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Should cognitive deficit be a diagnostic criterion for schizophrenia?
1Department of Psychiatry, University of Toronto, and Division of Youth Psychiatry, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ont. ralph.lewis@utoronto.ca
Journal of Psychiatry & Neuroscience : JPN
|April 8, 2004
Summary
Cognitive deficits are prevalent and stable in schizophrenia, appearing even before psychosis. Evidence suggests these core features warrant inclusion in diagnostic criteria for schizophrenia.
Area of Science:
- Neuroscience
- Psychiatry
- Cognitive Psychology
Background:
- Cognitive deficits are frequently observed in schizophrenia.
- The reliability, stability, and specificity of these deficits are debated.
- Their role in the pathophysiology of schizophrenia requires further investigation.
Purpose of the Study:
- To evaluate the evidence for including cognitive deficits in schizophrenia diagnostic criteria.
- To assess the prevalence, stability, and specificity of cognitive impairments in schizophrenia.
- To determine if cognitive deficits are a core feature of schizophrenia.
Main Methods:
- Systematic literature review.
- Analysis of studies on cognitive function in schizophrenia patients (adults, children, adolescents).
- Comparison of cognitive deficits in schizophrenia with other psychiatric disorders.
Main Results:
- Cognitive deficits are highly prevalent and marked in adult schizophrenia patients.
- Similar deficits are present in pediatric schizophrenia and prodromal stages.
- Deficits are relatively stable across illness course and more severe/specific in schizophrenia than affective disorders.
Conclusions:
- Cognitive deficits are a core feature of schizophrenia.
- Evidence supports their inclusion as a nonessential criterion in diagnostic criteria for schizophrenia.
- These deficits may be central to the underlying pathophysiology of schizophrenia.