosocial stress and we propose to hypothesize that resilience is a marker to improve neurocognition and outcome amongst patients suffering from schizophrenia
Summary
Schizophrenia is a disorder both biological and neurocognitive in nature seen in about 0.6% to 1% of the population [1]. There are a number of factors responsible for such poor functional outcomes and the most important one is cognitive impairment, which is seen in almost all patients with the disorder. NCF is directly related to neurobiological, neural functioning and neuronal changes [15] Despite this body of knowledge, there lack a clear trajectory of changes both biological and psychosocial that can explain how neurocognitive impairment leads to poorer outcome and whether improvement in NCF will be effective for better outcomes [16]. Good resilience may cause less cognitive dysfunction leading to better treatment outcomes by decreasing the individual’s response to psychosocial stress and we propose to hypothesize that resilience is a marker to improve neurocognition and outcome amongst patients suffering from schizophrenia. We shall briefly discuss how improving resilience can improve outcomes of schizophrenia
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