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Review
. 2019 Sep;21(3):239-248.
doi: 10.31887/DCNS.2019.21.3/amccleery.

Cognitive impairment in psychotic illness: prevalence, profile of impairment, developmental course, and treatment considerations

Amanda McCleery  1 , Keith H Nuechterlein  2
Affiliations
Review

Cognitive impairment in psychotic illness: prevalence, profile of impairment, developmental course, and treatment considerations

Amanda McCleery et al. Dialogues Clin Neurosci. 2019 Sep.

Abstract
in English, Spanish, French

Despite effective pharmacological treatments for psychotic symptoms (eg, hallucinations, delusions), functional outcomes for people with psychotic disorders are often disappointing. Although it is not included in the diagnostic criteria for psychotic disorders, cognitive impairment is one of the strongest determinants of community functioning in this clinical population, and thus it is an important target for intervention. In this review, we discuss the major areas of research regarding impaired cognition in psychotic illness. The specific topics covered include: (i) the prevalence of cognitive impairment in psychotic disorders; (ii) the profile and magnitude of cognitive impairment in psychotic disorders; (iii) the developmental course of cognitive impairment; (iv) the longitudinal stability of cognitive impairment; and (v) treatment approaches to improve cognitive performance in people with psychotic disorders. .

A pesar de los tratamientos farmacológicos efectivos para los síntomas psicóticos (como alucinaciones y delirios), los resultados funcionales para las personas con trastornos psicóticos a menudo son decepcionantes. Aunque el deterioro cognitivo no está incorporado entre los criterios diagnósticos para los trastornos psicóticos, es uno de los determinantes más importantes para el funcionamiento social en esta población clínica y, por lo tanto, es un objetivo clave para el manejo. En esta revisión se discuten las principales áreas de investigación relacionadas con el deterioro de la cognición en la enfermedad psicótica. Los temas específicos abordados incluyen: 1) la prevalencia del deterioro cognitivo en los trastornos psicóticos, 2) el perfil y la magnitud del deterioro cognitivo en los trastornos psicóticos, 3) el curso evolutivo del deterioro cognitivo, 4) la estabilidad longitudinal del deterioro cognitivo y 5) los enfoques terapéuticos para mejorar el rendimiento cognitivo en personas con trastornos psicóticos.

Les résultats fonctionnels chez les sujets souffrant de troubles psychotiques sont souvent décevants malgré un traitement pharmacologique efficace des symptômes psychotiques (hallucinations, délire). Bien qu’il ne figure pas dans les critères diagnostiques des troubles psychotiques, le déficit cognitif est l’un des déterminants les plus forts du fonctionnement en communauté au sein de cette population de patients ; c’est donc une cible thérapeutique importante. Nous discutons dans cet article les principaux domaines de recherche concernant le déficit cognitif dans la maladie psychotique. Les sujets spécifiques abordés comprennent : 1) la prévalence du déficit cognitif dans les troubles psychotiques, 2) le profil et l’ampleur du déficit cognitif dans les troubles psychotiques, 3) l’évolution au cours du développement du déficit cognitif, 4) la stabilité longitudinale du déficit cognitif et 5) les approches thérapeutiques pour améliorer la performance cognitive des sujets atteints de troubles psychotiques.

Keywords: affective psychosis; clinical high risk; cognition; cognitive enhancement; cognitive impairment; cognitive training; exercise; neurodevelopmental model; pharmaceutical agent; psychosis; schizophrenia; tDCS.

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References

    1. Perälä J, Suvisaari J, Saarni SI, et al Lifetime prevalence of psychotic and bipolar I disorders in a general population. Arch Gen Psychiatry. 2007;64(1):19. doi: 10.1001/archpsyc.64.1.19. - DOI - PubMed
    1. WHO . Geneva, Switzerland: World Health Organisation; 2018.
    1. Green MF, Nuechterlein KH. Should schizophrenia be treated as a neurocognitive disorder? Schizophr Bull. 1999;25(2):309–319. - PubMed
    1. Kahn RS, Keefe RSE. Schizophrenia is a cognitive illness: time for a change in focus. JAMA Psychiatry. 2013;70(10):1107–1112. - PubMed
    1. Green MF. What are the functional consequences of neurocognitive deficits in schizophrenia? Am J Psychiatry. 1996;153(3):321. - PubMed

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